Should Breast Tomosynthesis Replace Mammograms?

Breast cancer was responsible for half a million deaths worldwide in 2012. In that same year, more than 1.7 million people were diagnosed with this deadly disease. Early detection and treatment of breast cancer significantly increases one’s chances of survival, so annual screening through mammography is recommended for all women over the age of 40.

In 1992, the Breast Imaging Team at Massachusetts General Hospital began researching the use of breast tomosynthesis as an alternative to mammograms. This new technology, which creates a 3-D image of breast tissue, was approved by the FDA in 2011. Today breast tomosynthesis plus digital mammography is the standard protocol for all breast cancer screenings performed at Mass General.

The use of this new technology, however, is not yet the standard diagnostic tool nationwide. Though it has a number of benefits, its few disadvantages are preventing many from adopting it at this time.

Advantages of Breast Tomosynthesis

There are a number of ways in which breast tomosynthesis is proving superior to traditional mammography. These advantages include:

• Safety: Although this technology acquires X-ray images of the breast for several different angles in order to create a 3-D image, it exposes the patient to less radiation than traditional mammograms do.
• Less Pain and Discomfort: Because the patient’s breasts do not need to be compressed as firmly as they do during a mammogram, tomosynthesis is more comfortable for participants. This may increase the number of women who willingly have this important screening test done on an annual basis.
• Better Detection of Tumors: According to a clinical study done by researchers at Lund University in Sweden, breast tomosynthesis is successful at detecting 40% more breast cancers than traditional mammography.

Disadvantages of Breast Tomosynthesis

Although this new technology is proving valuable and worthwhile, its use as a standard protocol is being slowly adopted.  The reasons are:

• Risk of Over-Diagnosis: This technology increases the risk of over-diagnosis so more healthy women who have benign lesions may be recalled for further testing. This can lead to undue psychological stress for the patients as well as increased medical costs.
• High Initial Costs: Although the equipment for performing breast tomography screening is readily available, it is rather expensive. Technicians must also be trained on using this new equipment and medical personnel must learn how to interpret the results. All of this means high initial costs for hospital and diagnostic centers, many of which are holding off for the time being.

Will the Use of Breast Tomosynthesis Soon Be Widely Used?

“We believe that this technology will become commonplace in the near future,” Kristina Lang and Sophia Zackrisson, two of the researchers from the Lund University study, state.  “We see a change as inevitable. Breast tomosynthesis will be introduced, it is just a question of when and on what scale.”

Zackrisson adds that, “We see five to ten years from now as a possible timeframe for the large-scale introduction of the technique. There is also an aspiration for more personalized screening, and breast tomosynthesis could therefore be one of several methods used.”

You can learn more about breast tomosynthesis here.