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Cancer detection gets boost

1/29/2014

By ELIZABETH GOLDEN

egolden@dailynews.net

Hays Medical Center recently introduced new mammogram technology, which compared to traditional mammography, increases breast cancer detection by 30 percent, according to the Radiological Society of North America.

Tomosynthesis, or 3-dimensional mammography, allows doctors to examine the tissue one layer at a time as opposed to receiving only a 2-D image.

"Tomosynthesis has been around for a while now," said Dr. Aron Splichal, radiologist. "Just now, it is starting to become widely accepted as a standard of practice."

Tomosynthesis has been available for more than three years, but HaysMed received the technology in November and started seeing patients in December.

It is only one of two available in the state of Kansas.

While the technology is available to everyone, the initial use of tomosynthesis was thought to help women with dense breast tissue, "but we are finding significant benefit in women of all densities," Splichal said.

Lisa Dinkel, director of the Breast Care Center, said it is especially important women with previous history of cancer or family history should get a 3-D mammogram.

According to Splichal, the technology is more effective primarily because it greatly reduces recall rates, meaning the hospital has to call patients back for closer examination less frequently.

"When we see something on a mammogram," he said, "we often have to call the patient back to identify whether we need to take a closer look or not. Tomosynthesis has reduced this recall or allows us to skip straight to an ultrasound."

This is a result of taking multiple images as opposed to only one.

"They're millimeter slices," said Leah Rhoades, mammography supervisor. "So every millimeter, they take a picture. The average breast is 5 centimeters, so they take 50 pictures. It's very detailed."

Dinkel compared it to slicing a loaf of bread.

"It's like cutting it up, so you're seeing all the way through it," she said.

With the decrease in call-back rates, it also is estimated to decrease the cost of breast-care imaging.

"Over time, it is going to overall decrease the cost for patients, out-of-pocket and insurance costs," Splichal said. "This will be good for everybody."

All patients also receive the traditional 2-D mammogram with the tomosynthesis.

"We can see calcifications a little better with the 2-D," Splichal said. "We need 2-D for direct comparison with prior images, as this has been the standard for many years. But the 3-D is better at verifying skin calcifications."

Splichal said he is able to better define and locate calcifications and lymph nodes, which aids in deciding whether it is benign. In the past, additional testing occasionally was needed.

"Before I would see a little nodule on the breast with the 2-D," he said. "Now I can see indicators to tell if it's benign."

In order to receive the multiple images, the paddle tilts for compensation of the chest muscle and arcs 7 degrees to the left and right. It then centers and takes the 2-D image.

This process takes two seconds longer than a traditional mammogram.

There is an additional $75 charge for the 3-D mammogram to help cover radiologist and technical fees.

"The majority of time, insurance doesn't cover it," Dinkel said. "Once it's the standard for care in breast imaging, it will be covered. But we're not sure how long that will be."

For more information, visit www.haysmed.com/3dmammo.