3-D test helps detect breast cancer

  • Article by: Denise Grady
  • New York Times
  • June 24, 2014 - 7:37 PM

Adding a newer test to digital mammograms can increase the detection rate for breast cancer and decrease nerve-racking false alarms, in which suspicious findings lead women to get extra scans that turn out normal, a study finds.

Millions of women will get the newer test, tomosynthesis, this year. The procedure is nearly identical to a routine mammogram, except that in mammography the machine is stationary, but in tomosynthesis it moves around the breast. Sometimes called 3-D mammography, the test takes many X-rays at different angles to create a three-dimensional image of the breast. It was approved in the United States in 2011.

The verdict is still out on the long-term worth of this new technology. The new results are promising but not definitive, according to experts not associated with the study, published Tuesday in the Journal of the American Medical Association. Tomosynthesis has not been around long enough to determine whether it saves lives or misses tumors.

Even so, more and more mammography centers are buying the equipment — which is far more costly than a standard mammography unit — and marketing the test to patients as a more sensitive and accurate type of screening. It has come on the scene at a time when the value of breast cancer screening and the rising costs of health care are increasingly debated.

About 1,100 of about 13,500 mammography units in the United States perform tomosynthesis, according to Jim Culley, a spokesman for Hologic, the company that makes the only tomosynthesis equipment approved by the Food and Drug Administration. He estimated that more than 6 million American women will undergo tomosynthesis this year.

Recent studies have suggested that the benefits of mammography have been overstated and its potential harms understated, but many health groups still recommend it. More than 38 million mammograms are performed each year nationwide, at a cost of about $8 billion.

The new information on tomosynthesis is “not going to resolve the ongoing discussions about the overall utility of mammography,” said Dr. Barnett Kramer, of the Division of Cancer Prevention at the National Cancer Institute.

He added: “In a nutshell, it shows sufficient promise that the thought leaders are interested and so are the people who deal with imaging and screening at the National Cancer Institute.”

He was not part of the study, but the institute helped support it by providing a research grant to one of its authors.

Tomosynthesis uses more radiation than mammography alone, but the dose is still low and well within limits considered safe, doctors say.

Companies, including General Electric and Siemens, which market tomosynthesis equipment overseas, are expected to introduce it in the United States.

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