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2D vs. 3D Mammogram: When to Have the Upgrade

The latest mammogram technology for breast cancer screening is now available at Penn State Health St. Joseph’s Bern and Exeter locations, providing patients with an additional option for their care.

St. Joseph’s offers 3D mammography, also known as breast tomosynthesis, an advanced technology that takes multiple images of breast tissue and recreates a 3D picture of the breast. 3D mammograms have higher cancer detection rates than standard 2D mammograms, and also result in fewer patient callbacks.

Dr. Steven Chmielewski, a radiologist with Penn State Health St. Joseph, explained that 3D tomosynthesis provides multiple thin slice images of the breast, enabling radiologists to view each image separately. That avoids the issue of overlapping tissue, which can hide small cancers in a conventional mammogram.

“By minimizing the effects of overlapping tissue with 3D tomosynthesis, we can provide a more accurate, confident and earlier diagnosis,” Chmielewski said.

Because the images produced with 3D mammograms are clearer and easier to read, there is less need to bring patients back in for further screening.

“We’re finding that with 3D mammograms the recall rate is less because we can see more,” said Lynn Kaufman, director of imaging at Penn State Health St. Joseph.

The process for a patient getting a 3D mammogram is no different from that of getting a 2D, although the 3D does deliver a bit more radiation. The radiation dose from a 3D mammogram, however, is still well within FDA approved limits. Both 2D and 3D mammograms are low-dose x-rays.

3D mammograms are particularly important for women who have dense breast tissue, meaning that their breasts contain more glandular tissue compared to fatty tissue.

While fatty tissue appears gray on a mammogram, glandular tissue appears white – as does cancer. This means that women with dense breast tissue experienced more frequent callbacks because the x-rays were often difficult to read. Radiologists can get a much clearer look at the breast with 3D mammograms, making it easier to differentiate glandular tissue from cancer cells.

Reducing the number of callbacks for patients with dense breast tissue not only increases the comfort level of those patients, but may make women more likely to get mammograms on a regular basis.

“Since we will be reducing the callback rate for screening studies, particularly in patients with dense breast, I hope to lessen the anxiety associated with mammography, and improve compliance with this improved screening tool,” Chmielewski said.

It’s important for patients to understand the differences between 2D and 3D mammograms, because they typically will decide which type of x-ray they will receive, explained Kaufman. While most insurances now cover 3D mammograms, some do not, meaning that patients could be charged a fee for the advanced technology.

“Patients should always check with their insurance providers to make sure that they’re covered,” Kaufman said.

Women undergoing screening mammograms – those that are routinely administered to detect cancer in patients who have no symptoms – are given the option of having either a 2D or 3D procedure. Anyone who has experienced a problem and has been referred for a diagnostic mammogram, however, will be very strongly encouraged to opt for a 3D mammogram.

“If diagnostic is needed, we will definitely recommend that women do a 3D,” Kaufman said.

Mammograms are an essential – although sometimes underutilized – part of routine health care. According to Kaufman, Penn State Health St. Joseph is looking to reduce or remove barriers such as language, transportation, time constraints and immigration status that sometimes prevent women, both insured and uninsured, from getting mammograms.

“We’re going to work on ways to get more women to be compliant for screening,” Kaufman said.

Regardless of whether a woman chooses 2D or 3D technology, mammograms are an important piece of a woman’s health care, said Anne Welsh, lead mammography specialist at Penn State Health St. Joseph.

“Mammography is still the gold standard in breast imaging, and it is the first step in the screening process,” Welsh said. “2D is, and continues to be a benefit to patients, while 3D tomosynthesis is an advantage that makes the gold standard even more important, especially for women with dense breasts.”

In addition to the 3D systems in place at St. Joseph’s Exeter and Bern locations, patients may also have access to systems at Penn State Health Milton S. Hershey Medical Center. Efforts also are underway to make 3D screening available at St. Joseph’s Downtown Campus.

Ready for a Mammogram? Call 610-378-2100 to schedule an appointment.


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