Next-Generation Mammogram More Accurate, Less Painful

Dec. 13, 2004 — -- Dr. Marisa Weiss, a cancer specialist in suburban Philadelphia, says she hears the same thing from thousands of women: They know it is important to get a mammogram -- and they hate it.

"It's very painful. It hurts a lot," said Charleen Cesario, one of her patients. "It's very uncomfortable."

During the test, a patient has to stand with her breast squeezed into the X-ray machine. And a quarter of the time, she has to come back for more testing because a radiologist, trying to make sense of the murky image, comes back with a "false positive" -- reporting a shadow that looks like cancer, but turns out to be benign. Even the most experienced doctors find the images hard to decipher.

"We do have these women who are coming in day and night, saying, 'There's got to be something better. What is new out there?'" said Weiss, who founded breastcancer.org, an Internet-based advocacy organization.

To solve that problem, Dr. Daniel Kopans, professor of radiology at the Harvard Medical School, has developed with other researchers a new type of mammogram, called "digital tomosynthesis."

"I like to say it's a mammogram, only much better," Kopans said.

A conventional mammogram looks at the breast from just one angle at a time. As a result, a shadow on the image could be a tumor or just dense areas of healthy tissue that happen to line up.

The tomosynthesis machine, on the other hand, shoots images from 11 different angles in seven seconds. The computer combines and manipulates those shots, allowing a doctor to look at the image, layer by layer, from any angle necessary.

"We can find more cancers," said Kopans, "but, at the same time, we increase the specificity, and we have fewer false positives. It is basically a win-win situation."

Weiss said the new machine can take images in greater quantities -- and with less pain.

"It takes multiple pictures of the same breast without all the compression," said Weiss, "and it gives us a three-dimensional view of a three-dimensional structure."