From 2015 to 2017, 3D mammography screening increased from 13% of screening studies to 43%, according to a study published Monday in JAMA Internal Medicine Medical Journal.
"It's a significant increase over a two-year period," says Dr. Ilana Richman, lead author of the study and an assistant professor of general internal medicine at the Yale School of Medicine. "Technology has become really popular."
A mammogram is a chest x-ray. In 3D mammography, also known as digital breast tomosynthesis, a scan takes X-ray images from multiple angles to create a 3D image of the chest. Standard 2D mammography only captures images from the front and side of the chest.
Researchers found that the popularity of 3D mammography did not grow in all areas of the country. The combination of 2D and 3D mammography was more popular and grew faster in the northeast and northwest regions of the United States, while southeastern regions showed slower growth and overall use. Screening with both 3D mammography and 2D mammography was the most common screening method in less than 5% of the regions in 201
In regions with high 3D usage Mammography, residents were more likely to be wealthy, educated, and white.
"That's what we expected to see for a long time," said Robert Smith , Vice President of Cancer Screening for the American Cancer Society. Smith was not involved in the study. "When you roll out new, higher technology and more expensive equipment, the early adopters will generally be in more affluent parts of the country."
In areas with the highest 3D mammography growth and use, the average income of residents was $ 53, 835; In areas with slower growth and use, the average income was $ 45,454. The regions with high 3D mammography use also had a higher percentage of white residents (82.2% versus 70.5%) and lower percentage of black residents (5.3% versus 18.6%).
Although more research is needed to demonstrate the effectiveness of 3D mammography, these regional differences aggravate the existing differences in breast cancer results, Dr. Joy Melnikow and Dr. Joshua Fenton in a response to the study, also published in JAMA Internal Medicine.
The health differences were found at a population level, not an individual level, so we do not know if the richer and more educated women in these regions were the same people who were given 3D mammography, Richman said.
Scientists c released data on 9.7 million breast screening exams from 2015 to 2017 among women in the United States between 40 and 74 years. Breast screening exam data came from Blue Cross Blue Shield Axis, a database of insurance claims. The researchers also compared the data geographically and obtained demographic information from the US US Census Bureau's American Survey and 2010 US Centers for Disease Control and Prevention Surveillance Survey Surveillance Survey Survey.
3D mammography trends from Blue Cross Blue Shield requirements were also compared to Medicare data. There were no significant differences in the pattern of using 3D mammography between the two groups, according to the study.
How mammograms are different
In standard 2D mammography, normal tissue may overlap and fake a lot due to the nature of two-dimensional images. But the cost and amount of radiation is higher for 3D mammograms than 2D mammograms, according to the National Cancer Institute.
"The dose from these mammographic exposures is very low and therefore the real possibility that these additional exposures may cause measurable damage is also low," Smith wrote in an email. "As far as costs are concerned, it seems that more and more insurance covers 3D, so it will probably cost less a problem over time."
Both 2D and 3D mammography can identify breast cancer, and early studies have shown that 3D mammography reduces how many women need more testing due to a suspected finding, according to Richman. This is "a convincing cause for the patients" to get 3D mammography, and so there may have been a "quick shot", she said.
However, 3D mammography is not currently recommended by the US Preventive Services Task Force for routine breast cancer screening. Without these clinical guidelines, the US Food and Drug Administration requires that for a patient to get 3D mammography, they should get it along with standard 2D mammography, Smith said. The FDA certifies facilities for performing mammography and must approve new breast imaging equipment before it can be sold in the United States.
"We don't have enough data to say it's definitely better … over 2D," Smith said, but 3D mammography seems to be more popular.
"This study shows how early-stage technology starts," Richman said.