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    Top tech advancements improving breast cancer screening


    Early detection of breast cancer continues to be the best way to save lives and decrease healthcare costs over time. The technology used to detect breast cancer continues to advance, finding masses when they are smaller, giving patients less invasive options for treatment.

    Traditional two-dimensional mammography is still used by most providers, making up 65% of units sold in 2016, according to a report by Technavio market research company. However, three-dimensional mammography, also called digital breast tomosynthesis (DBT), comprised 32% of mammography units sold in 2016.


    “DBT isn’t really the future of breast imaging anymore; it’s the present. More and more practices are adding 3D capability, and many practices are replacing many or all of their 2D systems,” says Jay A. Baker, MD, chief of the breast imaging division and vice chair of clinical affairs at Duke University Medical Center in Durham, North Carolina. “While tomosynthesis is not yet available everywhere, and I wouldn’t say it is standard of care, there seems little doubt that the 3D images are just a better mammogram, and it will become the standard in short order.”

    The demand for more concise breast cancer screening is on the rise, and providers will have to compete to offer more comprehensive imaging, says Maen Farha, MD, medical director of the MedStar Union Memorial Hospital Breast Center in Baltimore and faculty member in the department of surgery.

    “What drives 3D mammography in large cities is competition. If the neighboring hospital has it, other hospitals have to have it,” says Farha. “Though 3D has proved to reduce the recall rate, it takes a lot more time. It is not a clear-cut advantage. 3D mammography has a bigger benefit for women with dense breasts.”

    3D drawbacks

    Though 3D mammography is gaining adoption, larger file sizes can include up to 400 images, slowing down read time from radiologists and making file transfer between providers more difficult.


    “The biggest factor is how many exams can be read without the radiologist experiencing fatigue. Even if they don’t experience fatigue, the radiologist will have to keep up with the workload,” says Garnetta I. Morin-Ducote, MD, associate professor of radiology at the University of Tennessee Medical Center, Knoxville, Tennessee, and medical director of the school’s University Breast Center. She adds that it is also important that radiologists have workstations that can manage large file sizes that need to be accessed quickly, because sluggish IT system can impede work flow.

    Baker agrees, adding that traditional picture archiving systems (PACS) that most radiologist use to view 2D images cannot support 3D images, so a thorough IT assessment is also needed if switching to 3D.

    “Many radiologists have to read the tomosynthesis exams off a dedicated breast imaging workstation, often provided by the tomosynthesis vendor. Those same radiologists still use their traditional PACS to read ultrasound, MRI, and non-breast imaging exams. The challenge is that the image display technology that we rely on has, in many cases, not kept up with the new imaging technology,” Baker says. “PACS vendors are responding, and more and more PACS systems can display the 3D exams. But until a PACS system can be upgraded or replaced, many radiologists who read DBT exams must jump back and forth between their regular PACS and the breast specific workstation.”

    Next: Beyond tech advancements



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