This month’s “Ask The Doctor” is the first in
a continuing series planned to keep our readers
up-to-date on health issues. Since October
is National Breast Cancer Awareness Month,
we’ve selected a timely first topic.
Q. What is mammography?
A. Mammography is an X-ray of the
breast used to detect breast cancer at an
early stage, when it is easier to treat.
Q. Who should have a mammography?
A. The American Cancer Society suggests
women consider starting annual screening
sometime between the ages of 40-44 to get
a “baseline” mammogram and continue
being screened every year until age 54.
Women age 55 and above can reduce the
screening frequency to every other year or
continue annual screening if they prefer.
Q. What is the difference between 2D
and 3D mammography?
A. If you have had a mammography in
the past, it was probably the traditional
method, also called “2D mammography,”
which produces digital images of your
breasts for viewing by a radiologist. The
brightness and contrast of the image can be
adjusted and the radiologist can zoom in
on specific areas to help detect small calcifications
(deposits of calcium), masses or
other possible early signs of cancer.
The breast is three-dimensional, made
up of blood vessels, milk ducts, fat and
ligaments. To better view your breasts, 2D
mammography can be supplemented with
a revolutionary method called 3D mammography
(also known as breast tomosynthesis).
With 3D mammography, digital
images of thin slices of the breast are taken
from different angles. Computer software
is used to reconstruct the slices images into
what is essentially a 3-dimensional mammogram
that can be examined one layer at
Q. What are the benefits of 3D mammography?
A. Screening for breast cancer with 2D
mammography together with 3D mammography
has been shown to increase
detection of cancer, especially for patients
with dense breasts.
Q. Are there other types of breast screening
A. If a mammogram shows you have
dense breast tissue, an ultrasound screening
is recommended for a complete evaluation.
Screening breast MRI is another effective
modality for breast cancer detection that
may supplement your mammography.
Q. If I have dense breasts, do I only need
A. No, mammograms are still the primary,
most sensitive imaging method for finding
breast cancer. Also, comparing your
mammogram with a previous year’s exam
allows small changes to be noticed. Mammogram
is the only approved stand-alone
screening imaging study for the breast. All
others are considered adjunct or supplemental
Q. Does insurance cover 3D mammography?
A. Some, but not all insurance companies
currently cover 3D mammography. If your
insurance does not cover it, some hospitals
will only charge for an out-of-pocket cost.
Breast screening services
Hospital breast centers with comprehensive
services generally offer 2D and 3D
mammography, breast MRI and breast ultrasound.
Dr. Norman Lee is a board-certified radiologist
with subspecialty fellowship training
in breast imaging. He is the medical director
of the Phelps Breast Imaging Center, which
is designated as a Breast Imaging Center of
Excellence by the American College of Radiology’s
Commission on Breast Imaging.