MAMMOGRAMS: The difference in resolution between standard and 3D mammography.
MAMMOGRAMS: The difference in resolution between standard and 3D mammography. Contributed

Make an informed decision on 2D or 3D mammography

SINCE the relaxation of the rules around medical services advertising a raft of competing radiology businesses are promoting all that is on offer including the very latest in breast imaging.

One service being actively pushed is 3D mammography, which for many women may not be necessary suggests Dr Deborah Pfeiffer, past president of the Australasian Association of Breast Physicians.

"I am concerned about the commercial advertising of breast imaging services without women understanding the basis of its need," Dr Pfeiffer said.

"Once upon a time, most women went to their doctor to ask who they should see for certain tests.

"Now women increasingly go to their doctor and tell them what they want."

So, while women may be better informed about what is available, they don't necessarily fully understand what is needed.

Depending on a women's breast density, 3D imaging may offer a significant advantage in detecting notable changes.

Currently Breastscreen Australia only offers conventional digital 2D mammography while 3D mammography, or tomosynthesis, is only offered through private providers.

"The difference between the two is that standard digital mammography uses two images of the breast in opposite planes and gives a high-quality image of the breast structure, but has some shortcomings, particularly in very dense breasts," Dr Pfeiffer said.

"3D images take more pictures, still in two views and with a slightly higher dose of radiation, and then uses a computer program to construct a three-dimensional view."

For women with very low-density breast tissue, 3D imaging doesn't offer any significant advantage, but for women with medium density, it could make the difference in being called back or not called back for investigation of a possible abnormality.

For women with high to extremely high density, 3D is better than 2D, but they may still need to also have an ultrasound.

The downside to 3D imaging is that it's more expensive and not fully covered by Medicare.

So, it comes down to a woman determining through her GP or specialist, whether the expense of 3D mammography is justifiable for them.

"For some women, it's not worthwhile, but for others, they should always have it," Dr Pfeiffer said.

Dr Pfeiffer points out that 3D imaging doesn't replace an MRI investigation which is only applicable for a small number of women.

To find out more breast imaging, contact your GP or BreastScreen Australia.

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