The goal of breast cancer screening is to find breast cancer early when it may be easier to treat. Researchers are doing this trial because they do not know if 3-D is better than 2-D mammography for breast cancer screening. Another important aspect of the trial is to build a tissue bank for future research. All women who join the trial will be asked to submit tissue samples, such as blood and swabs of cells from inside their mouths.
Risks and benefits[ edit ] Normal left versus cancerous right mammography image. The use of mammography as a screening tool for the detection of early breast cancer in otherwise healthy women without symptoms is controversial.
The Cochrane Mammographic tomosynthesis of screening indicates that it is "not clear whether screening does more good than harm". According to their analysis, 1 in 2, women will have her life prolonged by 10 years of screening, while 10 healthy women will undergo unnecessary breast cancer treatment.
Additionally, women will suffer from significant psychological stress due to false positive results.
Most of these recalls will be false positive results. Of every 1, U. Of the 10 referred for biopsy, about 3. Mammography may also produce false negatives. Furthermore, one form of breast cancer, lobular cancer, has a growth pattern that produces shadows on the mammogram that are indistinguishable from normal breast tissue.
Mortality[ edit ] The Cochrane Collaboration states that the best quality evidence does not demonstrate a reduction in mortality or a reduction in mortality from all types of cancer from screening mammography.
For women ages 40 to 49, 2, women would need to be screened at the same frequency and period to prevent a single death from breast cancer. There are four categories of cancers found by mammography: Cancers that are so easily treated that a later detection would have produced the same rate of cure women would have lived even without mammography.
Cancers so aggressive that even early detection is too late to benefit the patient women who die despite detection by mammography. Cancers that would have receded on their own or are so slow-growing that the woman would die of other causes before the cancer produced symptoms mammography results in over-diagnosis and over-treatment of this class.
A small number of breast cancers that are detected by screening mammography and whose treatment outcome improves as a result of earlier detection. Clinical trial data suggests that 1 woman per 1, healthy women screened over 10 years falls into this category.
These patients are then referred for further, usually more invasive, testing. Thus a screening exam is not intended to be definitive; rather it is intended to have sufficient sensitivity to detect a useful proportion of cancers.
The cost of higher sensitivity is a larger number of results that would be regarded as suspicious in patients without disease. This is true of mammography. There is a trade-off between the number of patients with disease found and the much larger number of patients without disease that must be re-screened.
Research shows  that false-positive mammograms may affect women's well-being and behavior. Some women who receive false-positive results may be more likely to return for routine screening or perform breast self-examinations more frequently. However, some women who receive false-positive results become anxious, worried, and distressed about the possibility of having breast cancer, feelings that can last for many years.
False positives also mean greater expense, both for the individual and for the screening program. Since follow-up screening is typically much more expensive than initial screening, more false positives that must receive follow-up means that fewer women may be screened for a given amount of money.
Thus as sensitivity increases, a screening program will cost more or be confined to screening a smaller number of women. Overdiagnosis[ edit ] The central harm of mammographic breast cancer screening is overdiagnosis: Gilbert Welcha researcher at Dartmouth College, states that "screen-detected breast and prostate cancer survivors are more likely to have been over-diagnosed than actually helped by the test.
This means an over-diagnosis rate of women per 10, invited to screening. Estimates of the false negative rate depend on close follow-up of a large number of patients for many years.
This is difficult in practice because many women do not return for regular mammography making it impossible to know if they ever developed a cancer. In his book The Politics of Cancer, Dr.
Epstein claims that in women ages 40 to 49, 1 in 4 of cancer is missed at each mammography. Researchers have found that breast tissue is denser among younger women, making it difficult to detect tumors. For this reason, false negatives are twice as likely to occur in pre-menopausal mammograms Prate.
This is why the screening program in the UK does not start calling women for screening mammograms until age In the case of permitted digital reproduction, please credit the National Cancer Institute as the source and link to the original NCI product using the original product's title; e.g., “TMIST (Tomosynthesis Mammographic Imaging Screening Trial) was originally published by the National Cancer Institute.”.
Although tomosynthesis – or 3D mammography – has only recently emerged as a promising tool in breast cancer detection, image acquisition and interpretation strategies are now being optimized through technological and reading workflow improvements, according to expert discussions at the European Congress of Radiology.
Digital tomosynthesis of the breast is different from a standard mammogram in the same way a CT scan of the chest is different from a standard chest X-ray.
Or think of the difference between a ball and a circle. Tomosynthesis, also digital tomosynthesis (DTS), is a method for performing high-resolution limited-angle tomography at radiation dose levels comparable with projectional attheheels.com has been studied for a variety of clinical applications, including vascular imaging, dental imaging, orthopedic imaging, mammographic imaging, musculoskeletal imaging, and chest imaging.
Tomosynthesis, a 3D-imaging technique recently approved by the FDA, is reported to improve breast cancer detection and reduce the number of patient recalls. Update - The following Q&As address Medicare guidelines on the reporting of breast imaging procedures. Private payer guidelines may vary from Medicare guidelines and from payer to payer; therefore, please be sure to check with your private payers on their specific breast imaging guidelines.