October 20, 2020

Should Your Mammogram Be 2D or 3D?

Mom and DaughterBy Cherry Odom, BSN, RN-BC

“We found 1,241 breast cancers across the Mission Health system in 2019. That is a lot of lives and families touched.”

Annual screening mammograms remain a woman’s first defense in early recognition of breast cancer. Advances in detection of breast cancer now provide women with options that tailor screenings adapted to the individual’s health history and breast anatomy.

2D and 3D Mammograms Defined

Sheri Fleeman, MD, mammogram radiologist at Mission Hospital McDowell and Breast Section Co-Medical Director of Mission Health, explained the difference between 2D and 3D mammograms: “A conventional 2D mammogram takes two pictures of each breast, one from the top and one from the side. A 3D mammogram, or digital breast tomosynthesis, takes hundreds of pictures from different angles that allow us to look at the breast tissue in multiple thin layers.”

Advantages of 3D Mammography

3D mammography is a more accurate mammogram. “It is a win-win,” said Dr. Fleeman. “The 3D decreases the likelihood that you will be asked to come back for additional images, and it increases the likelihood of detecting a cancer.” She added that studies have demonstrated a 10 to 30 percent increase in overall breast cancer detection over 2D mammography alone.

Recommended Mammogram

“I recommend 3D mammography for all women. It has become our new standard of care. You may request a 3D mammogram when scheduling the exam or at the time of the exam,” said Dr. Fleeman. No physician’s order is needed. Some insurance companies may add an upcharge for the 3D scan, so each woman should contact their insurance company before the imaging.

Men and Breast Cancer

Male breast cancer is rare — less than 1 percent of all breast cancers. “Men receive the same therapy as women, and 3D mammography is recommended,” said Dr. Fleeman. The symptom most common in men is a painless lump. Dr. Fleeman encouraged men to report lumps or anything they feel that is different or concerning in their breasts to their doctor.

Mission Hospital McDowell Breast Imaging

Both 2D and 3D mammograms are available at Mission Hospital McDowell Breast Imaging. A radiologist is in-house to read diagnostic mammograms ordered in the event of pain, lumps or nipple discharge and as follow-up screenings after breast cancer treatment. The patient receives the results of the diagnostic reading before they leave the building. Results for routine screening mammograms are sent to the patient within one week.

Breast MRI is offered, and stereotactic breast biopsy will be available by the end of 2020, allowing the biopsy to be guided by X-ray images using the mammogram machine.

No Longer “One Size Fits All” Screening

In the coming weeks this year, Mission Health will offer a complete risk assessment based on a questionnaire about breast density and family and personal breast cancer history. This will help determine someone’s lifetime risk of developing breast cancer and guide the type, frequency and starting age of annual screenings recommended by the American Cancer Society, the American College of Radiology and the Society of Breast Imaging.

Screening options in addition to mammograms include automated breast ultrasound (ABUS), breast MRI and genetic testing. It is more important than ever for women to ask questions and become more informed about breast health.

Mammograms Save Lives

Annual screening mammograms save lives through early cancer detection, and women are less likely to have more intensive treatment, such as mastectomy or chemotherapy. “While our governing bodies, such as the American College of Radiology, Society of Breast Imaging and American College of Obstetrics and Gynecology, do not provide guidelines on routine breast self-exams, I believe there is value in being familiar with how your breasts look and feel so you will understand what is normal for you,” said Dr. Fleeman.

Breast Screenings during COVID-19

“Unfortunately, breast cancer does not stop, even amid a pandemic,” said Dr. Fleeman. “We have implemented safety precautions such as masking, social distancing, and proper equipment and room sterilization between patients to ensure your safety, because mammography still saves lives. We are committed to your health and wellness and encourage you to keep up with your medical care, including scheduling your mammogram. We found 1,241 breast cancers across the Mission Health system in 2019. That is a lot of lives and families touched.”

What breast screenings should I get? You can call 828-213-9500 to talk with a radiologist from RadReach, Mission Health.

Sheri Fleeman, MD, is a mammogram radiologist at Mission Hospital McDowell and Breast Section Co-Medical Director of Mission Health.

To schedule a mammogram, call 828-213-9729. To learn more about women’s imaging services at Mission Health, visit missionhealth.org/pink.