Six months after Gritman Medical Center became the first site in the region to offer 3D mammography, doctors report finding at least five breast cancers that would have gone undiscovered using older two-dimensional breast cancer screening.
“There are five women walking around the Palouse right now who, without our 3D mammography system and our new CAD software, would have carried a breast cancer for another year or more,” said Dr. Christin Reisenauer, director of imaging at the Gritman Women’s Center.
In addition to offering low-dose 3D mammograms, Gritman is just one of nine hospitals worldwide using special Computer Aided Detection (CAD) software designed for use in evaluating images as part of a complete 3D mammography exam. The 3D system and CAD software are from Hologic, Inc. (NASDAQ: HOLX), the world leader in women’s imaging technologies.
CAD software uses a powerful computer to evaluate mammographic images to help doctors spot regions of interest they might otherwise have not seen. While CAD has been used for more than a decade with 2D mammography, Dr. Reisenauer is one of only a handful of doctors worldwide Hologic chose to evaluate CAD’s use with select images generated in a low-dose 3D mammography exam.
Mammographies are a crucial part of modern health care. About 1 in 8 U.S. women will develop invasive breast cancer over the course of her lifetime. After skin cancer, breast cancer is the most commonly diagnosed cancer among American women. The American Medical Association, the American College of Obstetricians and Gynecologists, the National Cancer Institute, the Mayo Clinic, the American College of Radiology and the American Cancer Society all recommend yearly mammography screening beginning at age 40.
What the figures show
Gritman installed Hologic’s new 3D system on April 15, the first site in the region to use this breakthrough technology. So far, Gritman’s Women’s Imaging Center has found:
• A 30% increase in total number of mammograms as compared to the same time period of 2013.
• 27 biopsy-proven and treatable breast cancers as compared to only 11 diagnosed tumors in that same period of 2013 - an astonishing 150% increase in breast cancer detection from conventional two dimensional breast cancer screening technology.
Dr. Reisenauer and her team examine each and every mammogram at Gritman. She reports at least five of those newly detected cancers would have escaped detection with a traditional two-dimensional screening exam.
“We were astonished to find these cancers were virtually invisible in the standard 2D image,” Dr. Reisenauer said. “The new 3D technology is allowing us to find breast cancers that were previously too small, faint or hidden to detect.”
A study published in the Journal of the American Medical Association in June reinforces Reisenauer’s findings. The study looked at 454,000 patients comparing 2D and 3D mammograms, using only Hologic’s 3D mammography systems, and found 3D technology resulted in a 41 percent increase in the detection of invasive breast cancers and a 29 percent increase in the detection of all breast cancers.
Dr. Reisenauer concedes that smaller sample size is a factor in the phenomenal 150 percent increase in detection rates observed by Gritman. But she also believes Gritman’s groundbreaking use of low-dose 3D mammography with the new CAD software was a contributing factor to their stellar results.
“It has long been known that because of dense tissue and other factors, conventional 2D mammography can miss 15 percent or more of breast cancers,” Dr. Reisenauer said. “With 3D mammography, we are more certain we will find the cancer if it is there and just as important, we are also more confident that the exam is truly negative when there is no cancer detected. This certainty benefits patients not only physically, but also their peace of mind.”
2D and 3D – what’s the difference?
A mammogram image makes the breast appear semi-transparent so doctors can see the blood vessels, glands, ducts and other structures inside, much like looking through a clear bowl of Jell-O with fruit in it. Cancers, however, can be hard to spot, especially if they are small and are concealed behind something else. A 3D mammogram creates a virtual 3 dimensional model of the breast which is divided into about 40 image “slices”. Doctors can study each 1 mm-thick slice separately, practically eliminating any place for a cancer to hide.
Computer Aided Detection (CAD) software is designed to flag suspicious structures that doctors might miss. The software literally places a marker over any suspicious area or shape for a physician to review and judge. Having CAD is like having a second reader evaluating the mammogram to hopefully increase cancer detection and to improve workflow efficiency. Computer Aided Detection has been almost universally used to analyze 2D mammograms for over 10 years, however until recently, CAD software was not available for use with the 2D portion of a low-dose 3D exam.
Because of Gritman’s proven commitment to women’s imaging, Hologic chose Dr. Reisenauer and her team to be one of an elite group of radiologists worldwide to try the new version of CAD that now analyzes the 2D images in a low-dose 3D exam. In addition to Gritman, leading medical centers and imaging practices in New York, California and Washington State were also involved in evaluating the software.
“Women are flocking to 3D mammography,” Reisenauer said. “I think it really exciting for our patients that Gritman, a relatively small hospital in Idaho, was chosen as one of fewer than ten facilities worldwide to evaluate and help perfect a breast imaging technology that is well on its way to becoming the highest standard for breast cancer detection yet developed.”