Breast tomosynthesis (3D) has been shown anecdotally to improve cancer detection and reduce recall rates when used in addition to conventional mammography but radiation dose levels are of concern according to Dr. Matthew Wallis of Cambridge University Hospital in the UK.
They conducted a study of 130 women: 64 had abnormal images (40 were cancer and 24 were non cancerous or benign lesions) and 66 had normal images, the readers experience ranged from 2-5 years to 25 years.
Wallis found that 2 views tomosynthesis (3D) performed better than digital Mammography (2D) but only for the less experienced radiologists (i.e. less than 10 years experience).
The study showed no significant difference between 2 D digital mammo and single view tomosynthesis (3D) regardless of the radiologist’s experience.
Compared with 2D mammo, 3 D did reduce recall rates, i.e. an abnormality found on the screening mammogram that necessitates the patient coming back for additional views. 2 3D views (imaging from the side and from the top) reduced recall rates by 11% and 1 view 3D by 9.5%.
At Breastnet our recall rate is not an issue because the films are read while you wait and as I am so old and therefore experienced I would not, according to this study, find any more cancers! For now we are performing 2 D digital mammography. If we add ultrasound screening in our dense breasted patients we find 3 times more cancers than 3 D with no additional radiation!