April 15, 2013 — Tomosynthesis (3-D mammography) is better able to show infiltrating ductal carcinoma than 2-D mammography in women at increased risk of breast cancer, a new clinical study shows.

As part of the study, six breast imaging specialists reviewed both 2-D and 3-D mammography images of 56 cancers diagnosed in patients at intermediate or high risk of breast cancer.

"We found that 41 percent (23/56 cancers) were better seen on tomosynthesis and 4 percent (2/56) were only seen on tomosynthesis," said Sarah O'Connell, a lead author of the study. Thirty percent of cancers (17/56) were better seen on 2-D mammography but none were only seen on 2-D mammography. The remaining were rated by the breast imaging specialists as being equally visible on both 2-D and 3- imaging, she said.

"The majority of cancers seen better or only on tomosynthesis were predominantly infiltrating ductal carcinoma, which typically presents as a mass, focal asymmetry or architectural distortion," said O'Connell.

The majority of cancers seen better or only on 2-D mammography were ductal carcinoma in situ (DCIS) which presents as calcifications, she said. "This was not surprising because tomosynthesis gives us the ability to scroll through the breast tissue in 1 mm sections, which provides us with more detail, but also may separate a cluster of calcifications, making them more difficult to identify," said O'Connell. O'Connell noted that work is being done to optimize visualization of calcifications on tomosynthesis.

The benefits of tomosynthesis are especially relevant to women at increased risk of breast cancer who have increased anxiety about breast screening and have the potential for biologically aggressive cancers, said O'Connell.

The study is part of the electronic exhibit program at the ARRS Annual Meeting in Washington, D.C.


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