3-D Mammography: Changing How We See Breast Cancer

October 3, 2017 Lisa Tito, MD


Technology gives women and doctors a more comprehensive picture of breast health.

The recent news that Julia Louis-Dreyfus has breast cancer is a sobering reminder that women need all the tools at their disposal to fight this disease. And while tomosynthesis—better known as 3-D mammography—has only been around six years, since the first system was approved by the U.S. Food and Drug Administration in 2011, in that short time it has already helped women take a giant leap forward in how they monitor their breast health.

“When we first started using 3-D mammography, our radiologist found three to four cancers that wouldn’t have been found with a traditional mammogram,” says Lisa Tito, MD, a board-certified breast surgeon at St. Joseph Health Medical Group’s The Breast Center in Santa Rosa. “I saw that happen before my eyes; those were immediate results.”


The process for 3-D mammography is actually quite similar to traditional mammography. With a 2-D mammogram, the breast is compressed between two plates and two x-rays are taken of each breast to spot any abnormalities in the tissue. “With 3-D mammograms, the breasts are still compressed, but instead of the two x-rays, there are multiple x-rays, or cuts, taken of each breast that are used to create the 3-D images,” Dr. Tito says. “The scan takes about eight to 10 seconds, as opposed to two to three seconds for a regular mammogram.”


Because the x-rays are taken from several different angles, more of the breast tissue can be seen in the resulting images. “The 3-D mammograms are more sensitive and can pick up more instances of breast cancer than standard mammograms,” Tito says. “And one of the great things is it’s also more specific—it can tell a radiologist if something isn’t a cancer and there doesn’t need to be a work-up, so there’s a lower rate of false positives. Women don’t have to come back as often for additional views and, compared to regular mammograms, there’s a lower rate of unnecessary biopsies.”


The 3-D mammograms are used in conjunction with regular 2-D mammograms, because they both involve the same x-ray technology and can be done during the same session. That means there is a slightly higher radiation exposure for 3-D mammograms than regular ones.

But women who are concerned about radiation “have to balance that with the fact that over a lifetime of mammograms they’ll probably have less radiation exposure because they won’t have to undergo as many extra views to look at something that is questionable,” Dr. Tito says, adding that as the 3-D systems continue to advance, the 2-D component may eventually be dropped.

Any woman who is concerned about radiation, or the discomfort of an extended mammography session, shouldn’t let that stop her from getting a mammogram, Dr. Tito says. “The 10 seconds of discomfort for regular mammograms is better than four to six months of chemotherapy, and sometimes that’s what they’re trading off. When we find the cancer when it’s smaller, there are a lot more treatment options. It’s scary to think about breast cancer, but even if it feels overwhelming, come in and get a mammogram. We’ll be right by your side.”


Women should start their screening mammograms between the ages of 40 and 45.

However, as guidelines vary, Dr. Tito recommends women discuss this topic with their physician, who can assess their risk factors and health history for an individualized screening approach.



The Center for Breast Imaging and Diagnosis at St. Joseph Hospital, Orange

Queen of the Valley Medical Center (Napa)

Hoag (multiple locations in Orange County)

Mission Hospital (Mission Viejo)

St. Joseph Hospital, Eureka

This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.


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