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3D mammography is more effective than 2D one, but we don’t know what it means yet

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Posted October 22, 2019

Mammography is a well-known word for women. Women over 30 should have mammography done regularly as an early breast cancer detection method. Mammography has been around since the middle of the previous century, but the technology is improving. Scientists from The University of Sydney say that 3D mammograms could improve breast cancer screening, but we still don’t know if it will help the patients.

This is what the current 2D mammography procedure looks like. Image credit: United States Marine Corps via Wikimedia

A normal contemporary mammogram is done by a special machine. The breast is compressed to even out the thickness of the tissue and provide a thinner layer for the X-Ray to penetrate through. Then the camera unit, which is nowadays fully digital, takes a high quality X-Ray. Then it is up to the specialists to analyse the image, looking for abnormalities. 3D mammography, also known as digital breast tomosynthesis, provides a 3D image of the breast, which should help finding tumours easier. But does it?

Australian scientists conducted a pilot study of 3D mammography in order to find out if it is actually effective and needed. In many countries, including Australia, only 2D mammography is supported by healthcare systems. This means that the technology of 3D mammography is sort of pushed aside at the moment just because it is relatively new. There are some health concerns as well, because when compared to 2D mammography 3D method more than doubles the radiation exposure. It should not be a problem as only low-energy X-rays  are used, but if there is no benefit, there is no point.

Scientists did find improvements compared to standard mammography in breast cancer detection. However, they noted that it is too soon to tell if health outcomes actually improve with the new technology. Nehmat Houssami, leader of the research team, said: “Our trial provides findings that could be further examined in larger, multi-service comparisons of tomosynthesis with standard mammography for breast screening, including longer term endpoints (such as interval cancer rates) that were beyond the scope of our pilot study”.

And so, as always, more research needs to be done. So far it seems like there is a benefit to tomosynthesis – it detected 49 cancers (40 invasive, 9 in situ), while standard mammography detected 34 cancers (30 invasive, 4 in situ). However, the reading times were significantly higher for 3D mammography – 67 seconds compared to 16 seconds of the 2D method.

Time will tell if the advantages of the 3D mammography will outweigh the disadvantages. It won’t be easy, because mammography is already seen as the best early detection method for breast cancer. For 3D mammography to make a significant contribution, it would have to be significantly better than current methods.

 

Source: The University of Sydney

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