Is There a Better Mammogram?

Demystifying Mammography and Preventive Breast Health

Research shows that regular breast cancer screening saves lives. Mammography has been the gold standard in breast cancer detection for years. More recently, a breakthrough technology has revolutionized mammography. Digital breast tomosynthesis, also called 3D mammography, is a screening and diagnostic tool that may improve early breast cancer detection by up to 40 percent.

With a conventional 2D digital mammogram, the exam produces two pictures of a woman’s breast tissue when compressed. With a 3D mammography exam, the X-ray arm moves around the breast and produces a 3D image of the breast tissue in thin, one millimeter layers. This gives the radiologist viewing the images a much clearer picture of the breast tissue and all its complexities. Sometimes breast tissue can overlap, especially in women with dense breasts, hiding masses or abnormal areas. With 3D images, the radiologist is able to view the layers of breast tissue in slices, seeing breast detail in a way never before possible.

The additional 3D images can significantly improve early breast cancer detection, as well as reduce the chance a patient will be called back for follow-up imaging by up to 40 percent.

Other advantages of 3D mammography:

  • It complements standard 2D mammography and is performed at the same time with the same system.
  • There is no additional compression required with a 3D exam.
  • Very low X-ray energy is used; nearly the same as a conventional mammogram and well below FDA safety standards for mammography.
  • It is approved for all women who can have conventional 2D mammograms and can be especially useful for screening women with dense breast tissue.
  • It is currently covered by most Medicare plans. Some private health insurance providers may charge a small out-of-pocket fee for the additional scan.

With so many mixed messages about when to start getting mammograms and how often, what type of mammogram is best– combined with fears some women have that mammograms might be painful, many women don’t get these important breast cancer screenings when they should. Annual mammograms are recommended for women beginning at age 40. Breast cancer is most treatable when found early.

Understanding Breast Health Screenings

Clinical Breast Exam (CBE) – manual examination by a healthcare provider, looking and feeling the breasts and under the arms for anything unusual, including lumps.

Screening Mammogram – produces X-ray images of the breast used to check for breast cancer in women who have no signs or symptoms of the disease.

Diagnostic Mammogram – also produces X-ray images of the breast, but it is performed as a follow-up to an abnormal screening mammogram or if a woman has breast symptoms, such as a lump.

Magnetic Resonance Imaging (MRI) – uses a magnet, radio waves and a computer to make a series of detailed pictures of areas inside the body.  It is suggested for women with a greater than 20 percent lifetime risk of developing breast cancer, family history of breast or ovarian cancer, and women who have been treated for Hodgkin’s lymphoma.

Ultrasound – uses sound waves to produce images. The image may show whether a lump is solid, filled with fluid or a mixture of both.

Dr. Paula George is a breast radiologist with St. Luke’s Hospital and St. Luke’s CDI. To learn more about 3D mammography and preventive breast health, visit