Top 10 Innovations for 2013
#9 Breast Tomosynthesiss
After cancers of the skin, breast cancer is the most common cancer among women,
accounting for nearly one in four cancers diagnosed in American women today. Breast
cancer death rates are higher than those for any other cancer besides lung cancer. For
women ages 40 to 59, the main cause of death is cancer of the breast.
Although these statistics are sobering, breast cancer death rates have declined by
almost 20% over the past decade, in part due to increased screening for breast
cancer, which typically uncovers the disease at a time when the chance for successful
treatment is higher.
Several imaging techniques can detect breast lumps before a woman or her doctor can
feel them. Mammography, which allows doctors to uncover an abnormal breast mass
up to two years before it can be detected by touch, remains the gold standard imaging
technique for breast cancer.
Mammography relies on a two-dimensional x-ray image. However, this technology
has limitations because the female breast is three-dimensional and composed of
different structures—including milk ducts, blood vessels, and ligaments—located at
various levels within it. When scanned and viewed as a flat, two-dimensional image,
the mammography scan can be confusing to interpret and doesn't always reveal every
cancer. This confusion is a major reason why normal tissue may appear abnormal and
why small breast cancers may be missed.
There is now a new imaging technology that is changing the way doctors screen
for breast cancer and it is improving the accuracy of diagnosis. Called breast
tomosynthesis or 3D mammography, the diagnostic technology was approved by
the FDA in 2011. Breast tomosynthesis does not currently replace traditional twodimensional
mammography testing, but instead, it is performed along with the
conventional mammogram to provide a more accurate view of the breast.
During the tomosynthesis portion of the exam, the x-ray arm of the machine makes
a quick arc over the breast, taking dozens of images at a number of angles. Later
combined to make a three-dimensional rendering of the entire breast, the images can
be viewed by a radiologist at a computer workstation to check areas of concern.
If cancers are found when they are small, treatment options are generally less traumatic and the chance
for cure is greater. What 3D technology offers doctors and mammography technicians is a much greater
opportunity to discover small cancer cells obscured by surrounding tissue that may not be visible on standard
mammograms. This is particularly the case in women with dense breasts, in which tumors often escape
detection. Preliminary study results of 25,000 women reported a 47% increase in cancer detection when
tomosynthesis was used.
3D mammography also reduces the much-feared callbacks for women. Due to a lack of diagnostic clarity,
one in 10 women typically is asked to return for additional testing following a routine mammogram screening
that has raised concern. However, in a recent study of 7,500 women, the recall rate of women screened with
breast tomosynthesis and traditional mammography combined was 6.6% compared to 11.1% for traditional
It's for reasons like this and others that one day, in response to greater use and patient demand, experts
believe that breast tomosynthesis is expected to fully replace conventional mammography.