3D-Tomosynthesis

1. 3D-Tomosynthesis Richard Melpignano BME-181 11 February 2013

2. Breast Cancer • Most commonly diagnosed cancer and second leading cause of death in women in the U.S • 220,000 diagnosed cases every year in U.S • 40,000 deaths every year in U.S • About one in eight women will be diagnosed with breast cancer at some point in their life

3. Traditional Mammography • Has been around for over 100 years • Uses X-rays to spot tumors in the breasts • Mammograms can help reduce death from breast cancer by 15% by spotting tumors early in development

4. Problems • Often unclear detection method • High amounts of over-diagnosis and under-diagnosis • This leads to multiple unnecessary screenings and more exposure to X-ray radiation • Limited 2-dimensional image leaves about 10% of cancers undetected • Denser breast tissue is difficult to read in some patients

5. New Detection Method • Mass General Breast Imaging teams began creating and designing a new breast cancer detection method over 10 years ago • Their method, Tomosynthesis, was approved by the FDA in February 2011 and has started to spread throughout the U.S • In Washington, D.C alone, over 35,000 procedures have been performed since August 2011

6. Tomosynthesis • Utilizes low-level X-rays to produce multiple images of the breast, layer by layer, using a swinging camera • This layering of images makes it simpler to detect normal breast structures (milk ducts, lobules, fatty tissues, etc.) from cancerous ones • X-rays are converted into limited 3-dimensional digital images for radiologists to examine • Computer Aided Detection (CAD) assists in spotting regions where cancer seems to be present • Dense tissue is more easily examined through Tomography than traditional Mammography

7. Mammography vs Tomosynthesis No lesion detected Lesion detected

8. Tomosynthesis (cont.) • Increases detection of Invasive breast cancers by 40% in comparison to 2D mammography • Total cancer detection increased from 6.1 patients per thousand to 8.0 patients per thousand (a 27% increase) • False-positive readings reduced by 15% • Uncertain readings and patient call-backs reduced by 20-30%

9. Tomosynthesis Problems • Tests take twice as long as mammography tests, resulting in slightly more radiation exposure. • Some calcification fields, which are precancerous indications, are more easily interpreted on 2-D mammograms • More expensive equipment and larger storage archives will be required

10. In The Near Future… • 3D Tomography will be added on to already existing 2D Mammography procedures in U.S hospitals • Tomography will be widely available within the next few years throughout the United States • As of now, the procedure costs $50 and is not currently covered by health insurance.

11. Resources • 3D Mammography: A Revolutionary Tool." 3D Mammography Revolutionary Tool for More Accurate Mammograms from Hologic.N.p., n.d. Web. 06 Feb. 2013. <http://www.hologic3d.com/content/3d-mammography-revolutionary-tool>. • Barclay, Laurie, MD. "3D Mammography May Improve Invasive Breast Cancer Detection." Medscape Medical News (15 Jan. 2013): n. pag. Medscape News Today. 13 Jan. 2013. Web. 6 Feb. 2013. <http://www.medscape.com/viewarticle/777709>. • "Breast Cancer Facts." National Breast Cancer Foundation, Inc.N.p., n.d. Web. 06 Feb. 2013. <http://www.nationalbreastcancer.org/breast-cancer-facts>. • "Breast Tomosynthesis a New 3D Mammogram - Washington Radiology Associates." Breast Tomosynthesis a New 3D Mammogram. N.p., 2012. Web. 06 Feb. 2013. <http://www.washingtonradiology.com/bca/index.asp>. • Lowe, Becky. "5 Benefits of Tomosynthesis." Block Imaging International, Inc.N.p., 18 Apr. 2011. Web. 06 Feb. 2013. <http://info.blockimaging.com/bid/47713/5-Benefits-of-Tomosynthesis-New-3D-Digital-Mammography-Technology>. • "Mammogram (screening or Diagnostic)." Massachusetts General Hospital Imaging. N.p., n.d. Web. 06 Feb. 2013. <http://www.massgeneral.org/imaging/services/procedure.aspx?id=2252>.