Let's learn about the modern 3D mammogram test (Tomosynthesis) to detect breast cancer.

If you're going to get screened for breast cancer , you've probably heard this new word: 'tomosynthesis.' While the name may sound a bit complicated, it has a very simple and very important idea. Simply put, it's a special mammogram test that takes three-dimensional (3D) images of the breast . Let's talk about it all in simple terms today.

What exactly is Tomosynthesis?

Imagine your doctor telling you about this test. He might call it digital breast tomosynthesis (DBT), or he might simply call it 3D mammogram . These are all the same thing.

This test is used in two ways:

1. Screening (tests done without any symptoms): An annual or periodic test to detect breast cancer early, even if you have no symptoms.

2. Diagnostic: This test is done to look deeper into the matter if you have symptoms such as a lump in your breast, discharge from your nipple, or if there is anything suspicious in a previous test.

But one thing must be kept in mind. Neither a regular mammogram nor this 3D mammogram can be 100% certain that you have cancer . For that , a biopsy is definitely required, which means taking a small piece of tissue from the breast and testing it.

How is this different from a regular mammogram?

This difference is very easy to understand.

A typical, two-dimensional (2D) mammogram takes two pictures of one of your breasts: one from the top down and one from the side. This is like looking at two pages of a book at once. Sometimes, a small cancerous lump hidden within the breast tissue can be hidden from view. Or, even normal tissue can be mistaken for a lump.

But in tomosynthesis, the X-ray machine moves in an arc around your breast, taking many pictures from different angles. Then a computer combines all these pictures to create 3D images that can be viewed in “slices” of your breast tissue.

This is like cutting a loaf of bread into slices. Then you can clearly see if there is anything inside. Therefore, if something is unclear during a regular mammogram , the number of callbacks is greatly reduced under this method. Also, research has shown that this method can detect more cancers than regular mammograms.

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How do you face this test?

Having this test is no different than having a regular mammogram. You don't have to worry about it.

Preparing before the test

• Do not apply deodorant, talcum powder, oils, or lotions to the armpits and chest area on the day of the test. These can show up as white spots on the X-ray images.
• You'll find it easier to wear a two-piece outfit (e.g. pants or a skirt and a blouse) because you'll have to remove the top from the waist.
• It's better to leave jewelry like necklaces and earrings at home.

During the test

When you are taken to the X-ray machine, the technologist will adjust the machine to your height and gently compress your breast between two plates. The best images are obtained when the breast is slightly flattened.

It actually only takes a short time to take the picture, about 4 seconds . During that time, you are asked to hold your breath. Then the pressure is released and the same is done for the other breast. The entire test takes about 30 minutes .

Is this painful?

It is normal to feel some discomfort during any mammogram examination. This is because the breast is compressed. In tomosynthesis, this compression is only a few seconds longer than in a regular mammogram. Therefore, there is no significant difference in pain.

There are things you can do to reduce pain:

• If you are menstruating, schedule the exam about a week after your period ends . Breast tenderness is less during this time.
• If you do not have any other medical conditions, you can ask your doctor and take a pain reliever like Ibuprofen or Acetaminophen about an hour before the test.
• If you're nervous about the test, listen to calming music and take deep breaths.
• Most importantly: If you feel pain, don't be shy about telling the technician.

What are the benefits and risks of this?

Main advantages

• Fewer false alarms: With clear 3D images, there are fewer cases where normal tissue appears suspicious. This means less unnecessary fear and fewer repeat tests.
• Detecting more cancers: According to research, this method can detect about one additional cancer per 1,000 women compared to a regular mammogram.
• Best for dense breasts: Some women have more glandular tissue than fat in their breasts. These are called 'dense breasts'. This dense tissue appears white on a regular mammogram, which can hide a cancerous lump. But this problem is much less common with 3D.

Possible risks

As with any medical test, there are minor risks.

• Low radiation exposure: Depending on the machine used, the radiation level may be the same as a regular mammogram or slightly higher. However, this amount is completely safe for health .
• False positives: A test that shows something suspicious, but later tests confirm it is normal. This can happen with any mammogram.
• Missed Cancer: Any mammogram can miss very small or difficult-to-detect cancers. That's why it's important to get tested at regular intervals .

How do I get the test report?

After the exam, a radiologist will review all of your new 3D and 2D images. Your doctor will receive the report within a few days, and he or she will notify you.

The result of the report may be:

• There are no signs of cancer.
• Or that further examination of a suspicious area is needed. For that, ultrasound,An MRI or biopsy may be recommended.

Remember, being referred for further testing does not mean you have cancer. Most of the time, after those tests, everything is confirmed to be normal.