The Women’s Imaging Center at Newton-Wellesley Hospital has been providing 3D mammography, called tomosynthesis for over two years now. In July of 2012, Newton-Wellesley Hospital became the first hospital in the United States to make this technology available to all its patients.
Mammograms are an important tool for the early detection of breast cancer. They are used to detect and evaluate breast changes and to look for breast cancer that is too small to be felt in women who have no breast complaints or symptoms. Finding breast cancer early with a screening mammogram greatly improves a woman’s chance for successful treatment. The Center offers high-quality care, the most up-to-date equipment and has been designated as a Center of Excellence by the American College of Radiology.
Your Questions Answered
Alan Semine, MD, Medical Director and Radiologist at the Women’s Imaging Center answers your questions about tomosynthesis (3D mammography). Dr. Semine is Clinical Professor of Radiology at Tufts University School of Medicine and previously served as President of the Massachusetts Radiological Society. He brings a wealth of experience in breast imaging, as well as extensive expertise in advanced interventional procedures in the evaluation of breast concerns. He helped pioneer the use of breast ultrasound, and breast MRI as well as digital mammography in clinical practice and most recently has pioneered the use of tomosynthesis in breast imaging.
What is tomosynthesis?
Tomosynthesis, also known as 3D mammography, is a new technology that allows the physician to see thin mammography sections of the entire breast. This results in better detail without the superimposed tissue above and below each section that can hide abnormalities on the traditional two-dimensional image provided by mammography.
What are the benefits of tomosynthesis?
Tomosynthesis provides physicians with a clearer image of the breast tissue and decreases the need for further examinations. This technology can help distinguish superimposed tissue from real abnormalities, leading to fewer call backs and less anxiety for women. Much more importantly, tomosynthesis is also detecting significantly more invasive cancers than digital mammography alone. This advantage has been confirmed in European studies. In fact, at Newton-Wellesley, our data shows that we have been detecting twice as many invasive cancers with tomosynthesis than we could without. These are smaller cancers detected at earlier stages.
Who should have tomosynthesis?
Almost all patients who need a screening or diagnostic mammogram can benefit from having 3D mammography. Tomosynthesis is proving especially helpful for women with dense breast tissue.
Does tomosynthesis have more radiation?
Yes, currently, adding tomosynthesis does involve additional radiation compared with the standard digital mammogram. The radiation dose for the combined digital mammogram and tomosynthesis remains well below the FDA guidelines for mammography. The better news is that Newton-Wellesley will soon be introducing a new technology that allows tomosynthesis to be done without the need for a two dimensional mammogram and with the same overall radiation as a standard digital mammogram.
What does the tomosynthesis equipment look like?
The equipment appears identical to a standard digital mammogram except that the tube head arcs over the breast during a four second exposure. The breast is compressed similar to a standard 2D mammogram but patients often find the compression less uncomfortable because of the changes in the design of the paddles. Our licensed technologists have special training with this new equipment and strive to help make the exam as comfortable as possible.
Who reads my tomosynthesis exam?
After your 3D tomosynthesis mammogram is obtained, the images are interpreted by the physician, a specially trained radiologist. The breast imaging radiologists at Newton-Wellesley Hospital have extensive experience interpreting mammography with tomosynthesis since they began using it soon after it first became available.
If I have to have additional tests, does this mean I have cancer?
The majority of women who have extra views do not have cancer. It is our responsibility to be exceedingly thorough and look into any changes in your breast tissue that may appear on your films. Often taking another image from a different angle will help determine if the area is truly of concern.
I have been getting regular mammograms. Do I still need to do breast self-examination?
Absolutely. A mammogram is the best single examination to detect breast cancer. It will detect 85 to 90 percent of cancers before they can be felt. However, that also means that 10 to 15 percent of cancers can be felt before they are seen on a mammogram. Sometimes cancers may be hidden by surrounding breast tissue, which makes self-examination crucial. There is a myth that by the time breast cancer can be felt – it’s too late. That is simply not true. If you feel a change in your breast, bring it to your physician’s attention.
When I check my breasts, they feel lumpy. How can self examination help if I don’t know what a cancer lump feels like?
Many of my patients are frustrated by the fact that their breasts feel lumpy. I recommend that they approach self examination with a different perspective. Don’t examine yourself with the idea of finding a lump. All breasts feel lumpy to varying degrees. Instead, check your breasts regularly enough to know how they feel. Then, continue checking to make sure they feel the same as they always have. If you notice any changes, share them with your physician because there is a possibility that you have detected an early cancer.
For more information about the Women’s Imaging Center at Newton-Wellesley Hospital, call CareFinder at 1-866-NWH-DOCS (694-3627) or visit www.nwh.org/breastimaging.
The Newton-Wellesley Mammography Program is licensed and inspected by the State of Massachusetts yearly, certified by the FDA and accredited by the American College of Radiology.