YOUR MAMMOGRAM - A CLOSER LOOK
Amy Patel MD, Breast Radiologist

Why

Your mammogram, take it seriously, ask questions and know more than I did! How did I not know to ask for 3d? Why did I always get a note saying dense breasts but had no idea this was a huge risk factor for me? I am so honored and grateful for my medical advisor, Dr. Amy Patel, for her amazing work and dedication on this topic to educate and empower women about their mammograms, let’s take a closer look, it could be life-saving.

xxoo, Cynthia

2D mammography are images taken while the x-ray tube is stationary. Therefore, the images produced are in static form where they are not stacked layers like pages of a book where you can look into the pages, similar to looking at a CT Scan. As a result, because the extreme limitation of 2D static images, it makes interpretation difficult, especially if you are a patient with dense breast tissue, as cancers may be hiding in the tissue that are unable to be seen because of the limitation.

2D Mammography

For over thirteen years, I received normal mammograms but with a note saying extremely dense breasts. Each year I continued to get my 2D mammogram, not knowing the difference in the level of accuracy a 3D mammogram would have provided. I was never informed about the risk factor of having dense breasts, they show up white on a mammogram and so does a tumor, making it very difficult for the radiologist to detect cancer.

What is the difference between 2D and 3D Mammography?

3D mammography is where the images are acquired while the xray tube is in motion. Those images are then combined into a single stack which is read at the workstation by the radiologist by scrolling through the images, similar to a CT scan or turning the pages of a book. With this technique, one is able to see subtle findings between the slices of the images so that if a tiny cancer is hiding, for example, in dense tissue, it will be more conspicuous to the eye as it is able to be viewed in a 3D dimensional manner unlike 2D mammography which acquires static images.

3D Mammography

How does a mammogram help with early detection for breast cancer? Since the advent of screening mammography programs in the United States in the 1980's, the breast cancer death rate has plummeted over 35%! If a cancer is detected when small (i.e, less than 1 cm (about 0.39 in), stage 1) your survival probability is close to 100%. However, if a cancer is found greater than 5 cm (about 1.97 in) with additional spread (stage IV), survival probability plummets to 10-20%.

Early Detection for Breast Cancer

It wasn't until I got an ultrasound that my tumor was confirmed. I never understood why I had not gotten supplemental screening when I was informed that I had dense breasts. I had no idea this would be risk factor for breast cancer-did you? Ask for supplemental screening if this happens to you!

Behind the Screens

Advances include integration of artificial intelligence in mammography and continue refinement of the 3D mammography modality to ensure better visualization and characterization, such as subtle findings like microcalcifications.

Advances in 3D Mammography

The Future of Artificial Intelligence

The Future of Artificial Intelligence
Mammography

What is it? AI is subsegment of computer science that develops algorithms that mimic intelligent human behavior such as learning, recognizing patternes, reasoning, and solving problems. When it comes to mammography, we are hopeful AI can help aid us in earlier cancer detection, accuracy, and combat areas such as interpretation fatigue and burnout.

Artificial Intelligence and Mammography

In breast imaging, AI tools have the potential to drastically improve our diagnostic accuracy and support our decision-making — to improve practice efficiency and the delivery of precision care. However, as a profession, we must assert that we cannot and will not be replaced.

We must make ourselves available to referring physicians to discuss diagnoses and treatment of patients. In breast imaging, discussing a result with the patient is central to what we do, particularly with diagnostic examinations. This puts patients’ minds at ease, especially if they have had a previous cancer diagnosis. Although applications of AI in medical imaging have the potential to create monumental changes in radiology, it is this human touch that cannot be replaced. Thus, radiologists will always add value, where technology alone cannot.

How does it help detect cancer?

Where can you find it? Do you need to ask for it? AI integration into mammography is still emerging, and institutions who are utilizing AI are in the clinical research phase. Is it the future of Mammography? AI holds promise for diagnostic accuracy, radiologist efficiency and interpretation fatigue, so many of us are hopeful of its future implications. How much more accurate is it than 3D? 3D mammography is showing in multiple studies approximately 2 additional cancers seen per 1000 screening mammograms.

AI-The Future, Accuracy and where to find

Amy Patel MD

Breast Radiologist

Dr. Amy K. Patel is a Board-Certified Radiologist who specializes in Breast Imaging. She is a Breast Radiologist, Medical Director of The Breast Care Center at Liberty Hospital, and Assistant Professor of Radiology at the University of Missouri-Kansas City School of Medicine.

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