3-D mammograms offer clearer view of breast cancer

Approved last year by the Food and Drug Administration, 3-D-equipped "tomosynthesis" machines are now available at some hospitals and diagnostic centers.

And while they look and feel like the standard, two-dimensional model, these high-tech, touch-screen devices are able to see more deeply and clearly into a woman's breast tissue, detailing even the fatty or dense flesh that can disguise a lurking lump.

"If we can reduce false alarms by 30 percent, we are doing a tremendous job for our patients and our community," said Dr. Mary K. Hayes, medical director of women's imaging for the Memorial Healthcare System. "Because it's less anxiety, less lost work time and lower costs because we're not having to do all those additional tests. So the patient wins, the employer wins, and the family wins."

And by cutting down on false alarms, the more accurate screenings also are cutting down on the cost and distress that come with extra procedures such as sonogram screenings and biopsies.

The 2-D portion of tomosynthesis is typically covered by insurance, but most health plans don't cover the costs of the 3-D portion yet because the FDA approval is relatively new, said a spokesman for Hologic, which manufactures the machines.

To help make the test more affordable, Memorial Regional and Memorial Hospital Miramar, Fla., are running a special throughout Breast Cancer Awareness Month in October, offering tomosynthesis screenings - normally $135 - for $99 and regular mammograms for $50 for those without insurance.

At Bethesda Women's Health Center in Boynton Beach, Fla., which has offered tomosynthesis for the past two months, standard digital mammograms will be offered for $75 instead of the usual $100 throughout October. Tomosynthesis will cost another $50, all year-round.

Memorial Regional Hospital in Hollywood, Fla., was on the forefront of discovering just what tomosynthesis means in detecting cancers of the breast. In 2008 and 2009, it was one of 16 hospitals across the nation that participated in a Harvard University-led clinical trial of 3-D mammography.

The study found that tomosynthesis detects 15 percent more breast cancers and cuts false alarms by 30 percent when compared with the standard, two-dimensional digital mammograms - helping to persuade the FDA to give its nod.

"For us, it's a tool that allows us to do a better job for our patients," Hayes said.

In addition to capturing 2-D images like standard mammograms, the tomosynthesis camera also moves in an arc over the breast, taking 15 mini-pictures over four seconds to yield a more layered, detailed view of the tissue. Hologic, the company that manufactures the machines, likens the results to pages in a book, allowing radiologists multiple views of potentially problematic spots.

"Basically, you're getting more information - you're getting slice by slice" instead of a single composite, 2-D picture, said Bethesda radiologist Dr. Ariana Alvarez.

Mary Shallcross, 61, was sold on the concept after seeing a TV news story last year.

"I have really dense breasts, and so when I heard about this, I thought, this is the test for me," said Shallcross, who drove from her home in Miramar to Memorial Regional in Hollywood after learning it was, at the time, the only facility in Broward with tomosynthesis. "That's why I came all the way out here."

Two days later, Memorial's sister hospital, Memorial Hospital Miramar, began offering the 3-D mammograms.

Kristie Labonte, 39, had her first mammogram last week, and when the nurses at Memorial Regional told her about tomosynthesis, the Dania Beach, Fla., resident opted for the more high-tech exam.

"With 3-D, you usually think of movies or something," said Labonte, who has breast cancer in her family and recently lost a friend to the disease. "I think it's amazing what they can do now to detect it early."

Dr. Darlene Da Costa, another Bethesda radiologist, said tomosynthesis' early detection benefits are important in the fight against the deadly disease.

"All we want is to find breast cancer early, as early as possible," Da Costa said. "So with this technology, we're able to save lives."

(c)2012 Sun Sentinel (Fort Lauderdale, Fla.)
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