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London, Ont. study aims to find better way of detecting breast cancer through 3D imaging

A new trial happening in London is looking to see if a new type of imaging can better detect abnormalities in breast tissue.
A new trial happening in London is looking to see if a new type of imaging can better detect abnormalities in breast tissue. Getty Images

An international study out of London, Ont. is looking to see if a new type of imaging can better detect abnormalities in breast tissue.

The imaging is called digital breast tomosynthesis and is a type of 3D imaging. Researchers out of Lawson Research Institute want to learn whether it is better at finding abnormalities than the conventional digital 2D mammogram.

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“One of the limitations we face with [how we currently do] mammograms is overlapping breast tissue,” said Dr. Anat Kornecki, Lawson scientist and radiologist at St. Joseph’s.

“When we only have two-dimensional views, it’s very difficult to separate a lesion from overlapping breast tissue, especially if the patient has dense breast tissue, which affects about 40 per cent of patients.”

During a tomosynthesis exam, the x-ray tube moves in an arc over the compressed breast and captures multiple images from different angles.

This is different from a conventional 2D mammogram, in which two X-ray images are taken of the breast: one from top to bottom, the other from side to side at an angle.

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After the images are taken in the 3D exam, they are reconstructed into a set of 3D images by a computer which allows radiologists to examine the breast at multiple layers of depth, making it easier to distinguish normal breast tissue from potential abnormalities.

Image of a left breast taken with 2D mammogram.
Image of a left breast taken with 2D mammogram. Lawson Health Research Institute
Image of the same left breast taken with 3D tomosynthesis. In this image there is a lesion (indicated by the arrows) that was not visible in the 2D image.
Image of the same left breast taken with 3D tomosynthesis. In this image there is a lesion (indicated by the arrows) that was not visible in the 2D image.
“By adding the three-dimensional views, we can separate the tissue and add to the [clarity] of our breast cancer efforts, which will hopefully lead to detecting breast cancer at an earlier stage,” said Kornecki.

This is especially important for those with dense breast tissue because it may allow for screening at an early age than currently recommended, since before the 3D imaging, they weren’t able to see anything, she said.

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The trial, called the Tomosynthesis Mammographic Imaging Screening Trial or TMIST, is happening at over 100 centres across Canada, the United States, and Argentina. Women are randomly selected to receive screening with standard 2D mammography, or digital 2D mammography along with the 3D imaging.

Over four years, the women will undergo either an annual or biennial screening with a long-term follow-up continuing for at least three more years.

The hope is the study will help radiologists evaluate whether the newer technology of 3D imaging is a more effective tool for detecting aggressive tumours.

Kornecki says the federal recommendation is to start getting mammograms at the age of 50 and to get one every two years. She says if a patient has a strong family history of breast cancer, they may be eligible to get a mammogram and MRI starting at the age of 30.

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Health Matters: Dec. 17
Health Matters: Dec. 17

Through the Ontario Breast Screening Program or OBSP, women between the ages of 50 and 75 receive regular notices, encouraging them to schedule a mammogram for breast cancer screening.