Breast cancer continues to be the most common malignant tumor and cause of death among women in this country. Until now, mammography has been the technique of choice in screening and the only to have produced a long-term fall in mortality. However, although the technique is very simple, up to 20%-30% of breast cancers may not be detected in conventional, or 2D mammographic screening. For that reason, MD Anderson Madrid has installed new tomosynthesis mammography equipment and, as Dr. Javier Blázquez, head of the Radio-diagnostics Service at MD Anderson Cancer Center Madrid, explains, “the development of the 3D image and the implementation of tomosynthesis has been a revolution in improving the diagnostic process, with the detection of 41% more cases of invasive breast cancer”.
Tomosynthesis is a diagnostic technique that makes it possible to reduce the tissue superposition in the image as the system sequentially captures consecutive views of the breast using a low dose of radiation. In tomographic breast studies, the x-ray tube moves tracing an arc, which depending on its size, permits the obtention of a variable number of projections on different planes and with 1mm thick slices. The data obtained are then reconstructed and from there, consecutive images of the breast are obtained allowing better detection and characterization of breast lesions.
So, unlike conventional mammography, tomosynthesis has improved the detection of lesions in dense breasts, common in young women above all. “The lesser sensitivity of conventional mammography in dense breasts is related to the characteristics of the 2D technique. As it is a bi-dimensional image, it is more difficult to identify possible malignant lesions or creates false positives of suspicious images”, points out Dr. Silvia Castilla, radiologist with the Breast Tumor Unit at MD Anderson Madrid.
This quality helps to reduce the number of biopsies and, above all, the number of patient recalls. “It used to be common to look at a lesion and not be able to tell for sure if the image was unclear due to tissue superposition or because of a real, underlying lesion. The solution was to compress the breast in that place and carry out a new magnified projection of the area to see if the superposition had disappeared or not. With images obtained with tomosynthesis, the problem is removed in most cases”, says Dr. Blazquez.
Reduction in the dose of radiation and greater comfort for the patient
Along with tomosynthesis, MD Anderson Cancer Center Madrid has also incorporated C-View technology in their Radio-diagnostics Service, which means screening can be carried out using a 2D synthesized image, which is very similar to a conventional mammogram. This technology provides an image of the breast blending the data from the different tomosynthesis slices acquired during the mammographic examination.
The main advantage of the new system is that is provides material that is extrapolable to 2D digital mammography, but with a lower dose of radiation. “Furthermore, the combination of 3D tomosynthesis images and 2D C-View images is produced with the breast compressed for a shorter time, which is very positive in terms of comfort for the patient”, concludes Dr. Castilla.