Advanced dimensions in breast cancer detection

Roseville clinic offers 3D mammography
By: Stephanie Garcia, Press Tribune correspondent
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Radiological Associates of Sacramento (RAS) is Northern California’s premier provider of specialty health care services, including diagnostic radiology, interventional radiology and interventional neuroradiology, radiation oncology, PET/nuclear medicine, hematology/medical oncology, gynecologic oncology, urology and thoracic/vascular surgery.

Where: 1640 East Roseville Parkway No. 100, Roseville

Phone: (916) 784-2277


Starting April 1, doctors in California must tell patients if a mammogram reveals they have dense breasts. Last September, Gov. Jerry Brown signed a law requiring health facilities to explain that breast density is associated with a higher risk of breast cancer, that it makes mammograms harder to read and that “a range of screening options are available.” Breast cancer risk is affected by a variety of factors, among them the density of breast tissue (meaning more glands and fibrous tissue relative to fat, according to a Radiological Associates of Sacramento press release.

Radiological Associates of Sacramento is the first breast imaging provider to offer breast tomosynthesis, also referred to as 3D mammography, giving local patients access to the latest generation of breast cancer detection technology.

Digital Breast Tomosynthesis employs 3-dimensional imaging that produces digitally reconstructed breast images. The improved accuracy of a 3D mammogram is known to increase the detection rate of early breast cancer and may reduce the number of false-positive exams.

“What makes this technology so exciting is that we are now able to view more vivid mammograms, resulting in greater detail and significantly fewer call-backs," said Dr. Hani Greiss, executive committee chair, RAS Diagnostic Division.

Breast tomosynthesis allows physicians to view the breast layer by layer and provides a clearer image of breast tissue, which can help distinguish superimposed tissue from real abnormalities, thus decreasing the need for further examinations and callbacks.

The machine delivers images of the breast from several different angles. These images essentially divide the breast into 15 layers that measure about 1.5 millimeters each. Greiss believes that being able to view the breast tissue one layer at a time improves the chances of finding smaller cancers at earlier stages and is especially helpful in women with dense breasts.

“The advantages of 3D mammography are the reduction in callbacks by up to one-third,” Greiss said.

Greiss is confident the new technology can detect cancers that may otherwise go a year or more without being diagnosed when using traditional mammography. He plans to add a second machine to the Roseville location this year.

“3D mammography has exceeded our expectations,” Greiss said. “The machines are fast and comfortable for the patient, and we are confident in their benefits.”

Because the tests are new, insurance companies may not cover them and may require patients to pay out of pocket. But RAS isn’t charging patients the difference at this point.

“If a patient wants this technology, we will make sure they get it,” Greiss said.

Patients need to request the 3D machine from their primary care physician and obtain a referral to RAS first.

“We only have one machine at this point in time, so if a patient would like this technology, requesting the machine during the initial appointment is their best way to secure an appointment,” Greiss said.

But the new technology isn’t without controversy. A study posted in theNew England Journal of Medicine suggests that mammography routinely finds cancers that would be better left unfound – cancers that would not progress, and do not need treatment. Furthermore, the study states that “despite substantial increases in the number of cases of early-stage breast cancer detected, screening mammography has only marginally reduced the rate at which women present with advanced cancer, leading to substantial overdiagnosis, accounting for nearly a third of all newly diagnosed breast cancers and that screening is having, at best, only a small effect on the rate of death from breast cancer.”

Greiss understands the findings of the study, but remains convinced that early detection is still the best chance they have to saves lives.

“Regular 2D mammography, especially in dense breast tissue, may not show smaller cancers,” he said.

Although there is no data to prove that tomosynthesis finds more cancer or saves lives, Griess and his team at RAS are excited to have the cutting-edge technology that is making their jobs and, more importantly, their patients’ lives, a lot easier.