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3-D Tomography Coming to NKCH

Digital breast tomosynthesis (3-D mammography) is advanced technology that helps physicians detect more and smaller cancers. North Kansas City Hospital expects to bring the latest technology in breast cancer detection to its Women’s Imaging Center in early 2016.

“Standard 2-D mammography takes images of the breast from top and from the side,” explains Julia Neperud, MD, a radiologist with Northland Radiology, Inc. and medical director of women’s services at NKCH. “Because the breast tissue often overlaps, it can be difficult to differentiate normal breast tissue from a true abnormality. 3-D tomography scans in an arc-like motion, allowing us to divide the breast into multiple 1 mm slices.”

The ability to evaluate the breast in thinner sections helps radiologists analyze the tissue more closely to determine if they see normal breast tissue or a possible cancer. “Because 3-D tomography gives us a more in-depth look at the breast tissue, the hope is that this will help reduce recall rates, false-positives and the need for as many diagnostic mammograms,” Dr. Neperud says.

2-D vs. 3-D

An increasing number of patients are inquiring about 3-D mammograms. Knowing the difference between the two can help primary care physicians and gynecologists counsel patients who are unsure which path to take.

“We will offer 3-D tomography to everyone because it can benefit every woman,” Dr. Neperud says. “Although the benefit is greater in those with more dense breast tissue, research shows more cancers are being detected in fatty breast tissue, too.”

Dr. Neperud recommends physicians first consider their patients’ breast density and family history. A strong family history of breast cancer is another reason to recommend 3-D tomography. “Many patients want the most advanced breast cancer detection technology, regardless of their breast density or history,” Dr. Neperud says.


Single slice 3D tomosynthesis image shows spiculated margins, sign of an invasive ductal carcinoma.

Another deciding factor could be cost. Currently, most insurance companies do not cover the full cost of 3-D tomosynthesis, and patients must pay an out-of-pocket cost up-front for the service.

For physicians concerned about increased radiation from the exam, the latest 3-D tomosynthesis technology now delivers essentially the same radiation dose as the 2-D screening exam. This is one of the reasons NKCH has chosen to offer the service at this time. “With this equipment, we will be able to obtain a more sensitive exam with little or no increase in radiation to the patient.” Dr. Neperud says.

When physicians talk with their patients about 3-D mammography, they should let them know what to expect. “A 3-D tomography exam will be the same as 2-D in terms of breast positioning, use of breast compression and essentially the same exam time,” Dr. Neperud explains. “But because 3-D tomography has hundreds of images, they take longer to interpret.” Same day reads will not initially be available for 3-D tomography.

“3-D tomography gives us yet another tool,” Dr. Neperud explained. Between ABUS and the recent advancements in 3-D mammography, it has been exciting. I do anticipate that 3-D tomography will eventually become the standard in mammography screening.”

Julia Neperud, MD

Dr. Neperud earned her medical degree from The University of Kansas School of Medicine. She completed her residency at The University of Kansas Medical Center and a fellowship in Body Imaging from MD Anderson Cancer Center. Dr. Neperud is board certified in diagnostic radiology and has a special emphasis in general diagnostic radiology, computed tomography, mammography, nuclear medicine, sonography, magnetic resonance imaging and interventional radiology.

To learn more, call 816.691.5201 ext. 3217.