Women ’s Hea lth Time Magazine has chosen 3D Mammography as its top “remarkable health advance“for 2014. This was due to the numerous studies published in 2014 demonstrating 3D Mammography to be a highly accurate screening tool for detecting breast cancer with fewer false positive results. These studies were performed using Hologic, 3D Mammography which has been available on the Gold Coast, at The Women’s Imaging Centre in Southport since August 2013. A summary of the latest research: 3D mammography improves cancer detection in dense breasts A major new study presented at the annual meeting of the Radiological Society of North America (RSNA) has found that digital breast tomosynthesis, also known as 3D Mammography, has the potential to significantly increase the cancer detection rate in mammography screening of women with dense breasts (significant fibrous or glandular tissue with minimal fatty tissue). Research has shown that dense breasts are more likely to develop cancer, a problem compounded by the fact that cancer in dense breasts can be difficult to detect on mammograms. Other imaging modalities like ultrasound and MRI are often used to help find cancers that can't be seen on mammograms, but both modalities have higher rates of false-positive findings which often results in more tests and unnecessary biopsies. The study compared compared 3D Mammography (3D Mamm) with digital mammography (DM) to just DM on its own in 25,547 women between ages 50 and 69. The 3D Mamm screening method detected significantly more cancer than DM alone: 211 cancers compared to only 163. When it came to dense breasts, the 3D Mamm + DM identified 80% of the cancers, versus 59% via DM alone. These findings are very positive and demonstrate an overall relative increase in the cancer detection rate of about 30%, and a relative increase in invasive cancer detection of approximately 40%. 3D Mamm not only improved the cancer detection rate in women with dense breasts, it also helped increase detection for women in the "fatty breast" categories from 68% to 84%. 3D Mammography significantly increases the detection of breast cancer whilst reducing false positives. Published in the June 2014 issue of the Journal of the American Medical Association (JAMA), a study of almost half a million women led by Dr Sarah Friedewald found that Hologic's 3D Mamm found significantly more invasive cancers than traditional mammography. The researchers also demonstrated that 3D Mamm reduces the number of women called back for unnecessary testing due to false positives. This study is the largest to date assessing 3D mamm technology - involving 13 U.S. academic and community-based sites. The study, "Breast Cancer Screening Using Tomosynthesis in Combination with Digital Mammography," included a total of 454,850 examinations (281,187 conventional mammograms compared to 173,663 3D mamms). Significant findings include: • A 41% increase in the detection of invasive breast cancers • A 29% increase in the detection of all breast cancers • A 15% decrease in women recalled for additional imaging • A 49% increase in PPV for a recall. • A 21% increase in PPV for biopsy • No significant change in the detection of ductal carcinoma in situ (DCIS). The JAMA 3D study validates the findings of previously published studies but on a much larger scale and addresses some of the common concerns with breast cancer screening – that we are finding too many cancers that don't need to be treated and too many women are being called back for unnecessary additional testing. Each of the outcomes measured was statistically significant and reinforced the benefits of Hologic 3D Mammography in addressing these challenges. Our experience with this technology at The Women’s Imaging Centre has replicated the research findings of numerous clinical studies and increased our diagnostic accuracy and confidence in our decision of positive or negative study across all patient populations and breast densities. Reducing false positive is an additional bonus due to the patient anxiety associated with a potentially positive finding. We feel that 3D Mammography has made a significant and positive impact on patient management. pm pindaramagazine.com.au Pindara Magazine 39
Pindara Private Hospital Magazine - Issue Five
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