Mammograms Go 3-D

With cancer screening, sometimes good enough is all you can ask for. That’s been the case with mammography, a technology that can save lives, detecting breast tumors when they are small enough to treat. But mammograms also produce a high rate of false positives, which can lead to anxiety–and even more procedures. Experts agree the benefits outweigh the pitfalls, but now, thanks to new advances, a breakthrough in mammography may be upon us.

The latest research, published in JAMA, was the most extensive of its kind to study the 3-D mammogram, which was approved by the U.S. Food and Drug Administration in 2011. The data show that reconstructing 3-D images of the breast, which is done by synthesizing images from different angles, can improve the detection of invasive breast cancer by 41%. The 3-D exam also leads to fewer repeat tests and unnecessary biopsies than the 2-D exams, which are the norm at most screening centers today.

Lori Safer, a 55-year-old occupational therapist from New Jersey, learned how valuable those enhanced images can be. After years of less-than-reassuring reports from her yearly mammogram, she found a center offering tomosynthesis, or 3-D screens. Her first scan found a malignant tumor that the 2-D scans had missed.

But doctors and insurers are still debating whether 3-D screening–a new and, for now, more expensive technology–should get widespread adoption. Researchers are also investigating how the savings from fewer callbacks and additional testing stack up against the higher cost of the 3-D exam.

Safer, for one, knows which kind of scan she’ll get every year. After treatment she’s now cancer-free, something she says could have been “a totally different story” without 3-D screening.

This appears in the September 01, 2014 issue of TIME.

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