High-Tech Mammograms Will Change Breast Cancer Care

The system also has the advantage of being more comfortable. The woman lies on her stomach on a cushioned exam table with a cutout in the middle. She suspends her breasts one at a time through the cutout while the CBBCT takes 300 images in the space of about 10 seconds. The radiation dose is comparable to that of mammography. Unlike conventional mammography, the CBBCT system clearly displays tissue around the ribs and outer breast near the armpits.

The pilot study will continue until 60 participants have been imaged. A larger trial is planned for next year.

Koning Corp. hopes to have a commercial scanner on the market as soon as the U.S. Food and Drug Administration approves the device. But other technologies may be further along, said Dr. Joshua Kalowitz, chief of breast imaging at Maimonides Cancer Center in New York City.

"There's a lot of new stuff on the horizon," he said. "Five years from now, we'll be in a lot better shape, but right now, we have to see which ones will end up being the best."

Computerized mammography does have its drawbacks -- at least for now. D'Orsi said there are so many options for setting up and reading the computer images that doctors are somewhat slower at determining their results.

"You have the ability to manipulate the image, invert it, adjust the brightness, which you can't do with film, so it may take longer," he said. "There's a learning curve to it because it's new, but you get faster and faster."

He's excited by the technology, which will soon make it possible to "see" tissue in ways that film and the naked eye cannot.

"We can invent novel new technologies," he said, among them a three-dimensional approach that will improve cancer detection. Already in the works are what he calls a "computerized method of peeling layers of breast away electronically," so that irregularities can be pinpointed more exactly.

And, as doctors and hospitals adapt to electronic patient charts, digital mammography will play an important role, said Butler. "Mammography was one of the last holdouts in going to a filmless environment, which is much more efficient," she said. "All of medicine is pretty excited about it."

But D'Orsi cautions that the most important thing is not the technology itself, but the person reading the results.

And, the National Cancer Institute warns women not to wait for the new technology. The guidelines in place for several years still apply:

Women in their 40s should have mammograms every one to two years.Women 50 and older should be screened every one to two years.Women who are at higher than average risk of breast cancer should seek expert medical advice about whether they should begin screening before age 40 and the frequency of screening.

More information

For more on digital mammography, visit the National Cancer Institute.

SOURCES: Carl D'Orsi, M.D., co-chairman, American College of Radiology Breast Imaging Commission, and professor of radiology and director, Breast Imaging Center at Emory University, Atlanta; Priscilla F. Butler, senior director, American College of Radiology Breast Imaging Accreditation Programs; Joshua Kalowitz, M.D., chief of breast imaging, Maimonides Cancer Center, New York City; Nov. 27, 2006, presentation, Radiological Society of North America annual meeting, Chicago