Question:

There is a high rate of many cancers in my family, so I've decided to get yearly mammograms at just 46 years old. Which is preferred: 2D mammograms or 3D mammograms?

Answer:

Mammograms are x-rays taken of the breast to detect abnormalities. Due to increased risk for younger women, it’s important to question whether a mammogram is necessary if you are below age 50. Women who have an extensive history of breast cancer in their family may consider that a high risk factor.1

Recent technological advances have led to 3D mammography, or breast tomosynthesis. These mammograms produce a 3-dimensional image of the breast by using two devices: an x-ray tube and a “2D” mammogram machine. While the machine compresses your breasts, the tube takes several low-dose x-rays of your breasts at various angles.2 Afterwards, a computer pieces these x-rays together to form a 3-dimensional image. Conversely, 2D mammograms produce only a flat perspective of the breast. A machine takes x-rays of the breast tissue by compressing breasts between two plates to spread the tissue apart. There are two types of 2D mammograms: standard and digital. Standard mammograms use large sheets of film to produce photos; digital mammograms use a computer to produce and store photos. In our article “Digital Mammography: Is Newer Always Better?” we investigate how standard mammograms compare to digital mammograms.

By analyzing several studies, the National Women’s Health Network concluded that digital mammograms may hold potential benefits over standard mammograms. The use of digital technology allows images to be easily shared with other clinicians, which may benefit rural and underserved communities.3 Digital (2D) mammograms may also have a lower dose of radiation than film, whereas 3D mammograms use more radiation than 2D mammograms.4 However, 3D images may allow doctors to see the breast tissue more clearly, and some studies suggest it may find more cancers.5 Please keep in mind that while 3D mammograms are FDA approved, most insurance companies do not reimburse you for this exam.6 You may have to pay an additional fee if you have a 3D mammogram.

Ultimately, we recommend that you discuss the risks and benefits of each with your doctor to determine which method is best for you.


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References

1. http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-risk-factors

2.https://www.acrin.org/PATIENTS/ABOUTIMAGINGEXAMSANDAGENTS/ABOUTMAMMOGRAPHYANDTOMOSYNTHESIS.aspx

3. https://www.nwhn.org/digital-mammography-is-newer-always-better/

4.http://www.cancer.org/healthy/findcancerearly/examandtestdescriptions/mammogramsandotherbreastimagingprocedures/mammograms-and-other-breast-imaging-procedures-what-is-mammogram

5. http://www.cancer.org/healthy/findcancerearly/examandtestdescriptions/mammogramsandotherbreastimagingprocedures/mammograms-and-other-breast-imaging-procedures-what-is-mammogram

6. http://www.fda.gov/forconsumers/consumerupdates/ucm420463.htm