3D Mammography: Hype or Hope?

3D Mammography represents one of the most significant advances in breast cancer screening and prevention for all women in nearly 4 decades (when mammography was first adopted in 1969).
The American Cancer Society’s estimates for breast cancer in the United States for 2014 are:

About 232,670 new cases of invasive breast cancer will be diagnosed in women.
About 40,000 women will die from breast cancer.
Conventional 2D digital mammography is the most common screening method for breast cancer. But researchers say this technique may flag findings that turn out to be non-cancerous. These findings, known as “false positives,” lead to higher patient callback rates, meaning some women are required to return for further scans or biopsies that may be unnecessary. Early detection is the most effective tool in approaching breast cancer. Tomosynthesis technology, also known as a 3D Mammogram, allows radiologists to see cancer more easily, and sooner than ever before. Studies have shown that with 3D Mammograms, 35% more cancers are found earlier.*

Another great advantage of 3D mammography is that it helps avoid follow-up imaging and biopsies and the anxiety that comes along with those call back appointments. The study shows a significant drop in the need to be called back – 38% lower recall rates* – and an 11% drop in biopsy rates.*

3D Mammography may also be particularly useful for detecting cancer in women at high risk of developing breast cancer including those with dense breast tissue and/or a family history.

In another study at the Perelman School of Medicine at the University of Pennsylvania, results revealed that, compared with 2D digital mammography, tomosynthesis (3D) reduced the average patient recall rate from 10.4% to 8.78%, and it increased the cancer detection rate by 22%. Furthermore, the proportion of positive screening mammograms from which breast cancer was diagnosed increased by 46% with tomosynthesis, from 4.1% to 6%.

Retrospective studies published in 2014 in The American Journal of Roentgenology (AJR) and The Journal of the American Medical Association (JAMA) confirm previous studies that 3D mammography finds significantly more invasive cancers and reduces unnecessary recalls.

The studies focused on the impact of 3D mammography and demonstrated the following key findings:

AJR KEY FINDINGS (1) JAMA KEY FINDINGS (2)
44% increase in invasive cancer detected with 3D mammography 41% increase in invasive cancer detected with 3D mammography
16% decrease in recall rate from screening mammography 15% decrease in recall rate from screening mammography
29% increase in the detection of all breast cancers 29% increase in the detection of all breast cancers
(1) AJR 2014 Jun 13 [Epub ahead of print] (2) JAMA. 2014;311(24):2499-2507. doi:10.1001/jama.2014.6095.

Bottom Line: 3D Mammography is the new gold standard in screening for breast cancer. 3D mammography increases cancer detection rates by finding more invasive cancers and reduces unnecessary recalls.