Porter’s new 3-D mammography machine brings breast cancer into focus

MIDDLEBURY — Porter Hospital has acquired a new, state-of-the-art mammography machine that uses 3-D technology in producing images so reliable that it gives staff radiologists a 41-percent better chance in detecting invasive breast cancer compared to the previous, two-dimensional mammography test.
It’s called digital 3-D tomosynthesis mammography, an advanced technology that furnishes radiologists with essentially CAT-scan quality images of the breast. The so-called “thin-slice data sets” produced through the machine allow the radiologist to differentiate tissue overlap from true masses in the breast, as well as see through dense breast tissue with much improved sensitivity.
The bottom line: It results in an estimated 40-percent decrease in false-positive call-back rates to patients who have to be asked to come back for a new round of testing due to findings on their mammography that couldn’t be ruled out as a benign or malignant mass. Fewer call-backs means more peace of mind for the patient, fewer chances of exposing patients to unnecessary radiation and less money spent on health care.
“It’s a win-win, across the board,” said Dr. Wade Cobb, director of breast imaging at Porter Hospital, now one of only 2,000 hospitals worldwide to have digital 3-D tomosynthesis mammography.
And the news will only get better.
The 3-D unit recently installed at Porter represents the most advanced iteration of the tomosynthesis technology now available and will soon allow for a 50-percent reduction in the radiation dose for a mammography, according to Dr. Stephen Koller, chief of Porter’s Radiology Department. This dose reduction will be made possible when the traditional 2-D technology is replaced with computer-generated 2-D views (some insurance carriers require 2-D mammography, which is traditionally done with radiation-generated images). That transition is now under way.
“There is more sensitivity and specificity,” Koller said of the 3-D technology. “We are able to find more cancer with decreasing call-backs.”
It was around two months ago that Porter purchased the machine to replace the conventional 2-D mammography machine that had reached its life expectancy. Koller was pleased to report that the new device, manufactured by Hologic Inc., costs about the same as a 2-D model. Patients spend around the same time with the new machine, which applies the same kind of compression to the breast while the images are taken.
Koller recommends that women have an annual physical and mammogram once they turn 40.
“Mammography, we feel, is a vital screening tool for the early detection of breast cancer,” he said. “And early detection is important, because when we find breast cancers early, they are small and very treatable, with a high likelihood of a long-term cure.”
It should be noted that the digital 3-D tomosynthesis mammography machine can also generate two-dimensional images of the breast. But virtually all Porter patients have opted for the 3-D service due to the extra accuracy that it affords. Koller said Medicare and some private insurers cover the 3-D exam; Blue Cross-Blue Shield does not at this point, but local physicians are optimistic that will soon change. The 3-D mammography option does not cost substantially more that the conventional test, Koller noted.
Porter Hospital administers roughly 20 mammograms per day, according to Koller.
The new machine has already yielded some potentially life-savings results.
“I found a breast cancer on a patient the first day we had (the machine) that was invisible on the routine images,” Cobb said. “And nearly as important, we have seen stuff on the conventional mammogram that was potentially something where we would have called the patient back, gotten additional imaging, resulting in more stress for the patient and more cost to the system, but when we looked at with the (3-D version) we could confidently say, ‘This is normal breast tissue and nothing to worry about.’”
Koller echoed that assessment.
“There have been a number of cases, in the two months that we’ve had the exam, that we have found important findings that we would have not seen with the old mammo technology,” he said.
Reporter John Flowers is at [email protected].

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