Which Type of Mammogram is Right For You?

For years, the 2-D mammogram has been the gold standard screening tool proven to lower breast cancer deaths and illness rates.

In recent years, another powerful tool to detect breast cancer has become available. In 2011, University Hospitals Seidman Cancer Center’s medical team, with the blessings of the Food and Drug Administration (FDA), introduced 3-D mammography.

“The breakthrough technology of 3-D mammography allows radiologists to see 200 images of each breast in a series of one-millimeter thick slices, as compared to 2-D mammography that takes a flat picture of each breast from two positions,” says breast imaging diagnostic radiologist Donna Plecha, MD.

To help you understand how advanced this technology is, Dr. Plecha compares a breast to a loaf of raisin bread.

“Only by thinly slicing the bread can you spot the raisins hidden inside each slice," she says. "That principal applies to 3-D mammography, which allows us to find more harmful, hidden invasive cancer cells early, when they are most treatable.”

3-D mammograms are always used in conjunction with 2-D mammograms, Dr. Plecha says. The result: Breast cancer cells now have nowhere to hide.

“Tomosynthesis – or 3-D mammography – heralds a new era in breast cancer screening for women 40 and older,” she says. “Multiple studies have definitively proven 3-D mammography increases cancer detection by helping to uncover cancer cells earlier and easier.”

A recent study using data from University Hospitals Seidman Cancer Center highlighted the benefits of the combined 2-D and 3-D mammography. These include:

• A 41 percent increase in invasive cancer detected with 3-D mammography
• A 15 percent decrease in unnecessary repeat mammograms ordered after something suspicious-looking was noted in the first exam
• A 29 percent increase in the detection of all breast cancers

"Based on our findings, a 3-D mammogram is highly recommended for 90 percent of the women walking through our door,” Dr. Plecha says. “Dense-breasted women do benefit. However, so do patients without dense breasts.”

Fewer False Alarms

Another big plus of 3-D mammography is the reduction of callbacks from false positives.

“With fewer false alarms we have considerably reduced our patients’ stress levels, and the need for costly additional testing,” she says. “All the way around, this new technology is a game-changer.”

Here is a look at what each type of mammogram involves:

• With the standard 2-D digital mammogram, the technician takes a flat image of each breast from two positions – the top and the side – resulting in four pictures. While the image is being taken, you're instructed to hold your breath for one second. This type of mammogram is covered by healthcare insurance under the Affordable Care Act.
• With 3-D mammograms, the camera sweeps in an arc and captures images of many small slices of the breast tissue. The slices are then combined into one three-dimensional image. During the mammogram, you'll hold your breath for three seconds. Currently, the 3-D mammogram is not fully covered by all insurance policies.

Learn more about the latest options in mammography offered at UH Seidman Cancer Center and several locations throughout Northeast Ohio.

Donna Plecha, MD is a breast imaging diagnostic radiologist at University Hospitals Cleveland Medical Center and Director, Breast Imaging, Mammography at UH Cleveland Medical Center and Director, Breast Cancer Imaging at UH Seidman Cancer Center. You can request an appointment with Dr. Plecha or any other University Hospitals doctor online.