When it comes to detecting breast cancer early, Bothwell Regional Health Center is trying to stay ahead of the curve with its new 3D mammography machine.
BRHC obtained the new machine earlier this year and started using it with patients in mid-April. It replaces a 2D mammography machine that had simply fulfilled its 10-year lifespan, and instead of purchasing an upgraded 2D machine, BRHC officials opted for the advanced technology offered by 3D.
2D scans offer doctors four photos of the patient’s breasts, while 3D offers up to 180.
“When they take the picture of the breast, what happens is this tube makes an arc over the breast,” explained Donita Shipman, radiology control technologist. “It takes 15 pictures, and the computer reconstructs that into one-millimeter slices, so an average breast, one picture, will give the doctor 45 pictures to look at.”
Because there are different tissue densities throughout the breast, it can sometimes be hard to tell with 2D scans if an abnormality is reason for concern or simply a section of fatty tissue. With the 3D technology, doctors can have a much more detailed look at those possible abnormalities.
Dr. William Decker, a radiation oncologist at the Bothwell Cancer Center, said he uses a simple analogy to explain the 3D process to his patients.
“We take images that is kind of like having a loaf of bread and slicing it, and then taking out each slice individually and looking at the slice and taking out the next slice and looking at it, so you can see all the way through it,” he explained. “When you’re doing it the two-dimensional way, you could have a little skin fold or something there that will actually look like a nodule just because of the way it’s pressed, but if you can look at each individual slice, you can see oh, that’s nothing, that’s just a fold.”
Shipman said there has been a 40 percent decrease in patient callback, and a 10 to 15 percent increase in cancer findings, meaning doctors are able to detect some cancers they wouldn’t have previously found with 2D scans. She said that can give patients “peace of mind.”
“(With 2D scans, the patient) might have to come back and have different views. We would do maybe 20 of those a month out of 400 some. Since we’ve been doing this, we’ve done zero in two months,” Shipman said. “So that’s 40 ladies that didn’t get that phone call from their doctor that said, ‘well they saw something on your mammogram they’re really not sure about. We need to get you back in.’ Probably 35 of those ladies after that second picture would’ve gotten, ‘oh it’s benign’ … but now those 35 that would have that anxiety and got that phone call, they’re not getting that phone call.”
Decker said 3D imaging not only cuts down on those nerve-wracking phone calls, but it also cuts down on the number of biopsies that are conducted.
“The main thing that helps us, from a patient standpoint, when we find cancers that are smaller, that makes them more curable. The other main thing is those false positives, the things that are really nothing but look like something when you do that two-dimensional pressed view; being able to look at it in 3D can exclude that, tell us it’s normal,” he said. “The old way of doing it we would have to call the patient back, do additional views, sometimes we have to do another study, sometimes you have to do a biopsy to prove it or disprove it.
“It cuts down on the number of times we have to do a biopsy, which means we cut down on the number of complications of a biopsy, discomfort and psychological trauma of going through a biopsy.”
The 3D scan takes about the same amount of time as the 2D scan; Shipman said she schedules appointments every 15 minutes. It does have slightly more radiation than the 2D version, but it is still under the FDA approved limit.
Lisa Church, executive director of communications and the Bothwell Regional Health Center Foundation, said the BRHC board decided to purchase the 3D machine instead of an upgraded 2D machine because they knew it would soon be the standard of care in the medical industry. They also decided if they could raise half of the $700,000 cost from the community, they could afford the new technology.
Due to a competitor releasing its own 3D mammography machine within the next month, vendor Hologic offered its technology to BRHC at half price: $350,000. At that time, fundraising was cut off, and a total of $233,000 had come in from the community between October and March.
“I’m always just really, really humbled by how supportive people are. And I also think that breast cancer is one of those causes that everybody identifies with because everyone knows someone who’s had it,” Church said. “So I think that also contributed to our ability to raise the funds to do that, but I think at the end of the day the biggest benefit is the better results that you get from this.”