What Is Tomosynthesis (3D mammography)?

By Cristiano Antonino Last updated May 2, 2023

Tomosynthesis or “3D” mammography is a new type of digital x-ray mammogram which creates 2D and 3D-like pictures of the breasts

This tool improves the ability of mammography to detect early breast cancers, and decreases the number of women “called back” for additional tests for findings that are not cancers.

During a “3D” exam, an X-ray arm sweeps in a slight arc over your breast, taking multiple low dose x-ray images. Then, a computer produces synthetic 2D and “3D” images of your breast tissue.

The images include thin one millimeter slices, enabling the radiologist to scroll through images of the entire breast like flipping through pages of a book, and providing more detail than previously possible.

The “3D” images reduce the overlap of breast tissue, and make it possible for a radiologist to better see through your breast tissue on the mammogram.

Why is there a need for tomosynthesis breast exams? What are the benefits?

With conventional digital mammography, the radiologist is viewing the tissues of your breast overlapping on flat images.

This tissue overlap can sometimes make cancers hard to detect.

Also, overlap can sometimes create areas that appear abnormal, but require that you be “called back” for additional tests to determine that cancer is not present (so-called false positives).

Tomosynthesis or “3D” mammography directly addresses the current limitations of standard 2D mammography

Multiple studies have shown that “3D” mammography increases the detection of breast cancer by approximately 25%, and decreases the number of false positive call backs by approximately 15%.

What is the difference between a screening and diagnostic mammogram?

A screening mammogram is done in women who have no breast signs symptoms.

A diagnostic mammogram is done in women who have been “called back” from a screening mammogram, or who have a clinical breast symptom such as a lump.

What should I expect during the 3D mammography exam?

Having a “3D” mammogram is similar to a having conventional digital mammogram, including the amount of compression of the breasts and the time in compression.

The main difference is that the X-ray arm sweeps in a slight arc over your breasts.

Why is compression important in mammography?

Decreases radiation dose
Separates glandular tissue
Decreases superimposition of tissue
Improves resolution or clarity of the image
Increases contrast to visualize subtle differences in tissue
Reduces scatter radiation

Who can have a 3D mammography exam?

It is approved for all women who would be undergoing a standard mammogram, in both the screening and diagnostic settings.

References

1 Bernardi D, Ciatto S, Pellegrini M, et. al. Prospective study of breast tomosynthesis as a triage to assessment in screening. Breast Cancer Res Treat. 2012 Jan 22 [Epub ahead of print].

2 The Hologic Selenia Dimensions clinical studies presented to the FDA as part of Hologic’s PMA submission that compared Hologic’s Selenia Dimensions combo-mode to Hologic 2D FFDM.

3 Skaane P, Gullien R, Eben EB, et. al. Reading time of FFDM and tomosynthesis in a population-based screening Program. Radiological Society of North America annual meeting. Chicago, Il, 2011

MRI, Magnetic Resonance Imaging Of The Heart: What Is It And Why Is It Important?

Mammary MRI: What It Is And When It Is Done

Breast Cancer Diagnosis: The Importance Of Periodic Mammography

Mammography: How To Do It And When To Do It

Pap Test: What Is It And When To Do It?

Breast Cancer: For Every Woman And Every Age, The Right Prevention

Transvaginal Ultrasound: How It Works And Why It Is Important