A growing number of health care facilities are embracing tomosynthesis, a 3D breast cancer scanning technology that uses low-dose X-rays and computer reconstructions to create images of the breasts to find cancers. According to a new study, the technology is effective at spotting more breast cancers and reducing the rate of false positives and recalls for additional imaging when compared to traditional 2D digital mammography.
The study included data from more than 1 million women aged 40 to 79 who were screened between January 2014 and December 2020 at five large health care systems in the United States. Tomosynthesis caught 5.3 breast cancers per 1,000 women screened, compared to 4.5 per 1,000 women screened with 2D digital mammography. Additionally, there was a lower rate of false positives and recalls for additional imaging with tomosynthesis.
Lead study author Dr. Emily Conant, chief in the division of breast imaging at the Hospital of the University of Pennsylvania, explains that tomosynthesis “can go through the tissue layer by layer to see if it is a real lesion or not.” However, she notes that tomosynthesis does not fully solve the issue of dense breasts, which can look like “a blizzard in some images” and hide lesions. Ultrasounds or breast MRI after either type of mammogram will still be needed to screen really dense breasts for cancer.
Tomosynthesis has its benefits, including better cancer detection and less anxiety due to false positives, but it also has its drawbacks. Dr. Katherina Sawicki Calvillo, a breast surgeon and founder of New England Breast and Wellness, notes that there is more radiation exposure. Dr. Marisa Weiss, chief medical officer and founder of Breastcancer.org, agrees that the benefits outweigh the risks, and recommends tomosynthesis for women at an elevated risk of breast cancer. Ultimately, the decision of which type of mammogram to use should be discussed between the patient and their doctor.