Despite the international publicity surrounding October as Breast Cancer Awareness Month, this deadly disease respects no holidays, recognizes no colors, and spares no lives. It will kill more than half a million women this year. Another million women will learn they have breast cancer, and one in three of those will eventually develop an advanced form of the disease.
While these numbers seem shocking, they are actually a testament to advances in early detection. When discovered early, women with breast cancer have a five-year survival rate of over 89%. Unfortunately, results from traditional, two-dimensional mammogram screenings are not always accurate. In some cases, small tumors can be overlooked and in others a mammogram may show an area that looks like cancer, but turns out to be normal. These instances are known as "false negatives" and "false positives" and they are more common than you think, especially in women under the age of 40. Their common occurrence even prompted a recent modification in the recommended age of women undergoing breast cancer screenings from 35 to 40, a policy change that continues to be hotly debated. One thing not up for discussion is that false positive and false negative breast cancer reads have a huge psychological, physical, and economic impact on women, which one study found adversely impacts women's health for years.
"We found that 41% [of breast cancers] were better seen on tomosynthesis and 4% were only seen on tomosynthesis."
Tomosynthesis, called TOMO for short, is a revolutionary software module pioneered by PerkinElmer. and used by X-ray systems manufacturers to enhance the performance of their systems. PerkinElmer's Dexela tomosynthesis offers new methods for optimised acquisition, reconstruction and visualization of data. By optimising tomosynthesis acquisition methods including variable spacing of projections, variable angular velocity and variable energy and radiation dose, Dexela's advanced tomosynthesis reconstruction software employs an iterative, statistical approach to minimise artefacts and maximise contrast. Recent studies show that tomosynthesis is better enable to detect smaller masses and infiltrating dutal carcinoma in the breast than traditional 2D mammography. When combined with conventional breast scans, tomosynthesis increases the detection of breast cancer and reduces false positive and false negative reads significantly.
"We found that 41% [of breast cancers] were better seen on tomosynthesis and 4% were only seen on tomosynthesis," said Dr. Sarah O'Connell, a lead author of a 2013 study conducted by the American Roentgen Ray Society, the oldest radiology society in the United States. "The majority of cancers seen better or only on tomosynthesis were predominantly infiltrating ductal carcinoma, which typically presents as a mass, focal asymmetry, or architectural distortion," Dr. O'Connell said, adding that TOMO scans are especially helpful to women at increased risk of breast cancer who also have increased anxiety about breast screening and have the potential for biologically aggressive cancers.
In another study conducted at Yale University's Smilow Cancer Hospital in New Haven, CT, researchers found that 3D imaging in combination with 2D scans, "increases cancer detection rates by 11%, and are particularly useful in detecting cancer in women with dense breasts," Dr. Jaime Geisel, a lead author of the study, reported. While noting that much more research needs to be done, Dr. Geisel said that the existing data for radiologists—and especially for women undergoing breast cancer screening—is already compelling.