Digital breast tomosynthesis, otherwise known as 3D mammography, represents a striking development in breast cancer detection. Tomosynthesis improves detection of invasive breast cancers and lowers the number of false positive results—thus reducing the need for additional, unnecessary follow-up testing.
Einstein uses 3D mammography, at no extra cost to patients, and was one of the first medical centers in the country to employ the technology, initially as a research tool in 2009 and then routinely on all patients after FDA approval in 2011.
As important a development as 3D mammography is, some insurance companies in Pennsylvania were hesitant to cover the cost of the exam.
That’s about to change. With a new mandate introduced by Pennsylvania Gov. Tom Wolf, all insurers must cover all 3D mammograms at no extra cost.
Debra Copit, MD, director of breast imaging for the Einstein Healthcare Network, says the mandate is long overdue.
Copit has seen the evidence of 3D mammography’s effectiveness with her own eyes.
With the layered 3D picture the procedure provides, radiologists can visualize far more detail from within the breast than with 2D imaging. This enhanced view translates into earlier breast cancer detection.
From the patient’s perspective, there is relatively little difference between 2D and 3D, although some women report less discomfort. “Most of the patients didn’t even they’d had it done,” says Dr. Copit.
Einstein partnered with 12 other hospitals and practices across the country for a clinical study that included approximately 450,000 patients, comparing 2D digital mammograms to 3D. This study resulted in a publication in JAMA in 2014.
The results of that study are compelling. Compared to 2D images, 3D mammography provides impressive advantages, including:
- 41% increase in invasive cancer detection
- 15% decrease in unnecessary recalls for false positive results
After the FDA’s approval of tomosynthesis, Dr. Copit says, "at Einstein it became routine on every single patient who came for a mammogram."
Lisa K. Jablon, MD, director of Einstein’s Breast Health Program, says she has seen many women whose cancers were detected by tomosynthesis. “I am sure that they would have been missed on a traditional 2D study,” Dr. Jablon says. “Clearly, often the smaller the cancer is, the greater the chance for cure. Smaller tumors often require less aggressive additional treatments, and certainly breast conservation is easier. I am so pleased that at Einstein our radiologists, spearheaded by Dr. Copit, have been on the cutting edge of this technology and all our patients reap the benefits.”.
Because 3D imaging is so similar to 2D imaging, many women first learn about 3D technology and its benefits when they’re informed of suspected breast cancer that only would have shown up in the enhanced imaging tomosynthesis provides. That’s when they’re told about the advanced screening.
"That happens on almost a weekly basis. It’s quite dramatic,” Copit says. “It really is."