By Roberto M. Robledo, The Salinas Californian

Using a touch screen behind a clear protective shield, radiologic technologist Cheryl Reeves operates Natividad Medical Center’s new mammography equipment. (Photo: Jay Dunn/The Salinas Californian)

Salinas, California (October 22, 2015) – Good news during National Breast Cancer Awareness Month: The latest technological advances have taken some of the pain out of the mammogram examination.

Better news: The new technology is in use at your county hospital.

Natividad Medical Center in Salinas has purchased the latest, state-of-the-art digital mammogram equipment — the Hologic Selenia Dimensions 3D System.

Natividad medical staff are using a procedure called digital tomosynthesis, or “tomo,” an advanced breast cancer imaging technique. The new system cuts time and pain for the patient requiring the once-dreaded mammogram.

Natividad is the only hospital or clinic in the region to obtain the 3D system.

It represents the evolution of the mammogram to a less time consuming, less painful procedure with more accurate results, said Dr. Evan Moser, a radiologist.

“Your chances are better at finding some cancers that are difficult to see at an early stage” when using the older two-dimensional mammogram equipment, Moser said.

“The images from the new system eliminate many of the “false positives” — the things that look like cancers but aren’t — and helps us problem solve and get to the answers more rapidly. Hopefully this prevent unnecessary biopsies and call backs,” he said. “It’s just a better tool than we already have — an improvement.”

Under the old 2-D mammogram, patients could be called back several times, forced to undergo the painful breast compressions so different angles of suspect tissue could be screened.

The new 3-D approach eliminates most callbacks — and need for multiple breast compressions.

“You’re able to look from the front, the side, you can tell where things are three-dimensionally in relationship to each other,” said Moser. “Whether it’s really a mass or not. You have a much better chance of telling it apart that way.”

The examination still requires compression of the breast, so there still will be some pain and discomfort involved. But in cases where the breast has to be super-compressed to get a proper look at an area with 2-D equipment, that procedure is eliminated using the new machine, said Moser.

“There is less pain because instead of three or four trips to the old mammogram machine there is only one trip to the new machine,” he explained.

The 3-D system allows doctors to examine breast tissue layer by layer, like slices in a loaf of bread. It differs from the flat image provided by the older 2-D machines. Finer details are more visible and no longer hidden by tissue above or below.

The 3D exam is given in the same manner as the 2D — the patient is positioned, the breast compressed and images taken from different angles.

The manufacturer, Hologic, says its Genius 3D mammography “detects 41 percent more invasive cancers … that have spread outside of the milk duct into surrounding, healthy tissues.” Up to 40 percent of false positives are also reduced, they say.

The exposure to X-rays is still a risk, up slightly under the 3-D approach but negligible, said Moser.

“There is never a zero risk when exposure to X-rays is involved,” he said. “But because of the value of the information it is determined to be well worth the risk of a very small chance of something happening.”

Radiation exposure is set by government. In the use of the 3-D mammography, it is regarded as a low-dose procedure, he said.

After it received approval from the FDA, the Tomo 3-D system has been in use nationally for the past year. Natividad launched its use in August. The number of patients who’ve received mammograms locally was not available.

The cost of the new mammogram procedure and which health care insurance companies will cover it is still being calculated by Natividad officials, according to Heidi Riggenbach, Natividad’s laboratory and radiology manager.

With respect to breast cancer in general, Moser said: “We’ve made great strides, and most patients tend to do really well. Treatments have improved, not only in the ability to find it, but more importantly they have the chemotherapy and drugs to stop it and in some cases of getting cured.”

By the numbers

No. 1: Breast cancer is the leading cause of death for U.S. women ages 40 to 55.

1 in 8: A woman’s chance of developing breast cancer in her lifetime.

8 in 9: Women diagnosed who have no family history of breast cancer.

100 percent: The five-year survival rate is nearly that good if breast cancer is detected early.

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