Breast Cancer Screening: Why A 2D Mammogram And Ultrasound Is Better Than A 3D Mammogram

Breast cancer screening is a vital part of women’s lives, and choosing the right kind of mammography test can play a crucial role in your ability to obtain an accurate diagnosis – and gain peace of mind.

Nowadays, we hear of a lot of women’s health practices going “3D”, which can be valuable in certain areas of diagnosis but may not always be the best option when it comes to mammography. Capturing images in 3D doesn’t necessarily improve the way we “see” radiology images — typically, it just costs more to get tested.

That’s why at Rosetta Radiology we recommend utilizing a combination of 2D tomosynthesis (also referred to as “tomo” or 2D mammography) and ultrasound technology over standard 3D tomographies.

Dense Breasts And Mammograms

In the United States, 1 in 4 women ages 40 to 74 has what is known as “dense breasts.” This means that, when seen on a mammogram, these women have more dense tissue than fatty tissue. Because dense tissue shows up as white masses on the images, it makes it difficult to differentiate between masses and tumors since they both appear white on the scans.

Proponents of 3D mammograms over 2D mammograms center their argument around the way in which the images appear. While 2D mammograms create images with overlapping breast tissue, 3D mammograms create image “slices” that allow radiologists to look through every layer of breast tissue.

When viewed from just this perspective, 3D mammograms may appear to be a better option, but research has found that despite this difference in slice capability and image rendering, there’s not much disparity in the number of false-positives from one technology to the other. In fact, Hitachi spokesman Matt Ernst noted in a recent article titled  Another View Of Breast Density that “with extremely dense breast tissue, digital breast tomosynthesis (also known as 3D mammography) has the same problem of distinguishing density from cancer lesions. Ultrasound is still finding more cancers”. This leads us to our next point: the argument for 2D mammography + sonography.

2D Mammograms + Dense Breast Tissue Ultrasound

In recent years there have been significant improvements in breast ultrasound, spurred by the awareness of dense breast tissue among patients in the United States. More and more, healthcare practices are searching for alternative imaging to mammography that will more efficiently image dense breasts. At Rosetta, our Women’s Health team pairs 2D tomography with sonograms, also known as ultrasounds. By doing this, we are able to secure the best diagnosis for women, particularly for those with dense breasts.

It’s not uncommon for women who undergo a standard 2D or 3D mammogram to end up with an abnormal or inconclusive result from their scan. In cases like this, patients are then required to undergo a second breast imaging procedure. This second screening usually relies on a sonogram or ultrasound.

Why Ultrasounds Pick Up On What Mammograms Might Miss

With an ultrasound, your radiologist will be able to determine if a lump or mass is filled with fluid or if it’s solid. Mammograms, whether it’s 2D or 3D, are not able to tell the difference. If a lump is fluid-filled then it’s just a cyst and you won’t need any additional testing. If the lump is solid, your radiologist will likely recommend a follow-up breast MRI or a biopsy. There are other conditions such as plugged milk ducts that can cause an abnormal mammogram and are more easily identified using ultrasound imaging.

By combining our 2D tomography with ultrasound technology we not only are able to attain a more accurate and in-depth result from your scan, it also eliminates the need for more expensive breast cancer screening such as a breast MRI. And, because sonograms have such low-intensity radiation, our patients don’t have to worry about undergoing significantly increased radiation as a result of combining the two procedures.

So, if your radiologist recommends combining these two imaging procedures – don’t be nervous! It doesn’t mean anything is wrong, it just means the radiologist needs a better, clearer picture.

More Information

To learn more about how the combination of 2D tomography and a sonogram can benefit your breast cancer screening procedure, contact us. If you are looking to schedule your breast cancer screening, simply book an appointment today!

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