3D mammography reduces unnecessary recalls, increases cancer detection

A recently published clinical study conducted at TOPS Comprehensive Breast Center in Houston, Texas, demonstrates that 3D mammography (breast tomosynthesis) significantly reduces unnecessary recalls while simultaneously increasing cancer detection.

The study, "Implementation of Breast Tomosynthesis in a Routine Screening Practice: An Observational Study," was led by Stephen L. Rose , MD, and published in the June issue of the American Journal of Roentgenology (AJR). The AJR is the scientific journal of the American Roentgen Ray Society, the first and oldest radiology society in the United States.

The study examined the use of Hologic's 3D mammography in conjunction with 2D mammography. The researchers found that 3D mammography:

• Reduced recall rates by 37 percent;
• Increased the detection of cancers by over 30 percent; and
• Increased the detection of invasive cancers by more than 50 percent

Instead of viewing all the complexities of the breast tissue in a flat image as with a traditional mammogram, 3D mammography uses multiple low-dose images to create a 3-dimensional view of the breast. 3D mammography allows the doctor to examine 3D breast images layer-by-layer.

The 2010 through 2012 study population included 13,856 women who received conventional 2D mammography screening exams prior to the introduction of Hologic's 3D mammography and 9,499 women who received a 3D mammography screening exam. Images in both time periods were interpreted by six radiologists with an average 12 years of reading experience. 

Dr. Rose calls 3D mammography a revolutionary advance in breast cancer screening. He has been a major proponent of the technology including testifying before the U.S. Food and Drug Administration (FDA) Advisory Panel reviewing the technology for approval in the U.S. in 2010.

As medical director at TOPS and president of Houston Breast Imaging (HBI), Dr. Rose was instrumental in establishing Houston's first breast imaging centers to offer 3D mammography technology. Dr. Rose and HBI, a group of 13 board certified specialists dedicated to breast radiology, have since added this technology in four Houston TOPS breast centers and five Memorial Hermann breast clinics. TOPS and Memorial Hermann Centers in conjunction with HBI have performed more than 60,000 3D mammography screening exams, the largest experience in Texas and one of the largest in the country.

"We are finding cancerous breast tumors as small as two to three millimeters," Dr. Rose said. "We are finding cancer earlier and this will allow us to reduce the amount of treatment patients need."  Dr. Rose projects that as 3D mammography becomes the standard breast cancer screening tool the size of tumors found will get smaller and accuracy of deciding between benign and cancerous tumors will improve.

"We can transform lives of women by making 3D mammography the standard breast cancer screening tool," said Karen T. Stall , founder of the Karen T. Stall Research Breast Institute which provided some of the funding for the research and purchase of 3D equipment.

"Findings in Dr. Rose's paper demonstrate that 3D mammograms overcome many limitations of conventional mammography, namely missed cancers and unnecessary recalls," said Peter Soltani , PhD., Hologic Senior Vice President and General Manager, Breast Health. Hologic is the manufacturer of the equipment used in the Dr. Rose study.