2D vs 3D mammogram: Best option for breast cancer screening

Breast cancer screening is important for everyone. Technological advancements leading to early detection have contributed to an overall decrease in breast cancer deaths, however breast cancer remains the second leading cause of cancer deaths in women. According to the American Cancer Society, it accounts for about 30 percent of all new female cancers each year.

Catch breast cancer early with a mammogram

The gold standard of screening for breast cancer is the mammogram - a low-dose digital X-ray of your breasts. The screening involves compressing each breast between two panels for a few seconds so the X-ray can get a clear image of the tissue within each breast. A mammogram can be either two dimensional (2D) or three dimensional (3D) depending on which type of scan you and your provider choose.

Understanding that early detection is critical to saving lives, deciding when to start mammograms and how often to have them should be based on your age and your risk for developing breast cancer.

Mammography is an important tool in protecting your overall health and wellness. There are two ways to refer to a mammogram:

• Your yearly mammogram, used to check for potential signs of cancer is called a screening mammogram.
• If a screening mammogram finds something abnormal or if you have a lump, discharge, pain or other concern, it’s called a diagnostic mammogram.

It’s recommended that individuals at high risk of breast cancer have a screening mammogram every year starting at age 40. Those who are not high-risk should have one every other year beginning at 40. Your health care provider may recommend a different schedule based on your personal health and history.

Mammography can be either 2D or 3D. Depending on your preference, insurance coverage, physical makeup and provider recommendation, it may make sense to choose one over the other.

2D mammography

The traditional 2D mammogram has a long history of saving lives by detecting breast cancer in its early stage. During the test, the mammography machine compresses your breast between two panels while creating flat, 2D images of your breast tissue from two angles – usually the top and side. Images from a 2D mammogram are similar to those of an X-ray. The resulting images are then viewed and analyzed by a radiologist.

Advantages of 2D mammograms

• Covered by all insurances for preventive screenings.
• Widely available.
• Lower radiation exposure than 3D mammograms.
• Effective for finding and diagnosing breast cancer.

Limitations of 2D mammograms

• Images contain less detail than 3D mammograms.
• Increased chance of the patient needing to return for another scan.

3D mammography

The most detailed images of breast tissue are produced by a 3D mammogram, or tomosynthesis. Similar to a 2D mammogram, breasts are compressed between two panels while images are taken. However, to create 3D images, the imaging is taken in an arc over the breast, taking several images from several angles, which are combined by a computer to produce the 3D image. The resulting image is then viewed and analyzed by a radiologist.

Advantages of 3D mammograms

• Better image quality and quantity, making it easier to find and diagnose breast cancer.
• Beneficial for those with high-risk for breast cancer.
• Better for patients with dense breast tissue or implants.
• Lower rate of patients having to return to re-scan.

Limitations of 3D mammograms

• Some insurance plans don’t cover 3D mammograms.
• Can be more expensive than 2D mammography.
• Slightly more radiation than 2D imaging.

Key differences between 3D and 2D mammograms

Both 2D mammograms and 3D mammograms are performed in the same way and take nearly the same amount of time. The key difference between the two is the quantity and quality of images.

• 2D mammograms take a small number of flat images.
• 3D mammograms take a series of cross-section images of breast tissue.

Is a 2D or 3D mammogram more accurate?

Both 2D and 3D imaging are acceptable for screening exams, but the 3D mammogram is becoming more standard because the images are more detailed.

How much radiation is in a 2D vs 3D mammogram?

A 2D mammogram uses slightly less radiation than a 3D mammogram. If radiation levels are important, your provider can help decide what is best for you.

Is a 2D or 3D mammogram more painful?

2D and 3D mammograms are performed exactly the same, so one is not more painful than the other.

Additional methods of screening for breast cancer

There are additional ways to screen for breast cancer, depending on the situation. Your provider can help determine what is best for you. Other options include:

• MRI (magnetic resonance imaging): 3D images are made using a magnetic field. These images show the difference between normal tissue and abnormal tissue.
• Ultrasound: Sound waves “see” the inside of your body and computer monitor shows images created by measuring the sound waves.

If you are a current patient, you can schedule your mammogram online using your Allina Health account. If you are new to Allina Health, call the clinic location near you to schedule.