<p>Today I scheduled a routine mammogram. I ended up scheduling a 3-D mammogram. Anybody know anything about 3-D mammograms?</p>
<p>Good for you. Our local Breast Imaging Center just got one. Apparently, it is better at detecting smaller things, and there are fewer “recalls” for additional imaging (although more radiation exposure).</p>
<p>[Physician</a> Q&A: Dr Kara Carlson on 3-D Mammography](<a href=“http://www.evergreenhospital.org/QADrKaraCarlson]Physician”>http://www.evergreenhospital.org/QADrKaraCarlson)</p>
<p>Massachusetts General Hospital is first in the nation to do mammography screening using 3D breast tomosynthesis</p>
<p>07/Mar/2011</p>
<p>"The Breast Imaging Program at Massachusetts General Hospital (MGH) today welcomes its first patient to undergo three-dimensional (3D) breast tomosynthesis screening. Also known as 3D mammography, this technology promises to improve cancer detection and reduce false positives.</p>
<p>Approved by the FDA February 11, 2011, breast tomosynthesis – a new imaging technology pioneered by the MGH Breast Imaging Program under the leadership of Elizabeth Rafferty, MD, director of Breast Imaging at MGH – produces a 3D image of the breast and gives doctors a clearer view through the overlapping structures of breast tissue. “Like flipping through the pages of a book, the radiologist is able to look at one page at a time instead of seeing the whole breast reduced to a single frame, as is the case with standard mammography,” says Rafferty. This more comprehensive view increases the ability to detect and diagnose small cancers. In addition, tomosynthesis can help radiologists rule out abnormalities that may have looked suspicious in a 2D mammogram, reducing the need to call women back for additional imaging or biopsies. </p>
<p>The technology, Hologic’s Selenia Dimensions system, improves images by digitally combining multiple X-rays to reduce distortion created by tissue overlap or density. As a result, the radiologist is able to pinpoint the size, shape and exact location of a lump or tumor; the image is not flattened like a standard mammogram. Tomosynthesis also screens the entire breast, not just the problem area. This is significant because 15 percent of women with a cancer in their breast also have another cancer in the same or other breast."</p>
<p>[Massachusetts</a> General Hospital is first in the nation to do mammography screening using 3D breast tomosynthesis - Massachusetts General Hospital, Boston, MA](<a href=“http://www.massgeneral.org/imaging/about/pressrelease.aspx?id=1340]Massachusetts”>http://www.massgeneral.org/imaging/about/pressrelease.aspx?id=1340)</p>
<p>Sounds like further technical progress in mammography, with MRI a valuable adjunct too as needed.</p>
<p>Does this type of mammogram reduce the amount of painful squeezing which occurs during a typical mammogram? I had one just last week and it was one of the more painful tests I have ever endured.</p>
<p>What’s the radiation load relative to a regular mammogram?</p>
<p>First, I’d like to say that I am in no way associated with Massachusetts General Hospital. I put their information up for the OP, as this is a new mammogram method apparently clinically available at Mass General. </p>
<p>The link I posted above takes you to a video which explains the process very nicely. Standing straight facing the machine, it’s the machine that moves around you. Here is a link directly to their hospital radiology site explanation, which also contains their video explanation.</p>
<p>[3D</a> Mammography (Tomosynthesis) - Massachusetts General Hospital, Boston, MA](<a href=“http://www.massgeneral.org/imaging/services/3D_mammography_tomosynthesis.aspx]3D”>Breast Tomosynthesis)</p>
<p>I did read that this newer technique remains under the FDA radiation limit for a mammogram, but yes, does use more radiation than the 2D technique.</p>
<p>Please reference all questions to your own personal physicians regarding mammograms and furthermore, on 3D mammograms. The video is a nice, brief introduction to this newer technique.</p>
<p>I recently had a breast MRI. No radiation and no squishing. It did take 45 minutes in that loud machine but I was comfortable and ended up with 1000 views for them to look at. Happily, they found nothing!</p>
<p>Not every insurance will pay for a breast MRI without paying for a mammo first.</p>
<p>^^you’re probably right. I volunteered to be one of the first subjects on this machine so there was no charge. I imagine it will normally be used to answer follow-up questions that arise on a regular mammogram.</p>
<p>At least my insurance co’s will cover the 3D procedure thanks to strong lobbying from Hologic. I get sick and tired of the recall notices.</p>
<p>I almost always have to have a second look because of cysts, but the hospital where I have my mammograms knows this, and I get taken in for an ultrasound immediately after. That said, I’d love to have just one test instead of two.</p>
<p>I am considering an ultrasound. I have a friend and a relative whose breast CA was identified early, via ultrasound. Anyone here have one? Did you do it in addition to or instead of a mammo?</p>
<p>My breast cancer was found with an ultrasound after having an a mammo. I think that is what they use if they have an questions…and then of course a biopsy.</p>
<p>Because of family history, I have an ultrasound in addition to my yearly mammogram - it’s done as part of the same visit and my insurance covers both. I’m intrigued by the 3D mammogram - I wonder if my doctor will recommend it when I go for my annual mammogram this winter.</p>
<p>OP here. Thanks for the responses. I am scheduled to have a 3D mammogram. </p>
