Breast cancer is the most common type of cancer in women, and the success rate of treatment is very high when detected early. For this reason, regular breast screening programs are vital for protecting women's health. Although traditional mammography methods have been used as the standard screening tool for many years, the fact that the images are only two-dimensional could lead to some types of cancer being overlooked. The modern technology that eliminates this limitation is the 3D tomosynthesis (digital breast tomosynthesis) method. This method goes far beyond the information offered by classic mammography, making it possible to examine breast tissue in cross-sections.
What is 3D Tomosynthesis?
3D tomosynthesis is an advanced imaging technology that allows multiple low-dose X-ray images of the breast taken from different angles to be reconstructed in three dimensions as millimetric cross-sections via computer software. In classic 2D digital mammography, overlapping breast tissues can be examined layer by layer in three-dimensional imaging. This significantly increases the accuracy of cancer diagnosis, especially in women with dense breast tissue. The method is recommended by leading screening guidelines worldwide and is increasingly becoming the standard.
Working Principle
During tomosynthesis, the X-ray tube moves in an arc of approximately 15-50 degrees over the compressed breast, taking multiple low-dose images during this process. Computer software reconstructs these images into 1-millimeter cross-sections. The radiologist can clearly distinguish between normal breast tissue and suspicious formations by examining each section separately. Since classic 2D mammography images can also be obtained in the same session, there is an opportunity for comparison.
In Which Situations Is It Used?
3D tomosynthesis is used in a wide range of applications for both routine screening and diagnostic evaluation:
- Routine breast cancer screening: Annual check-ups for women over 40
- Dense breast tissue: Cases where classic mammography is insufficient
- Women with a family history: High-risk group
- Suspicious mass evaluation: Detailed examination of lesions detected on 2D mammography
- Microcalcification analysis: Evaluation of calcifications that are early signs of cancer
- Post-operative follow-up: Check-ups for patients who have undergone surgery
- Investigation of asymmetry and structural distortion
- BRCA gene mutation carriers
- Evaluation of suspicious formations palpable during breast examination
- Nipple discharge examination
Advantages of 3D Tomosynthesis
Compared to classic mammography, tomosynthesis technology provides significant advantages:
- Higher diagnostic accuracy: Increases the cancer detection rate by approximately 40 percent.
- Reduction in false-positive results: Decreases the rate of unnecessary biopsies and recalls.
- Superior performance in dense breasts: Overlapping tissues can be separated.
- Early-stage detection: Small tumors are visualized more easily.
- Low radiation dose: Modern devices use low-dose technology.
- Patient comfort: Procedure time is short, similar to classic mammography.
- Reduced need for additional imaging: Detailed evaluation in a single session.
- Clarity for the physician: Detailed cross-sectional images facilitate clinical decision-making.
- Reduced patient anxiety: Comprehensive evaluation can be performed at once.
How Does the Examination Process Proceed?
Before the tomosynthesis procedure, the patient's detailed history is taken; if there are previously performed mammography, ultrasound, and MRI reports, the patient is asked to bring them for comparison. For women with a regular menstrual cycle, the ideal time for the procedure is the first week after the period ends. During this period, breast tissue is softer and less sensitive, which increases both patient comfort and image quality.
Imaging Phase
The patient stands in front of the device with the upper body undressed. The breast is placed between compression plates; this compression is necessary for image quality and dose reduction. Images are taken within a few seconds while the device moves in an arc. The total imaging time is approximately 10-15 minutes for both breasts. In modern devices, compression time is kept as short as possible.
Evaluation of Results
The images are examined by the radiologist section by section. If there is a suspicious finding, additional ultrasound, MRI, or biopsy may be planned. The result report is delivered to the patient in a short time, and a coordinated treatment plan is made with the relevant branch physician when necessary.
Points to Consider
To obtain the most accurate results from the examination, some recommendations must be followed:
- Deodorant, cream, or powder should not be applied to the chest area before the imaging.
- Any suspicion of pregnancy must be reported to the physician.
- Old mammography images should be brought for comparison.
- Patients with breast implants should state this situation in advance.
- Breast sensitivity increases in the premenstrual period; appropriate timing should be preferred.
- The suitability of the procedure during breastfeeding should be consulted with the physician.
- Breath-holding may be requested during the imaging; instructions must be followed.
- Wounds, moles, or scar tissues in the breast area should be reported to the technician.
Integrity of 3D Tomosynthesis with Other Breast Imaging Methods
In the evaluation of breast health, 3D tomosynthesis is not a standalone method but an important part of a comprehensive breast imaging program. Along with tomosynthesis, methods such as breast ultrasound, contrast-enhanced breast MRI when necessary, and elastography offer the physician an opportunity for holistic evaluation. In young women with dense breast tissue, ultrasound provides important additional information that supports tomosynthesis results. For women in the high-risk group, annual MRI screening serves as a critical method that complements the tomosynthesis program.
The Impact of Early Diagnosis on Life
Catching breast cancer at an early stage not only extends life expectancy but also expands treatment options. In early-stage breast cancer, advantages such as breast-conserving surgery, less extensive axillary surgery, and a reduced need for systemic treatment are achieved. This directly affects the patient's quality of life both physically and psychologically. The rate of late-stage cancer diagnosis in women participating in regular screening programs is very low, and this statistic clearly demonstrates the role of 3D tomosynthesis in early diagnosis.
As Koru Hospital, we offer 3D tomosynthesis technology to our patients with our commitment to protecting women's health. Thanks to our experienced gynecology, general surgery, and radiology teams and our state-of-the-art digital mammography devices, we achieve the highest level of accuracy in the early diagnosis of breast cancer. With our regular screening programs tailored to every woman, our patient-oriented approach, and our multidisciplinary breast health council, we rapidly initiate advanced examination and treatment planning in case of suspicious findings. Early diagnosis protects the quality of life beyond the lives it saves; with this awareness, we see it as our most important goal to support our patients at every stage and to continue serving as a leading institution in the protection of women's health.
