Health & Medicine

As screening technology advances, recommendations for screening timelines remain

As we approach breast cancer awareness month, it's a good time to review the long-standing, scientifically proven guidelines for breast cancer screening.

Research continues to show that early detection of breast cancer is key to saving lives. The American Cancer Society and the American College of Obstetrics and Gynecology still recommend that women begin annual breast cancer screenings at age 40. Several large landmark studies, occurring over several decades, strongly support mammography starting at age 40 for patients at average risk, or earlier for those considered high risk, primarily due to a strong family history.

Most imaging centers have moved to digital mammography, which is faster and allows the interpreting physician to manipulate the images, adjusting the light and contrast, to get a better view of the breast tissue. Digital mammograms are stored electronically and easily retrieved for comparing current with prior studies. The radiation dose from 2-D digital mammography is slightly less than previous film screening technology.

The 2011 FDA approval of tomosynthesis — commonly known as 3-D mammography — has provided radiologists with yet another valuable tool in early breast cancer detection. Tomosynthesis produces a stack of images or multiple one millimeter slices of breast tissue, which allows the imaging physician to identify a true mass, often masked by overlapping shadows.

Using tomosynthesis, breast imaging experts can view complex, overlapping breast tissue one layer at a time, as opposed to the flat or two dimensional image created through traditional mammography. This technique is particularly helpful in screening women with moderate to extremely dense breast tissue.

Technology like tomosynthesis can not only help detect smaller, earlier cancers than traditional 2-D digital mammography, but is also working to reduce the incidence of patients being recalled after screening. This helps eliminate the undue stress and anxiety that leaves women wondering, "What is wrong? Do I have cancer?" when they are asked to return for additional images.

Today's 3-D mammographic technology is well established in many local breast imaging facilities. In our practice, we have diagnosed a number of cases of early breast cancer that we would never have seen on 2-D imaging alone.