digitalrads

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Understanding Breast Density [Infographic]

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When to use (or not use) intravenous radiographic contrast or gadolinium for CT scans and MRI examinations. From a lecture to primary care providers.

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The addition of tomosynthesis to conventional digital mammography results in a 30 percent reduction in the overall recall rate.

Posting by: Eric M. Baumel, MD

Breast tomosynthesis, also known as 3D mammography was approved by the FDA on February 11, 2011.

Breast tomosynthesis minimizes the effect of overlapping breast tissue by having the X-ray tube and detector moving in tandem, acquiring the images at different angles. These images are then combined to create a three dimensional picture that can be manipulated by the radiologist when reviewing the mammograms. At the current time, the tomosynthesis images are acquired at the same time as the conventional 2D mammograms.

Using conventional mammography, about 10 - 15% of women are called back for additional imaging. Tomosynthesis reduces the need for many of these call backs, because the initial studies with tomosythesis will be free of overlapping structures.

Another benefit is the improved imaging in women with mammographically dense breasts, because of the elimination of viewing the overlying tissues above and below the areas of interest.

Because of the 3D information included in obtaining the tomosynthesis images, the relative position of a suspicious area in the breast can be more precisely identified in all three planes.

A recent large study of tomosynthesis was published online July 30, 2013 in Radiology by Brian M. Haas, M.D. and colleagues, from the Yale University School of Medicine in New Haven, Conn.

The addition of tomosynthesis to conventional digital mammography resulted in a 30 percent reduction in the overall recall rate.

"All age groups and breast densities had reduced risk for recall in the tomosynthesis group," Dr. Haas said. "Women with dense breasts and those younger than age 50 particularly benefited from tomosynthesis."

Lower recall rates help reduce patient anxiety and also reduce costs from additional diagnostic examinations, Dr. Haas said.

Tomosynthesis has one significant drawback: a radiation dose approximately double that of digital mammography alone. However, Dr. Haas noted that new technology approved by the U.S. Food and Drug Administration could reduce the dose.

[digitalrads]

A Challenge For Physicians:

A study of 300 physicians' websites showed only a third had information centered on patient conditions and treatment options.

Only 4% had any blog postings in the last year on new research.

We'll try to do a little better.