"I felt like it made a difference. That early detection did help," she said. Sawyer's younger sister died of breast cancer a few years ago. A month after her annual 2-D mammogram had shown nothing, she felt a lump. It was already at Stage 3.
The 3-D mammogram has particular benefits for women with dense breast tissue — or half of all women. They are not only at increased risk for breast cancer, but also for the cancer going undetected until it reaches a later stage. Last year, the Virginia General Assembly passed a law, effective July 2012, which required doctors to notify patients if a mammogram shows they have dense breast tissue. (See info box).
Denser tissue does not correlate to feel, but shows white on mammograms and blocks the X-ray, explained Riverside radiologist Pettus. "There's a need for something for women with denser tissue in a complex pattern," he said, but questioned 3-D use for all women.
Riverside currently does not have a Hologic machine, but is evaluating a purchase, according to spokesman Peter Glagola.
Similarly, the Bon Secours Maryview Foundation is half-way to its fund-raising goal to add breast tomosynthesis to its Harbour View location in Suffolk. Hasan, who practices at various locations in Hampton Roads, including the Millie Lancaster Women's Center at Bon Secours Health Center, has used the 3-D screening at Sentara locations. "It definitely does help. In the couple of weeks we've done it, I've picked up a couple of things," she said. "All of us have found things we didn't see in other screenings."
She put the decrease in call-backs at almost 40 percent. Typically, with a 2-D mammogram, the rate of call-back is one in every 10 women, of whom a tiny fraction will actually have cancer. "Usually it's just overlapping breast tissues. With the 3-D, we're able to scroll through the slices and see it's just a shadow, not a mass," said Hasan.
Allison, who has the most experience with the new technology, put the improvement in detection at 35 percent, with detection for invasive, aggressive cancers even higher, at 40 to 50 percent.
The American Cancer Society and other cancer advocacy groups recommend all women over 40 receive an annual mammogram. Allison emphasized its importance, whether 2-D or 3-D, to ensure early detection. "The goal is to find it before you can feel it," she said.
Salasky can be reached by phone at 757-247-4784
This breast cancer screening method, sometimes called "3-D" imaging, received approval from the Food and Drug Administration in 2011. As in a traditional 2-D mammogram, the breast is compressed while the X-ray arm of the machine makes an arc above, taking a series of images at different angles. A computer then reconstructs the breast tissue, showing it in one-millimeter layers instead of a flat image.
Currently, it is used in conjunction with a 2-D mammogram, which means that patients receive more than double the exposure to radiation, but still well within the American College of Radiology safety guidelines. To find a machine near you, go to http://www.Hologic3D.com or http://www.BreastTomo.com.
There are four measurements for breast density; they cannot be determined by feel. By law (since July 2012), doctors in Virginia must notify women by mail if their tissue falls into the two highest categories. Those in the highest category are at six times the risk of having breast cancer than the general population.
• scattered fibroglandular
• heterogeneously dense, 10 percent
• extremely dense, 40 percent