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Detecting more breast cancers earlier

May 24, 2015 | Kristina Lindgren
UC Irvine Health breast imaging expert Dr. Stephen A. Feig

There is no better tool today to screen for breast cancer than three-dimensional mammography, said UC Irvine Health breast imaging expert Dr. Stephen A. Feig.

This advanced screening method, also known as breast tomosynthesis, can detect up to 30 percent more early-stage breast cancers than traditional mammography.

Because this method also results in fewer false positives and is especially effective for the more than 50 percent of women with dense breast tissue, Feig said, 3-D mammography is now the preferred method for screening at UC Irvine Medical Center in Orange.

Early detection saves lives

“We find more cancers earlier with 3-D mammography, and by detecting cancers early, we save more lives,” said the longtime radiologist, who heads the UC Irvine Health breast imaging team.

Moreover, he added, the clarity of 3-D mammography reduces the rate of false positives by as much as 20 percent. That means fewer secondary tests and fewer biopsies. “It not only saves patients time and needless anxiety, it also saves in radiation exposure.”

How does 3-D mammography work?

Standard digital mammography produces a single image of the compressed breast. In 3-D mammography, the X-ray tube moves in an arc, capturing a series of images of the entire breast that can be viewed in one-millimeter “slices,” or layers.

This allows the radiologist to examine layers of breast tissue from multiple angles, scanning for abnormalities.

“We are able to find masses that would otherwise be obscured in women with dense breast tissue,” Feig said. “Think about looking for fish in a pool. If the pool has a lot of algae, you won’t be able to see the fish, especially the smallest fish. With 3-D technology, we can see even the smallest masses.”

Improved technology, less radiation

When 3-D mammography was first approved by the U.S. Food and Drug Administration in 2011, there was concern about increased radiation exposure. Feig said the technology has improved so much that the dose for 3-D screening is essentially the same as for 2-D digital mammography.

That’s because the breast imaging center’s Hologic Selenia® Dimensions® 3-D system software can convert the layered images to a 2-D image. The 2-D image is not only useful for comparison, it is also better at detecting the hallmark calcifications of ductal carcinoma in situ, he said.

When it comes time for a biopsy, the 3-D capability enables Feig and fellow UC Irvine Health radiologist Dr. Joan Campbell to determine the exact location of the mass to be sampled.

“It’s much better — and faster — for the patient,” Feig said.

Getting the results

Feig said they report the results of screening mammograms to the patient’s physician the same day.

Patients who undergo a diagnostic mammogram — ordered after a clinical examination or screening mammogram has indicated the presence of an abnormality — get their results immediately.

Some physicians are recommending that women of average risk for developing breast cancer delay screening to age 50 and then have mammograms at two-year intervals. However, Feig adheres to the American Cancer Society’s recommendation of annual mammograms beginning at age 40.

“Breast screening, especially with 3-D mammography, detects more cancers early, which saves lives — it’s as simple as that,” he said.

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