Breast tomosynthesis is an advanced imaging technique, which uses a low-dose x-ray system and computer reconstructions to create three-dimensional images of the breasts.

The largest improvements with tomosynthesis are seen in the significantly better cancer detection and significantly fewer false positive findings when tomosynthesis is used, for women with dense breast tissue, who have lower sensitivity to conventional two-dimensional mammography, and women with more radiolucent breasts.

What is Tomosynthesis?

• Breast tomosynthesis, also known as 3D mammography or digital breast tomosynthesis, is an advanced imaging technique, which uses a low-dose x-ray system and computer reconstructions to create three-dimensional images of the breasts.
• Conventional mammography is two-dimensional: two x-ray images are taken of the breast, a cranio-caudal and a mediolateral oblique view. In breast tomosynthesis, the x-ray tube moves in an arc over the compressed breast capturing multiple images of each breast from different angles. These digital images are then reconstructed into a three-dimensional image set similar to computed tomography (CT) imaging in which a series of thin high-resolution slices are assembled to create a 3D reconstruction. These three dimensional image sets help minimize the tissue overlap that can hide cancers or make it difficult to distinguish normal overlapping breast tissue from tumours.
• While mammography is the best screening tool for breast cancer available today, it does
  not detect all breast cancers.  Breast tomosynthesis overcomes some of the limitations of standard mammography.

What does it mean for my patient?

• The largest improvements with tomosynthesis are seen in women with dense breast tissue, but women with more radiolucent breasts also demonstrate significantly better cancer detection and significantly fewer false positive findings when tomosynthesis is used.  By decreasing the false positive rates your patients will have a lower overall biopsy rate and will require fewer additional imaging examinations.  As an example, results from the Malmö Breast Tomosynthesis Screening Trial in Sweden have demonstrated a 43% increase in breast cancer detection rate.

• Women with dense breasts not only have lower sensitivity to conventional mammography, they are at increased risk of breast cancer, and this risk is now being shown to be at least as significant as a strong family history of breast cancer.

 What does it mean for me?

• Broadway Radiology will report breast density on all mammogram reports, using the BI-RADS breast density classification. 

• You may wish to consider tomosynthesis for some of your patients, particularly those with dense breasts.  Annual surveillance with tomosynthesis may be appropriate for these patients.

• Breast Density Categories following BI-RADS 5th Edition 2015:

A:  Almost entirely fatty content.
B:  Scattered areas of fibroglandular density.
C: Heterogeneously dense glandular tissue which may obscure small masses.
D: Breasts are extremely dense which lowers the sensitivity of mammography.

How much does it cost?

There is no additional cost in obtaining breast tomosynthesis over standard mammography, it is the same cost, $220.00.