Breast Density Changes the Breast-imaging Landscape

Cristen Bolan, MS


Appl Radiol. 2013;42(3):20-25. 

In This Article

Combo-mode Imaging With Tomosynthesis

One of the most logical extensions of 2D mammography is 3-dimensional mammography, or breast tomosynthesis. While breast tomosynthesis has been in use in Europe for several years, it only recently became available for breast screening in the U.S., opening up new possibilities for women with dense breasts.

Figure 1.

The ACUSON S2000™ Automated Breast Volume Scanner (ABVS) by Siemens Healthcare gives you the power to acquire, analyze and report on detailed sonographic volumes of intricate breast anatomy and pathology.

Hologic Inc.'s Selenia Dimensions 3D mammography system, the first device of its kind to receive FDA 510(k) clearance, is indicated for diagnostic performance. Technologists can use a one-touch control to transition between imaging modes: FFDM (2D imaging), tomosynthesis (3D imaging), or "combo-mode" imaging (2D+3D imaging). The latter feature quickly acquires a digital mammogram and a tomosynthesis scan in the same compression (a screening exam consists of a digital mammogram and breast tomosynthesis image set).

A recent study analyzed results from 12,631 examinations interpreted by using mammography alone and mammography plus tomosynthesis. Researchers found that with mammography plus tomosynthesis there was a 31% increase in the cancer detection rate; the false-positive rate was 13% less; and there was a 26% increase in the detection of higher-grade cancers.[6]

In another study, led by Liane Philpotts, MD, Chief of Breast Imaging at the Yale University School of Medicine, New Haven, CT, investigators concluded that adding 3D to a screening exam reduced recall rates by 40%.[7]

"With Hologic's 3D technology, we can see the entire breast more clearly in 1-mm slices," said Dr. Philpotts. "This allows us to find additional cancers earlier and also dismiss ambiguous spots that are actually normal breast tissue."