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3-D Mammogram Makes Better Breast Cancer Test, Study Says

Adding a three-dimensional mammogram to traditional screening caught more deadly breast cancers than standard scans alone and resulted in fewer women being called back for more tests because of unclear findings, a study found.

When combined, the two screening methods caught 41 percent more cancers than traditional mammography alone, according to research funded by Hologic Inc., maker of the 3-D test, and published in the Journal of the American Medical Association. With the combination approach, 15 percent fewer women had to get more tests because of hazy results, researchers said.

The study is the largest to evaluate the effectiveness of 3-D mammography, a technology approved by U.S. regulators in 2011 that is not as widely available as conventional screening, the authors said. The method lets doctors see through the layers of the breast like the pages of a book to find cancers that may not be detected in traditional 2-D test, they said.

“We have a technology that is improving upon the main limitations of standard mammograms,” said lead study author Sarah Friedewald, section chief of breast imaging at Advocate Lutheran General in Park Ridge, Illinois, in a June 23 telephone interview. “We now have a more accurate examination.”

The U.S. Preventive Services Task Force, an independent medical advisory group to the government, in 2009 recommended against routine mammograms for women ages 40 to 49 who aren’t at an increased risk for breast cancer, while suggesting a mammogram once every two years for those 50 to 74. The guidelines recommended against annual screenings for women in their 40s because they are more likely to get false-positive results that can lead to unnecessary biopsies.

The American Cancer Society suggests annual mammograms starting at 40.

Tomosynthesis Technology

More than 232,000 women and 2,360 men will be diagnosed with breast cancer this year, according to the National Cancer Institute. About 40,000 will die.

The 3-D technology, known as tomosynthesis, is designed to detect tumors that overlapping tissue can mask in conventional mammogram images. Currently, Bedford, Massachusetts-based Hologic has the only approved 3-D mammogram device in the U.S. More than 1,100 of these devices are in use nationwide, said Peter Valenti, division president of Breast and Skeletal Health Solutions at Bedford, Massachusetts-based Hologic. About six million women in the U.S. will be screened this year with a Hologic device, he said.

“The results of the JAMA study are very significant when translated into real world numbers,” Valenti said in an e-mail. “If 3-D was the standard of care in the U.S., more than 500,000 women each year would not have to undergo the anxiety, lost work time of a recall.”

Hologic rose 1.8 percent to $25.60 at 4 p.m. in New York trading.

Study Findings

Researchers looked at 281,187 digital mammograms and 173,663 digital mammograms plus 3-D mammograms during the study. They found that the addition of 3-D mammography reduced by 15 percent the times women had to come back to the office for additional testing. The researchers didn’t calculate the amount of unnecessary biopsies, Friedewald said.

Rachael Bennett, an analyst at Dallas-based MD Buyline, which provides research for health-care systems, said about 80 percent of hospitals they assist have purchased Hologic mammogram systems. Half of those bought 3-D systems and the others bought standard systems that could be upgraded to 3-D. The 3-D systems cost about $400,000 to $450,000 on average, while the Hologic 2D system costs about $300,000, she said.

Medicare and many insurance companies are not reimbursing hospitals for mammograms using the 3-D systems yet, Bennett said. Some hospitals are absorbing the cost, while others are passing along the cost as fees to patients, she said

Etta Pisano, dean of the College of Medicine at the Medical University of South Carolina in Charleston, who wrote an accompanying editorial, said more studies are needed to better identify who would benefit most from this additional technology.

“This is a promising technology,” she said in a June 23 telephone interview. “I don’t think women have to seek it out yet. It’s a higher radiation dose, it’s more expensive. Should everybody get it? We’re not there yet.”

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