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Breast Matters - New and Improved Mammogram Technology

New and Improved Mammogram Technology
Issue No. 4

New and Improved Mammogram Technology

Date: 06/02/2014


Susan Harvey
Susan Harvey, M.D., director of the Johns Hopkins Section of Breast Imaging.

It’s a simple but powerful equation: Regular mammograms equal early breast cancer detection and improved survival rates. Recently, that equation has gained even greater significance thanks to a new form of mammography, according to breast imaging expert Susan Harvey, M.D., director of the Johns Hopkins Section of Breast Imaging.

Tomosynthesis, also known as 3-D mammography, allows the breast to be viewed in 1-millimeter, 3-D “slices,” as opposed to the current standard of 2-D mammography.

This new technology increases the specificity and sensitivity of mam­mograms; it’s been shown in studies to increase cancer detection.

“Typically, about 10 percent of women who get a standard 2-D mammogram have to return for a second mammogram, because the original images indicate there may be an abnormality. By allowing visualization in thin slices, tomosynthe­sis eliminates overlap of normal tissue, thereby decreasing inaccurate readings,” Harvey says. She adds that the medical literature shows this new technology, approved by the U.S. Food and Drug Administration in 2011, decreases false positive results by 40 percent.

Johns Hopkins at Green Spring Sta­tion was one of the first Baltimore-area locations to install 3-D mammography. Currently, it is being utilized in con­junction with 2-D mammography as a screening tool. Harvey is excited about this state-of-the-art technology, which is better able to detect abnormalities than 2-D mammography and can reduce patient anxiety.

However, as with most new technolo­gies, the widespread adoption of tomo­synthesis is not without challenges. The machinery is costly and, because many insurance companies are reluctant to pay for the 3-D mammogram procedure, medical institutions may be unable to justify its cost.

The 3-D mammography’s increased amount of radiation exposure, compared to 2-D mammography, may be of concern to some patients. Harvey addresses this factor: “The exposure [from 3-D mam­mography] is minimal. Even at the increased level, it is well under the re­quirement for safe imaging,” she says. It’s also worth noting that newer, additional technology that performs 2-D and 3-D mammography simultaneously decreases radiation exposure to the level of 2-D mammography alone. This technology is currently available at our Green Spring Station location, and it will be expand­ing in the coming month to our main campus in downtown Baltimore and to our White Marsh facility.

Obstacles aside, Harvey is confident that tomosynthesis will eventually replace 2-D mammography. “It increases accura­cy and decreases false positives. It’s going to become the standard of care,” she says.

To learn more about tomosynthesis or to schedule an appointment with Johns Hopkins Imaging, please call 410-735- 7100.

Fast Facts about 3-D Mammography

  • Takes four seconds per view.
  • Has been approved by the FDA.
  • Is particularly effective for women with dense breast tissue and those with an increased risk for breast cancer.
  • Is currently performed in conjunction with a routine mammogram.

Maryland Passes Breast Density Notification Law

In June 2013, Maryland became the seventh state in the nation to enact a law requiring breast imaging facilities to notify women whose breast tissue density is significant.

Susan Harvey, who testified regarding the bill, H.B. 312, explains its significance: “Standard mammograms often cannot detect cancers in women with denser breast tissue. So, an increase in breast density leads to a decrease in sensitivity. Additionally, breast density is a risk factor for breast cancer,” she says.

With the passage of the bill, patients are notified that breast density is significant to their care. The notification will also contain information explaining that dense breast tissue may make it harder to detect cancer on a mammogram and can be associated with an increased risk of breast cancer. The information presented in the letter is intended to raise patients’ awareness of dense breast tissue and its potential implications, and to inform patients’ future conversations with health care providers about breast health.

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