Why Your First Mammogram Should be 3D

Before you book your very first mammogram, do your homework. The imaging itself is quick and may be just slightly uncomfortable, but the pictures can be drastically different depending on the type of mammogram you have. Your options are either 2D or 3D and the results can be like watching your favorite show on an 80’s TV with a grainy picture or on a flat screen HD TV like you probably have at home. And when it comes to your breast health, especially those first images, which will serve as a baseline, the picture quality really matters.

Why 3D is the Best Choice for Your First Mammo

Dr. Paula George, a RAYUS Breast Radiologist at Midwest Breast Care in St. Louis, MO has a highly trained eye for breast cancer. She looks at images of mammograms day in and day out and can spot an area of concern that would look like nothing to the untrained eye. When it comes to your first mammogram, Dr. George strongly recommends 3D. Her reasoning is two-fold. First, it gives you a great baseline with the most information, and it also decreases the chances you’ll be called back for a re-scan.

Quote and image of Dr. Paula George

Ask anyone who has been “called back” after a mammogram and they’ll tell you that news can come with anxiety. It doesn’t mean breast cancer has been detected, in fact, the vast majority of callbacks turn out to be normal, but it does mean the radiologist saw something suspicious and needs to take another look. It happens most frequently on a first mammogram because there are no other images of your breasts for the radiologist to cross-reference. Want to lessen the chance of being called back? Get the test that shows the radiologist much more detail.

What is 3D Mammography (aka Tomosynthesis)?

A 2D mammogram takes 2 pictures of each breast – one from the top and one from the side. For every one picture in a 2D, the 3D captures 40-50 images from many different angles. It takes a millimeter-by-millimeter look through your breast tissue and any masses, that may be associated with breast cancers, are more easily recognized. Both tests are done on the same machine and have the same type of radiation exposure – through a 3D exam takes a few seconds longer on each side.

When 3D mammography (also called tomosynthesis) is used, it has been shown that breast cancer detection rates, especially in women with dense breasts, has increased up to 40% according to research presented to the Radiological Society of North America. Dr. George explains how 3D images assist radiologists in detecting smaller tumors, “When we do tomosynthesis, you get a much deeper look at the breast. You can see it millimeter by millimeter, so you can pick up small cancers better.”

Dense Breasts and 3D Mammography (Tomosynthesis)

Dense breast tissue is found typically in younger women and women between the ages of 40 and 44. An estimated 40-50% of women under the age of 50 have dense breasts. With 40 being the recommended age to start getting mammograms, 3D may be your best choice, especially in getting the best baseline images and the best chance of detecting small cancers. According to Dr. George, “It’s advisable if you have dense breasts or a personal or family history of breast cancer to do 3D mammography, but you don’t have to continue with that year after year.”

Keeping up with Changing Mammogram Guidelines

The mammogram recommendations, along with technology, have been changing over the past several years. Click here to find out more about our recommendations in light of the changing mammo guidelines. In short, we encourage our patients to start the annual mammogram routine at age 40 and to opt for 3D if possible, especially if you have dense breasts, a history of breast cancer in your family, or have had breast cancer.

In this count,ry an estimated 1 out of 7-8 women will develop breast cancer in their lifetime according to the American Cancer Society. That’s about a 12% lifetime risk. Why not start out with the best imaging possible?

How to Find the Best Breast Imaging

When it comes to finding the best place to go for breast imaging, first take a look at whether or not the facility is dedicated to women’s imaging. These centers will have radiologists who look specifically at breast images all day long.

Another thing to look for is what accreditations your radiology center has been designated. Check to see if your facility is an accredited mammography facility through the American College of Radiology (ACR). The ACR has several different programs for imaging centers with The Breast Imaging Center of Excellence (BICOE) being awarded to breast imaging centers that achieve excellence by seeking and earning accreditation in all of the ACR’s voluntary breast-imaging accreditation programs and modules, in addition to the mandatory Mammography Accreditation Program.

When it comes to your mammogram, insurance covers the traditional 2D imaging and some policies also fully cover 3D. Other insurance policies require out-of-pocket charges for 3D, but they are typically less than $100. So it is important to investigate your policy, weigh your options, your personal health history, and your doctor’s recommendations when you are booking your first mammogram.