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Breast cancer checks go 3D

Union Leader Correspondent

March 08. 2013 11:15PM

Dr. Ophelia Chang of St. Joseph Hospital stands with the Breast Care Center's new 3D mammography machine. (KIMBERLY HOUGHTON/Union Leader Correspondent)

NASHUA - Technological advances are offering doctors a better way to screen patients for breast cancer, prompting a local hospital to lead the way with three-dimensional mammography.

The Breast Care Center at St. Joseph Hospital is one of the first women's centers in New Hampshire to offer 3D mammography - known as tomosynthesis - for breast cancer screening. The 3D mammography is the most advanced technology in breast cancer detection, allowing doctors to see smaller cancers sooner than traditional, two-dimensional mammography, said Dr. Ophelia Chang, medical director of Breast Care Services at St. Joseph's.

"Cancer can be very subtle in mammograms. We have already found some cancers that we wouldn't typically find, using this new technology," said Chang, who is passionate about providing every patient with the tools necessary to fight breast cancer.

Chang said breast tomosynthesis helps radiologists see breast tissue better by decreasing the effect of overlapping areas. The 3D images can pick up subtle distortions that may not be visible until years later when using traditional screening methods, she said.

Breast cancer screening with tomosynthesis - when combined with a conventional mammogram - has a higher cancer detection rate than conventional mammography alone, according to a release.

Studies show that the 3D technology improves detection of breast cancers with a significant reduction in recall rates, according to the hospital. During a tomosynthesis examination, multiple, low-dose radiation images of the breast are acquired at different angles.

The images are then used to produce a series of one-millimeter thick slices that can be viewed by radiologists as a 3D construction of both dense and fatty breasts.

"Most patients who benefit from tomosynthesis never even know it," said Chang, explaining that false positives found using the 3D technology are significantly less than traditional mammography.

If something unusual is found during a mammogram, tomosynthesis can be used to immediately determine whether the abnormality is trivial, or whether it is something that would require a biopsy and further investigation.

Many times, the 3D screenings will determine that the abnormality was insignificant - nothing that would cause a doctor alarm. But if the same abnormality was found using traditional mammography, that patient could go home with serious but unwarranted concerns, Chang said.

"There is no arguing with technology. This is all about the health of the women in the community," she said.

The 3D mammography was first used at St. Joseph's on Feb. 11. Currently, about 9,000 patients are screened at the local Breast Care Center each year, said Chang, who hopes more women will be routinely screened because of the latest technological advances. Chang said it took several tries to get the $1 million tomosynthesis machine, but she is pleased to be one of the first in the region to offer the 3D services.

"It really is adding the smarts and intelligence to the technology that was already in existence," she said. "It is leveraging the digital technology into something much more."

The radiation dose for 3D mammograms is about equal to those mammograms conducted before digital mammography in 2007. However, when compared to the digital mammograms most recently performed, there is about twice the radiation with tomosynthesis, Chang said.

Patients uncomfortable with the radiation may opt out of the 3D mammogram, but Chang said only one or two patients have decided not to use the technology since it was first offered last month.

Statistics indicate that one in eight women will develop breast cancer and the stage at which breast cancer is detected influences survival.

If the cancer is detected early, the five-year survival rate is 98 percent, according to the American Cancer Society.

Patients are encouraged to check with their providers to determine whether tomosynthesis is covered in their health insurance plan.

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