<p>From what I understand, an ultrasound can only be scheduled in conjunction with or after a mammogram - and through a doctor. The 3D mammogram just takes the place of a routine 2D mammogram, if you choose. </p>
<p>Here, it costs $50 dollars more for a 3D mammogram and that $50 dollars needs to be paid at the time of the procedure. I noticed on the link provided by BunsenBurner that there’s no cost differential in that location. No fair 
but it is what it is.</p>
<p>Again, thanks for the responses. When I called to schedule my mammogram, I had no idea that they’d dangle choices in front of me. Now that I’ve looked into it a bit, I’m glad I made the appointment for 3D.</p>
<p>Hmmm, a hospital near my home will also be offering a 3 D mammogram very shortly. I don’t think that it will cost me anything because I don’t pay anything for xrays or lab now, as long as it is in network (this hospital is in network). Reading the mammogram is another story, as not all radiologists are in network (we had a thread about that topic)! I do need a RX for mammography, but that and in network facility is all that I need to worry about for ins. coverage. </p>
<p>I got a call back for ultrasound last year and everything was fine. My doctor told me that from now on he is going to put ultrasound on the RX with the mammogram so that I don’t have to go back twice. Frankly, waiting for the ultrasound results (given to me within 30 minutes of completing the ultrasound was a very stressful for me, esp. since the woman waiting to go in for more tests was already diagnosed with breast cancer and was sitting there in tears as I went in). I think that I would rather have the 2D mammogram with ultrasound over being exposed to more radiation. Thoughts?</p>
<p>Another thing that I thought was strange is that a “teaching hospital” in my area does not have current plans to offer 3D mammography (I just called to inquire), and a smaller community hospital in my area is going to offer this within weeks.</p>
<p>^I work for a large teaching hospital and am part of the team that analyzes new technology purchases. There could a myriad of reasons they aren’t offering 3D mammography yet:</p>
<p>-they don’t have any mammography equipment old enough to warrant being replaced.</p>
<p>-the technology may still be suspect- while it sounds cool, the quality on the 3D mammograms may or may not be as good as the 2D ones (trust me - newer isn’t always better). To give you an example, when Cardiac CT angiography came out, everyone thought it would do away with cardiac caths since it was less invasive. Turns out the quality of the CTs wasn’t very good and most people end up having to have a cath anyway. Our CCTA sits unused most of the time.</p>
<p>Plus, you need to remember this was just approved by the FDA in Feb. The FDA doesn’t require new technology (or even drugs) to be better than existing ones - only that it’s proven to be as effective and safe as current technology (and drugs). The review panel says the newer technology was 7% more effective than 2D mammograms. 7% doesn’t sound like a lot to me.</p>
<p>-there may be concerns about the radiation levels - very hot topic in radiology right now. People are very concerned about exposing patients to more radiation than absolutely necessary. My understanding is 3D mammograms double the radiation exposure.</p>
<ul>
<li>they don’t have the space for a 3D machine - not sure what the footprint is on it compared to 2D but if it’s larger, it may require significant renovations to accommodate it.</li>
</ul>
<p>I haven’t looked at the 3D machines closely yet but I think you’re right to be concerned about radiation. Even though the radiation levels on a 2D mammo is low, when you start having one every year from the time you are 40, it adds up by the time you’re 60 and quite frankly, they don’t know the long-term consequences of it. Repeated concentration exposure to radiation can increase one’s risk of cancer.</p>
<p>Having said that, I could see good reasons for a particular patient wanting 3D. If you have very dense breast tissue (I do), 3D might be the better choice.</p>
<p>Momlive thanks. I am trying to weigh the 2D mammo plus Ultrasound, vs. the 3 D mammography. I am absolutely concerned about the additional radiation levels. I understand that ultrasound does not expose one to radiation, btw. I do tend to be the type of person to stand back and wait when there is a new medication, procedure, etc. because as you say, newer is not always better. Sometimes one can’t stand back and wait and see. In this situation, I can wait and stick with the 2 D mammography. I think that I will stick with the 2 D mammography for now, but I might discuss this the next time I see my doctor. Thanks.</p>
<p>This topic is very timely for me and I appreciate all the info on the 3D. I am scheduled in 2 weeks. That means I am starting to get very very anxious. Very. My mom had agressive non-estrogen dependent breast cancer in 2001. I started mammograms that year at age 38. Do some of you other posters get this nervous every year?</p>
<p>I have very dense, fibrocystic breasts and have had many false positives and diagnostic mammos, ultrasounds etc. Perhaps the 3D would be a good alternative. It is all I can do to wait the 1/2 hr for results and not run screaming out in my pink paper towel top. The best thing I did though, was switch to her breast surgeon, who is associated with the hospitals’ mammography center, and has an adjacent office. The radiologist reads the xrays right then, and any additional films/ultrasounds are done immediately. That is soooo much better than getting that darn letter 2 weeks later.</p>