Here’s where to find 3D mammography in the South Sound. It finds breast cancer sooner
When it was time for Dianne Munroe to get her annual mammogram, she decided to wait three months.
The move might have saved her life.
“Even though I had no symptoms, I decided I wanted to wait until the new breast center opened in Burien so that I could use the 3D machine,” Munroe said.
Three dimensional (3D) mammograms offer what their name implies: a 3D look at breast tissue.
“Instead of a piece a paper you’re actually looking at the layers of breast tissue like you’re flipping through the pages of a book” said Dr. Ani Fleisig, a surgical oncologist based at Highline Medical Center. “The detection rate is much better with 3D for that reason.”
Health centers all over Puget Sound have been switching to the new technology but not all yet.
Munroe, now 66, had been having annual mammograms since age 40.
“I was vigilant about breast health,” she said. Her mother had breast cancer in the 1990s.
Minutes after the 2016 exam, medical staff told her they needed more pictures. They had seen something suspicious.
“I kind of knew,” she recalled. “It was very small, a 1A,” she said, indicating a classification where the tumor is smaller than a peanut and has not spread to the lymph nodes.
Munroe was diagnosed with invasive ductal breast cancer. She had a lumpectomy, followed by radiation.
Because her cancer is hormone caused, she’s on a five-year course of hormone suppressants.
She also follows up with an annual 3D mammogram.
“I’m going into year four and the last mammogram in late September said everything is normal,” Munroe said. “I’m cancer free.”
3D mammography
“3D will become the standard across the country,” Fleisig said. “We only offer 3D mammography now. It’s standard.”
CHI Franciscan introduced the process in 2016 and has completely phased out 2D. It was approved by the FDA in 2011.
For decades, clinicians have used standard X-rays for mammography. But X-rays have their limitations. Notably, they superimpose imagery. That can mean trouble diagnosing cancer in women with denser tissue.
“That dense breast tissue can obscure or hide smaller cancers,” Fleisig said.
Clinicians now can have a virtual sphere, rather than a flat circle, to look at.
“You won’t potentially miss things that will be superimposed on more dense breast tissue,” Fleisig said.
Smaller, earlier stage breast cancers can be detected. Once cancer is diagnosed, the standard of care is the same.
Because Munroe had dense breast tissue, Fleisig thinks her cancer would not have been visible on a regular 2D mammogram.
“For her, it was actually very fortuitous that she waited,” Fleisig said. “If not, it would have been another year for that breast cancer to be diagnosed.”
If the cancer had gone undetected longer, Munroe might have required a mastectomy and/or chemotherapy, she said.
Munroe’s insurance hasn’t balked at the 3D procedure.
“The procedure was very similar (to 2D), and you probably wouldn’t know it was a different procedure,” Munroe said.
Breast health
3D mammograms don’t mean women should skip their annual check-ups, Fleisig said.
CHI Franciscan patient guidelines recommend beginning screening between ages 40 and 45. Fleisig suggests 40, with annual exams every year starting at 45.
“Everyone has different risk factors,” Fleisig said.
She recommends genetic testing if a close biological family member has had breast cancer.
Some of Fleisig’s patients think they don’t need mammograms if the cancer doesn’t occur in their family. That’s a mistake, she said. The majority of breast cancer cases do not have a heredity link.
As with most other cancers, survival rates go up based on earlier detection.
Fleisig also suggests self-exams.
“It doesn’t mean you need to do a monthly breast exam, but (you need) to know if there are any changes or anything abnormal,” she said.
If something is found, women should see their doctor immediately.
Smoking, excessive drinking and obesity are all lifestyle factors that increase the odds of breast cancer, she said.
3D has its critics
A recent story by Kaiser Health News said the health care industry is spending millions of dollars to promote 3D mammograms. The story questioned the procedure’s safety and effectiveness.
The Susan G. Komen breast cancer organization says 3D mammography gives the patient slightly more radiation exposure than standard 2D, but still within safety limits. It also says the effectiveness of 3D is under study.
A study published in the British medical journal The Lancet found no significant difference in detecting cancer between 2D and 3D. The article called for more study.
Where to find 3D mammography
▪ Franciscan Medical Pavilion, Bonney Lake
▪ Milgard Medical Pavilion at St. Anthony
▪ Carol Milgard Breast Center, Tacoma
▪ MultiCare Auburn Health Center
▪ MultiCare Gig Harbor Medical Park
This story was originally published October 30, 2019 at 6:10 AM.
