Traditional 2D mammography takes two flat X-ray pictures of the breast—usually from the top and the side. This helps find lumps and tiny calcium spots. The American College of Radiology suggests yearly mammograms for women starting at age 40, especially if they have average risk, and continuing as long as life expectancy allows.
But 2D mammograms have some problems, especially with dense breast tissue. Dense breasts have more glandular and fibrous tissue, which look white on the images, just like tumors. This can hide problems. Because of this, some cancers might be missed (false negatives), or results may seem suspicious when they are not (false positives). This can cause extra tests and worry for patients.
Also, 2D images are flat, which makes it hard for doctors to tell exactly where and how big a lump is. This leads to more recalls, meaning patients come back for more pictures to check things better.
3D mammography, also called digital breast tomosynthesis (DBT), takes many low-dose X-rays from different angles around the breast. These pictures are put together to make thin layers, making a 3D view of the breast tissue. This helps doctors see the tissue in greater detail and avoid the problem of overlapping tissue seen in 2D images.
Approved by the FDA in 2011, 3D mammograms can be done with traditional 2D images, or some systems create 2D pictures from the 3D data to lower radiation exposure. This technology is being used more and more in outpatient centers and radiology offices across the United States, especially where many women get screened.
Many studies show that 3D mammography finds more cancers than 2D alone. A review of over 2.6 million patients found that combining 3D and 2D mammograms detected about 6.36 to 7.40 cancers per 1000 women screened. In contrast, 2D mammograms alone found about 4.68 cancers per 1000. It also found more invasive cancers, which are more serious.
Some imaging centers found that 3D mammograms catch 20 to 40% more invasive breast cancers than traditional tests. Finding cancer earlier can help patients get treatment sooner and may improve survival.
False positives happen when mammograms suggest cancer, but follow-up tests show there is none. These cause stress and add costs from extra tests. 3D mammography reduces false positives by giving clearer pictures and helping doctors tell the difference between harmless and dangerous findings.
Research shows 3D mammography lowers the number of patient callbacks for more tests by up to 40%. This also means fewer unnecessary biopsies and fewer visits. It helps reduce work for both doctors and staff who manage appointments and calls.
Dense breast tissue can make detecting cancer harder because the extra tissue blocks the view on 2D images. The Fox Chase Cancer Center identifies four breast density types: fatty, scattered fibroglandular, heterogeneously dense, and extremely dense.
Women with scattered and heterogeneously dense breasts get the most benefit from 3D mammography. They find more cancers and have fewer recalls. Women with fatty breasts have fewer recalls but don’t detect many more cancers. Those with extremely dense breasts do not see much difference with 3D mammography over normal screening.
Because 3D images are layered, doctors can see inside dense tissue better. This helps find smaller or earlier cancers that might be hidden in flat 2D pictures.
3D mammography uses multiple low-dose X-rays, so radiation exposure can be higher if combined with standard 2D mammograms. But synthetic 2D images made from the 3D data can cut the radiation dose by about 45% compared to doing both 2D and 3D scans separately.
The exact dose depends on the number of views and the machine used, but it stays within safe limits for yearly screenings. Considering the better cancer detection, the small increase in radiation is usually accepted by doctors.
Many medical offices across the country are starting to use 3D mammography to improve breast cancer screening. For example, Wake Radiology UNC Health Rex in Raleigh, North Carolina, was the first outpatient group there to use an AI-assisted 3D mammography system called ProFound AI®.
Their team of over 50 radiologists uses this system to look at more than 200 images from each 3D mammogram. This helps them find suspicious areas with better accuracy.
Dr. Susan Kennedy, Director of Breast Imaging at Wake Radiology, says AI tools help radiologists find cancer and reduce unnecessary recalls. This mix of technology and doctor skill shows where breast imaging is headed.
3D mammography creates a large amount of images—over 200 per scan—so doctors have more work in reading them. AI and workflow automation can help make this process smoother and faster.
AI programs like iCAD’s ProFound AI® help doctors by analyzing the many images from 3D mammography. These programs look for patterns that a doctor might miss and mark areas that may need closer exam.
Dr. Kennedy explains that AI is not here to replace doctors but to help them work better and catch more cancers. By using both doctors and AI, accuracy can improve and mistakes can be lowered.
Using advanced imaging means medical offices need to manage appointments, calls, and follow-ups carefully. Companies like Simbo AI create phone automation and answering services to help with this.
Their technology can handle booking appointments, sending reminders, and directing patient calls automatically. This frees staff to focus on patient care. In busy clinics, this helps reduce wait times and improves patient experience.
Automating phone work also helps prevent missed appointments and reporting delays. Quick diagnosis can make a big difference in breast cancer treatment.
New research shows it is important to choose screening methods based on each woman’s risk factors, such as breast density, family history, and genetics. Studies from Fox Chase Cancer Center found breast density itself is a risk for breast cancer. Women with denser breasts face more challenges in diagnosis and may have higher cancer risk.
3D mammography is a better choice for personalized screening, especially for women with scattered and heterogeneously dense breasts. Combined with AI, imaging centers can make better plans tailored to each patient. This helps use resources wisely and avoid extra tests.
Medical practice leaders and IT managers thinking about 3D mammography should balance costs and benefits. They need to pay for the new machines and train staff, and maybe upgrade storage for the large image files.
But the better accuracy, fewer recalls, fewer biopsies, and happier patients can improve the practice’s reputation and keep patients coming back. Using AI tools like Simbo AI can reduce workload and help manage staff better.
Clinics in cities and suburbs, like in the Southeast US and North Carolina, may adopt 3D mammography faster because they have more patients and specialist doctors.
Rural and underserved areas might find it harder to get this technology but could use tele-radiology (remote reading) and AI tools to help. This can improve access and support cooperation with specialists.
Practices also must follow state laws about telling patients their breast density. Using 3D mammography along with AI and automation can help clinics lead in women’s health and improve patient care.
3D mammography has important clinical benefits compared to 2D. It finds more cancers, especially invasive ones, lowers false alarms, and shows dense breast tissue better. Radiation dose is a bit higher but newer methods help keep it low.
Adding AI for image reading and automating office work can handle the extra images and make operations better. Medical leaders should think about these factors and their patients when deciding on breast imaging services.
The future of breast cancer screening in the US looks to be more accurate, personal, and efficient with these new tools.
Wake Radiology UNC Health Rex became the first outpatient radiology practice in the Triangle to use AI for 3D mammography, enhancing breast cancer detection.
The practice has adopted iCAD’s ProFound AI®, a state-of-the-art platform designed to assist with 3D mammography and breast cancer detection.
ProFound AI analyzes a large data set from 3D mammograms, marking areas of concern for radiologists, which helps enhance focus and accuracy.
3D mammography generates 200+ images per patient, compared to the four images produced by 2D mammograms, offering more detailed assessments.
Radiologists will use AI tools to better interpret mammograms rather than being replaced by AI, enhancing diagnostic capabilities.
The goal is to improve cancer detection rates and decrease recall rates, translating into better patient care.
Dr. Susan Kennedy is the Director of Breast Imaging at Wake Radiology, heavily involved in implementing AI technology in their practice.
3D mammography has significantly improved breast cancer detection rates, providing a more comprehensive view of breast tissue.
ProFound AI was developed using one of the largest datasets of 3D mammograms, which enhances its pattern recognition capabilities.
Founded in 1953, Wake Radiology has consistently introduced innovative imaging methods and subspecialized radiology in Wake County.
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