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Improved Imaging Option in Breast Cancer Screening By Christine Chung, MD

May 03, 2016 01:32PM ● By Elena Hutslar

Mammograms have been considered the gold standard in breast cancer detection for the past 45 years and have been shown in numerous studies to decrease death from breast cancer. The US Preventive Services Task Force recommends mammograms once every two years for women aged 50-74. I follow the guidelines of the American Medical Association and National Comprehensive Cancer Network and recommend annual screening mammograms starting at age 40 for my female patients.


In mammography, the breast is compressed between two plates, and images are taken from two angles. Overlapping breast tissue can make these images harder to interpret, particularly in women with dense breasts. This can lead to false positives in 10% of patients and, more worryingly, false negatives in 15-20% of patients, according to the National Cancer Institute.


Tomosynthesis, approved by the FDA in 2011, could improve the way women are screened for breast cancer, particularly those with dense breast tissue. Multiple low-dose X-ray images of the breast are taken in an arc around the breast. These images are reconstructed to form a three-dimensional picture, resulting in a clearer image of the breast. A recent study published in the Journal of the American Medical Association in June 2014 showed that tomosynthesis was better at detecting breast cancer than mammography. 


Does this mean that tomosynthesis could supplant mammography as the standard of care for breast screening? As Dr. R James Brenner, the former president of the Society of Breast Imaging, Professor of Radiology, UC San Diego, and the Director of Breast Imaging at Bay Imaging Consultants said, “Tomosynthesis is simply a quantum jump over planar mammography as it is done today. It is more resource intense but will likely replace most conventional mammography in the United States over the next decade."    


Approximately 6 million women were screened with tomosynthesis in 2014, and that number can only be expected to rise since Medicare approved payment for tomosynthesis screening, effective January 1, 2015.


Dr. Chung is a radiation oncologist with Diablo Valley Oncology & Hematology Medical Group. She sees patients in Pleasant Hill and Berkeley and can be reached at 925-825-8878.

Join Dr. Chung and other breast cancer specialists at a breast cancer update on May 17, 6:30-8:30pm, at the Lafayette Library. RSVP at 925-677-5041.