3D mammograms. What are they and what is the cost? We will teach you all about it.
I am sure you have heard about 3D mammograms. They're not available
everywhere yet and sometimes you have to pay a little bit more out-of-pocket to
get this new technology. Are the benefits worth the costs? We think so. In this
lesson, I'm gonna teach you exactly what a 3D mammogram is... why younger women and
women with denser breasts benefit the most and why women at "high risk" should also
get 3D mammograms. I'm also going to go over the downsides, predominantly the
cost associated with 3D mammograms. So let's get started. What is a 3D mammogram?
3D mammograms, also known as "breast tomosynthesis" allows radiologists to
look into your breasts with better clarity when compared to a 2-dimensional,
standard digital mammogram. So let me explain. When you normally have a
screening mammogram, a 2-dimensional mammogram, the x-ray machine x-rays
through your breasts in one direction and then compresses a different way and
takes a different x-ray view and a radiologist then looks at it on a computer to
find things. 3D mammography adds a really neat twist to that. When it takes an
x-ray, the x-ray machine actually moves. It "arcs" a few degrees and it goes click
click click click click and then it does the same and the other direction, "click click
click click click." As a result using very sophisticated
computer programs and consoles they can toggle through your mammogram with
better clarity to find smaller things. One of the benefits is that there's an
increased statistical chance that if you have a breast cancer that the
radiologists, using 3D mammography, will find it. It's a small benefit, but it's
significant. A second benefit is that it lessens your chance of being "called back"
for another x-ray, a different view, or an ultrasound because sometimes the 3D
imaging can look at something and say "I'm sure that's nothing" whereas before
when you had just two dimensions and they're not sure and they call you
back for more imaging. So it lessens "call backs" and also and one of the
biggest benefits of this is that a 3D mammogram can lessen the chance that
your radiologists recommends a breast biopsy that turned out to be nothing.
Meaning an unnecessary biopsy. Why do women with dense breasts and younger
women benefit most from a 3D mammogram? Well, if you have dense breasts it means
two things. It's sort of a "double whammy" problem. it's very manageable but I'll
explain. The first of the two is that if you have dense breasts, it's harder to
see through the density of the breast to find a tiny little cancer rather than in
a breast that is less dense because you can see it better. The way to think about it
is... if you have dense breast it's more like x-raying in a brick versus less
dense breast it's more like x-raying through a glass of water. It's harder to
find tiny little findings and catch a breast cancer early. The second
downside to having dense for us is that it overall increases your lifetime risk
of developing breast cancer. And so, you're at increased risk but mammography
is not quite as helpful? Don't take the message home that you shouldn't get
mammograms. In this situation it's even more important. So women with dense
breasts is one of the main benefits of having 3D mammography. Younger women,
typically have denser breasts and as they age their breasts go through
something called "fat replacement." So, in most women, not all, their breasts
become less dense over time. So if you're in your 40s and getting screening mammograms
it really is essential to ask for 3D mammograms because your breasts are
likely, statistically, more dense than women that are older. If you are in your
50s 60s or 70s there's probably a benefit from 3D mammography but as you get older,
the benefit to you becomes less and less than if you're younger or have very
significantly dense breasts. Women deemed at a very "high risk" in their lifetime for
developing breast cancer definitely benefit from 3D mammograms and sometimes
screening MRIs. Women that carry the BRCA mutation also known as the "Breast Cancer
Gene" or other cancer-causing mutations that are associated with breast cancer,
really should get 3D mammograms Women that have a very strong family history
of breast cancer should consider getting 3D mammograms. Women that have had a
prior breast biopsy with terms called "atypia" or "Atypical Ductal Hyperplasia" (ADH) in
that biopsy that wasn't cancer, "Atypical Lobular Hyperplasia" (ALH) or "LCIS" are all terms
associated with an increased lifetime risk for developing breast cancer. If
you've had a breast cancer before and are doing great and surviving this and
going back for a screening mammogram that's one situation that I would
generally advise you to get a 3D mammogram If you've had cancer radiation
to your chest usually for Hodgkin's lymphoma when you were young, in your
teens or in your twenties, you're at a very high risk for developing breast
cancer in your lifetime and definitely benefit from 3D mammograms. Take our
video lessons to learn more about screening "MRIs" and also "High Risk"
elsewhere in the Breast Cancer School for Patients to learn more about these
complex, but very important topics to you. What are the "downsides" of a 3D mammogram?
Well. they're really two and the first one is not that significant. Initially, 3D
mammograms when compared to digital mammograms had a slightly higher
dose of radiation to the breast than the standard two-dimensional mammogram. Any radiation adds up over time and causes cancer in and of itself. But as
time has moved on and the technology has improved that difference is essentially
zero. Now, some imaging facilities will have slightly more radiation than a
standard mammogram and even some imaging facilities and
technologies have slightly less radiation than a standard mammogram.
So that downside is a little bit uncertain and generally not considered
very significant. The biggest downside... "cost." Insurance companies do not pay for
the added cost of a 3D mammogram over a two-dimensional standard mammogram. It's
a long story, gets into politics and cost and insurance companies. But let me give
you an example of a situation that you might encounter and give you some advice.
You go in for your mammogram they ask you if you are interested in a 3D
mammogram. Hopefully they tell you the cost out of pocket upfront and sometimes
they do not. You say "sure." Sounds like a good thing. You undergo your mammogram
and then at the end, either that day or you get a bill later. It is charged in
this way. The insurance company pays for standard 2D mammogram the same
amount, but the imaging facility will charge you an "additional fee" usually
about $25 to $50 for both mammograms...in addition to what your
insurance pays. So really to get a 3D mammogram it's about twenty five to
fifty dollars out-of-pocket, completely unrelated to insurance. So ultimately,
it's up to you to weigh the benefits of a 3D mammogram which are increasing the
chance you find a small cancer, a decrease in the callbacks, decreasing the chance
you have a biopsy that ultimately you did not need
versus the downsides which are predominantly the costs maybe a little
worry about radiation but that's quite small. So these are your choices and
these decisions are for you to make and I hope that this video has been helpful to
help you make those decisions. 3D mammography is becoming the standard of
care. The Breast Cancer School for Patients recommends 3D mammograms for
all women. It's definitely worth the effort to find a breast imaging center
that offers 3D mammograms and get one every year. To learn more about 3D
mammograms, visit the Breast Cancer School for Patients, where we teach you
everything you need to know. We're here to help you get the best possible breast
cancer care in your community. Register on our website to get our list of
questions to prepare you for your next doctor visit.