Transcription:

Bill Klaproth (Host): Columbus Community Hospital offers 3D mammography or breast tomosynthesis for breast cancer screenings. These screenings have many advantages over other screening methods. Here to tell us more about those advantages is Dr. Anthony Krueger from Columbus Community Hospitals north central radiology. Dr. Krueger, thanks for talking with us today.

Anthony Krueger, MD (Guest): Hey Bill, thanks for having me.

Host: You bet. Dr. Krueger, let’s jump into this. Can you start off by telling us what is 3D mammography?

Dr. Krueger: Sure, yeah. So 3D mammography or 3D tomosynthesis is a three-dimensional picture of the breast. So historically we’ve had 2D or two-dimensional mammograms. What that would be is just like any 2D, like a piece of paper or a loaf of bread. You're just looking straight down on the loaf of bread. That would be 2D. What 3D is is actually taking that loaf of bread into slices and being able to look at each individual slice individually to help you get through dense breast tissue or any breast tissue at all. So breast tissue and cancers can look similar on mammograms. So it’s important to separate those out is what the 3D mammography helps you out by separating out the normal breast tissue from the cancers.

Host: Right. Are there other differences between 3D mammography and some of the other screening methods?

Dr. Krueger: Yeah. So most of the differences relate to the benefits of the 3D mammography. So it has better detection rates. It can diagnose breast cancers more accurately. The last time I checked, it had about a 20% increase in breast cancer detection rate versus the 2D mammograms. Actually, it also has a 40% decrease in call back rates. Meaning we might see something on the mammogram. We don’t know if it’s cancer or just normal breast tissue or just something else going on in the breast. We bring the patient back, historically with the 2D method, and we would compress the breast. Try to separate out that normal tissue form that breast cancer. Try to look at it on a different view. With 3D mammograms, we’re having all those individual slices to look. So that means we’re less likely to bring the patient back to do those extra views because we can tell what’s going on right away and not need to kind of separate out that breast tissue like we previously had.

Host: So how long has this method been available and how long has the hospital been offering this?

Dr. Krueger: So really the study started out with it right around the 2000s. I don’t know. Early 2000s. 2001 to 2010 range. They started doing studies on this. Just taking a modality that was present previously in other body parts, the tomosynthesis where you take those individual slices. You're kind of going on an arch around the breast taking individual x-rays. Then they put all that data together to put into slices. So that’s been around for quite a while. They just started using it with mammograms or doing research on it in the 2000s. They noticed that they were noticing a lot more of these breast cancers as opposed to the 2D method. So really became kind of more mainstream in probably right around 2014/2015. In Columbus, let’s see. They got this about three years ago in 2016. So we’ve been using it ever since then. Definitely been seeing lots more cancers and less call back rates.

Host: Well that’s really good information. So are there any risks associated with 3D mammography?

Dr. Krueger: No risks that you would have that are any different from the 2D mammogram. The only risk would be when you compress the breast in there, you could have some irritation of the skin or maybe some pinching of the skin or some bruising. That is also very rare and would be considered kind of a minor complication, if at all happened. As far as the risk of radiation or anything like that, the FDA has cleared 3D mammogram in the dosage used in the 2D or 3D mammograms and considered it safe for patients. It actually has very, very little radiation dose. You get radiation dose just from being in the environment. It comes up through the ground, comes down through by atmosphere. You can actually get about seven mammograms in one year and still have less radiation done than you would just walking around for a year on Earth. People obviously only get one mammogram a year. So very, very little dose.

Host: So totally safe when it comes to the radiation dose. Then when it comes to comfort, it seems to be an area a lot of women have an issue with is comfort. Is it any more comfortable for women?

Dr. Krueger: You know, it’s about the same. You still have to compress the breast with paddle. So they put kind of a detector on one side and another paddle on the other side and kind of compress down the breast a little bit. You probably could get away with just a little bit less compression. So it might be just a tad bit more comfortable to the patients, if anything. Since you're getting all that extra detail, those better images with the 3D, you don’t nearly have to squeeze the breast as much as you did before. Because before you were trying to separate out that tissue on a 2D image. Now we can separate out that tissue from the 3D images. So it might be a little bit more comfortable for the patient.

Host: How many patients does your team see on average either monthly or yearly?

Dr. Krueger: Yeah. So Columbus Community Hospital does about 4,000 mammograms in a one year period. That’s a pretty big number for a community this size.

Host: So that’s a really good number of people. Let me ask you this, Dr. Kreuger. How does it feel for you when you catch something that could have been missed using other methods?

Dr. Krueger: It’s a great feeling. Definitely a great feeling. The earlier you can detect these breast cancers, the better outcome the patient’s going to have. The less likely that it’s spread to anywhere else, to any lymph nodes or to anywhere else in the body. The earlier you catch it, it’s going to be localized to just that breast and the treatment options are very well if you can catch the breast cancer early. So anytime you can pick it up before it would have been detected on any other methods is a very, very good feeling. It makes you feel good for the patient that they’re likely going to have a better outcome.

Host: Well, that’s great to hear Dr. Krueger. That has got to be a really good feeling. So is there anything else you would like to mention about 3D mammography?

Dr. Krueger: I think the main thing is just to make sure that every woman is getting mammograms starting at age 40 and then continuing that every year is the main thing that I would like to get across.

Host: So starting at age 40 then is the guidelines?

Dr. Krueger: Yes. That’s the guideline by the American College of Radiology and many other cancer societies.

Host: Well that’s good to know and thank you for talking with to us today about 3D mammography. Really interesting. For more information about breast cancer screening at Columbus Community Hospital or to learn more about north central radiology, head over to columbushosp.org. That’s columbushosp.org. This is Columbus Community Hospital Health casts from Columbus Community Hospital. I'm Bill Klaproth. Thanks for listening.