Will your next mammogram be in 3-D?

What you need to know about 3-D mammograms and why you'll want one for your next visit.

On March 7 of this year, a woman in Boston got a mammogram. Yes, so have tons of others before her and, hopefully, since her. But you should care about this particular lady on this particular day because she was the first patient in the United States to use a three-dimensional mammography imaging machine-the only of its kind approved for use by the FDA and the one that Elizabeth Rafferty, MD, spent over a decade helping to create. "I wish we could prevent breast cancer, but we're not there yet," says Dr. Rafferty, director of breast imaging at Massachusetts General Hospital. "The best tool we have to save lives is early detection-and at its cornerstone, mammography. The hope is that this new 3-D technology will find more breast cancers and find them sooner."

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Why is that superimportant? When the cancer is found early and it's still confined to the breast, the 5-year survival rate is 98%. That's why you really shouldn't skip mammograms; that's also why you want to know more about this new test.

How it works: Using a technology called tomosynthesis, the mammography system takes multiple x-rays and then combines the scans to create a three-dimensional image. It can also generate the standard two-dimensional scan.

Why it's better than the regular scan: The 3-D image allows doctors to look behind and beside structures and potentially see smaller tumors or lesions that may have been hidden on a standard mammogram, explains Dr. Rafferty. So that should mean better detection, more accuracy, and fewer false positives. It's way (way) too soon to say if these scans are making good on their promises, but preliminary studies are encouraging: Radiologists reported a 7% improvement in their ability to distinguish cancers from noncancers when they used the new system. Before you say you're not impressed, consider that nearly 40 million mammograms are conducted every year, so that would equate to a good number of women spared the agony of a false positive and the cost of follow-up tests.

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Who should get one: You. Your mom, your sister, your aunt-these machines, made by the company Hologic, benefit all women, particularly those with dense breast tissue (which does a better job at hiding cancers, especially in a 2-D image). As far as getting a mammogram in general, most professional cancer organizations recommend annual screenings starting at age 40. There are more than 100 3-D mammography systems currently in use around the country. To find one near you, visit pinkribbon.hologic.com.

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What it'll feel like: Pretty much like the last mammogram you had-so yes, your breast still has to be compressed. In a standard mammogram, that's done to separate the structures so radiologists can see them better, says Dr. Rafferty; for 3-D scans, it's to hold the breast perfectly still. A few differences: The machine arcs over you to get the x-rays (instead of being stationary), and women who get the combo 2-D and 3-D mammogram are exposed to twice as much radiation (though it's still an amount that's okay per the FDA). And the cost? Hospitals have to pay more for the machines, but for you, the price is the same for now.

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What they will think of next: More improvements to the 3-D machine-including finding a way to immobilize the breast to eliminate the need for compressions, says Dr. Rafferty. Scientists are also working on molecular breast imaging, where small amounts of a radioactive tracer is put into an arm vein; the tracer attaches to "hot spots," which are detected by a special camera. "This has promise," says Dr. Rafferty. "It would be less expensive than a mammogram; the holdback is the dose of the tracer-the amount needed is a little too high right now, but they're working on that." Another experimental research area: optical imaging. This test would use just light to help detect large areas of blood vessels that could be signs of breast tumors-no radiation, no breast compressing. Studies are under way on these and other imaging tests, as scientists keep pushing to find the best method of detecting breast cancer as early as possible.

Tell us: Would you want to try the 3-D mammogram?

By Teresa Dumain, Prevention

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