Case Study | March 19, 2013 | Hologic Inc.

3D Mammography Minimizes Need for Follow-up in Hard to Reach Indian Population

Tséhootsooí Medical Center, Fort Defiance, Arizona

3D mammography (breast tomosynthesis) system

Christian Gomez, M.D., of the Tsehootsooi Medical Center, Fort Defiance, Arizona, credits the use of Hologic's 3D mammography system with helping its patient population avoid burdensome follow-up visits by providing more accurate, on-the-spot assessments of screening exams.


In 2011 Fort Defiance Indian Hospital changed its name to Tsehootsooi Medical Center. Tsehootsooi means \"meadow between the rocks.\" To the directors of the hospital and its board, it's about independence, part of the plan to separate the hospital from its past association with the Indian Health Service.

3D Mammography Minimizes Need for Follow-up in Hard to Reach  Indian Population

For years, high cancer diagnosis rates and limited access to quality health services plagued the Navajo residents cared for by the Tséhootsooí Medical Center in Fort Defiance, Arizona. 

Cultural, socioeconomic and distance barriers make it very difficult for women in the hospital’s service area to receive screening mammograms on a regular basis. The hospital experiences about a 50 percent no-show rate among its patients and only a staggering 20 percent of patients are able to return for follow-up visits.

“The majority of our patients live up to 200 miles away, roundtrip. Even if they can make the journey for their mammography screening exams, follow-up visits are usually out of the question. The challenge we’re facing is a ‘one and done barrier’ to patient care,” said Christopher Anthony, director of ancillary services at Tséhootsooí Medical Center. “If we don’t find the problem while the patient is here, we’re unlikely to get a second chance for further testing.” 

Faced with these daunting challenges, physicians at Fort Defiance felt tremendous pressure to provide their patients with the most complete and accurate mammography exams available and to drastically reduce the need to recall these patients. The hospital determined that the use of breast tomosynthesis, or 3D mammography, would make dramatic inroads in meeting the special needs of its patients. 

Tséhootsooí Medical Center installed a Hologic Selenia Dimensions tomosynthesis system in January of 2012 and its impact was felt immediately. During the first round of screening exams with the new system, a woman with extremely dense breasts was diagnosed with a stage 4 cancer that was not seen on the 2D digital mammogram.

Tomosynthesis provides a 3D image of the breast and gives radiologists a clearer view of areas within the breast that might otherwise be obstructed by overlapping tissue, if viewed on a conventional 2D mammogram. Although it provides benefit for all women, it is especially effective in women with dense breast tissue.  

A Quick and Conclusive Diagnosis Without Additional Imaging

“A lot of the credit for that positive reading has to go to the 3D mammography technology. The Dimensions system provided our physicians with a whole new vantage point for imaging the breast,” said Anthony. “Seeing the more complete view allowed our physicians to make a quick and conclusive diagnosis without requiring additional imaging. The ability to make a definitive diagnosis while the patient was here minimized the chance that she would be lost to follow-up, and let us get a head start on her treatment.”

Fort Defiance hopes that once word spreads about this new technology, patients will be less reluctant about coming in for their screenings, particularly if they are more confident they will receive conclusive results on their first visit, avoiding the burden of another long trip.

“Tomosynthesis helps our physicians provide more accurate, on-the-spot assessments, reduces our false positive recalls and minimizes the need for additional testing,” concludes Anthony. “We’re now able to provide a traditionally disenfranchised community the best possible care with limited time commitment on their end. We believe this will help save lives and provide women better peace of mind.”

Case study supplied by Hologic Inc.

The views and opinions expressed herein are those of Christopher Anthony and his colleagues at the Fort Defiance Indian Hospital and are not necessarily those of Hologic.

This information is intended for medical professionals in the U.S. and other markets and is not intended as a product solicitation or promotion where such activities are prohibited. Because Hologic materials are distributed through websites, eBroadcasts and trade shows, it is not always possible to control where such materials appear. For specific information on what products are available for sale in a particular country, please contact your local Hologic representative or write to [email protected].

Hologic, Dimensions and Selenia are trademarks and/or registered trademarks of Hologic and/or its subsidiaries in the U.S. and/or other countries.

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