*Early detection of apparently precancerous breast lesions saves lives.
*Advances in imaging techniques make a more precise and clear view of breast tissue possible.
*Women with an average, or high, risk of breast cancer can benefit from these advances.
Despite mammography being the best available early-detection tool in breast cancer today, it does not detect all breast cancers. A new technique has been developed to improve the diagnosis of breast disease: tomosynthesis. More sensitive and effective in the detection of lesions, breast tomosynthesis overcomes some of the limitations of standard mammography.
Performed at the same time as normal mammography, tomosynthesis (3D mammography) consists of taking very thin (1 mm) tomographic slices of the breast, which prevents the superimposition of tissue. In reality, this is a 3D mammogram, which is especially useful in dense breast tissue.
During a mammogram, two X-rays of each breast are usually taken from different angles, from top to bottom and obliquely from side to side. To do this, it is necessary to move the breast away from the body, compress it and hold it between two glass plates to guarantee complete visualisation. Although compression is necessary to obtain images of the breast, it can cause overlapping of breast tissue in which the abnormal tissue can be hidden and superimposed normal tissue can appear as abnormal. As in conventional mammography, only 1 compression is performed in each breast.
It is similar to performing a breast CT, however, instead of acquiring four X-ray images, the usual projections obtained with mammography, hundreds of images are taken. These enable the discovery of possible smaller lesions, as the chest is seen as it is, not as a result of the overlaying of images.
From the outside, the equipment which performs tomosynthesis tests is very similar to a mammography, although with one significant difference, it has a tube head which is not static (unlike traditional mammography) but which moves over the breast, taking images whilst moving around in an arc. “The three-dimensional reconstruction of these images provides higher sensitivity, which is associated with more effective detection of breast pathology.”
Tomosynthesis increases sensitivity (up to 40% more cancers are identified) and specificity (it is easier for the radiologist to know whether the pathology seen is breast cancer) than with conventional mammography, significantly reducing the indication for unnecessary biopsies and improving the detection of very small lesions. If cancerous lesions are found when small, it is possible to give less aggressive treatment.
The dose of tomosynthesis radiation is very similar to that of conventional mammography.
25,000 new cases of this cancer are diagnosed in Spain every year. According to data presented at the 3rd Spanish Breast Congress, this technique can detect up to 43 per cent more cases of cancer than mammography, thanks to the greater amount of information which can be obtained.
While innovative diagnostic imaging is being implemented widely, it is certainly still not available in all centres. At HC Marbella we already use tomosynthesis as a diagnostic test, to ensure a fast and accurate diagnosis, at the same time improving the patient’s experience.
Sources: Breastcancer.org / Radiologyinfo.org / Mskcc.org / 3º Congreso Español de la Mama.
October 25, 2018
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