Mammography is specialized medical imaging that uses a low-dose x-ray system to see inside the breasts. A mammography exam, called a mammogram, aids in the early detection and diagnosis of breast diseases in women.

An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.

Three recent advances in mammography include digital mammography, computer-aided detection and breast tomosynthesis.

Digital mammography, also called full-field digital mammography (FFDM), is a mammography system in which the x-ray film is replaced by electronics that convert x-rays into mammographic pictures of the breast. These systems are similar to those found in digital cameras and their efficiency enables better pictures with a lower radiation dose. These images of the breast are transferred to a computer for review by the radiologist and for long term storage. The patient’s experience during a digital mammogram is similar to having a conventional film mammogram.

Computer-aided detection (CAD) systems search digitized mammographic images for abnormal areas of density, mass, or calcification that may indicate the presence of cancer. The CAD system highlights these areas on the images, alerting the radiologist to carefully assess this area.

Breast tomosynthesis, also called three-dimensional (3-D) mammography and digital breast tomosynthesis (DBT), is an advanced form of breast imaging where multiple images of the breast from different angles are captured and reconstructed (“synthesized”) into a three-dimensional image set. In this way, 3-D breast imaging is similar to computed tomography (CT) imaging in which a series of thin “slices” are assembled together to create a 3-D reconstruction of the body.

Although the radiation dose for some breast tomosynthesis systems is slightly higher than the dosage used in standard mammography, it remains within the FDA-approved safe levels for radiation from mammograms. Some systems have doses very similar to conventional mammography.

Large population studies have shown that screening with breast tomosynthesis results in improved breast cancer detection rates and fewer “call-backs,” instances where women are called back from screening for additional testing because of a potentially abnormal finding.

Breast tomosynthesis may also result in:

• earlier detection of small breast cancers that may be hidden on a conventional mammogram
• fewer unnecessary biopsies or additional tests
• greater likelihood of detecting multiple breast tumors
• clearer images of abnormalities within dense breast tissue
• greater accuracy in pinpointing the size, shape and location of breast abnormalities