Mammography:


3D MAMMOGRAPHY OFFERS MORE
ACCURATE SCREENING FOR
BREAST CANCER
A new three-dimensional system for
performing mammograms has been
approved by the FDA. The new system
was developed by Hologic Inc.

While current scans are all two-
dimensional, this new technology
hopes to be able to more accurately
diagnose and screen for breast
cancer. Providing doctors with both 2D
and 3D images, this new scanner
allows side-by-side comparisons for
analysis.

Existing 2D mammogram equipment is
often skewed as breast tissue may
mask small tumors. The new 3D
scanner possibly offers  more accurate
scans.

A benefit of the new screening
technology is that women may not
have to return for a second scan as
frequently, as the original scan will be
more thorough, offering much more
insight as to the current health of the
breast.


BREAST PEM IMAGING COMPARED
TO MRI
Breast MRI is considered the gold
standard in breast imaging. But new
data from a National Institutes of
Health-sponsored, multi-site study of
approximately 400 women with newly
diagnosed breast cancer shows that
positron emission mammography
(PEM) may reduce unnecessary breast
biopsies. The study found that PEM
was significantly more precise at
identifying benign and cancerous
lesions, known as positive predictive
value (PPV). As a result, clinicians may
be able to reduce unnecessary
biopsies.

A common complaint regarding breast
MRI is its tendency to identify
suspicious lesions which require
biopsies that ultimately are found to be
benign. This finding may be a welcome
outcome for women and physicians
looking to reduce the patient trauma
associated with biopsies, and for
payers looking to lower costs
associated with unnecessary
procedures. The study of 388 women
showed that PEM demonstrated a 6-
percent improvement in specificity at
comparably high sensitivity. PEM also
had 31 fewer unnecessary biopsies
and 26 percent higher PPV than
breast MR.

“The results of this study mean that
not only do physicians have an
additional, powerful tool to help treat
breast cancer but that PEM is a
legitimate and better alternative for the
16 percent of women who cannot
tolerate MR due to claustrophobia,
metallic implants, body habitus, or
gadolinium reaction,” says Wendie
Berg, MD, PhD, principal investigator
for the trial.  Berg’s article in the
January 2010 issue of Radiology
examined the reasons why high-risk
women who were recommended for an
MR breast screening test refused to
take the exam.
In the past when studies have looked
at MRI, it’s a very sensitive test and it
does show us additional cancer in a
high percentage of patients who have
it. But it’s problematic because it will
sometimes find additional lesions that
are not cancer and it’s been shown in
several recent cases that it does not
actually reduce the rate of positive
margins and it does not reduce the
rate of recurrence. So it’s
controversial. Meanwhile many of
these women will end up with
unnecessary biopsies and sometimes
even unnecessary mastectomies
because of findings that were
suspicious on the MRI.





DIGITAL MAMMOGRAPHY
Hologic Selenia  Digital Mammography
system:
Digital (computerized) mammography
is one of the most recent advances in
X-ray mammography.
In standard (analog) mammography,
images are recorded on film using an
X-ray cassette. The film is viewed by a
radiologist using a "light box" and then
stored in a jacket in the facility's
archives. With digital mammography,
the breast image is captured using a
special electronic X-ray detector, which
converts the image into a digital
picture for review on a computer
monitor. The digital mammogram is
then stored on the computer.
Radiologists who perform digital
mammograms can alter the orientation,
brightness and contrast of the image
after the exam is completed to more
clearly see certain areas if needed.
One of the most obvious benefits of
digital mammography is clear, crisp
imagery. Much more detail can be
seen in a digital image than in a
traditional film image, which leads to
more tumor detection at earlier stages.
This especially  useful for younger
women with dense breasts because it
can image them with significant detail.


OTHER DEVELOPMENTS
CT Laser mammography system by
Imaging Diagnostic Systems;

Digital mammography by GE
Healthcare;