A 3D mammogram uses X-rays to create an image of the breast tissue. The procedure is similar to that of a conventional mammogram, but it provides a clearer picture of the breast tissue.

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A 3D mammogram, or digital tomosynthesis, differs from a standard mammogram offering a 2D picture.

A 3D mammogram helps doctors screen thoroughly for breast cancer, including in people with no noticeable signs or symptoms of the disease. This technique may be particularly important for certain individuals, such as those with dense breast tissue.

Accurate imaging is critical, as breast cancer is common. According to the American Cancer Society, 1 in 8 females may develop breast cancer in their lifetime.

This article explains the 3D mammography process in detail. It also explains who might need a 3D mammogram and what they can expect from the screening. Finally, it will outline the general coverage of health insurance policies and other ways to get help toward the cost of a 3D mammogram.

3D Mammogram image of breasts.Share on Pinterest
Photography courtesy of NIH Image Gallery

A 3D mammogram procedure is similar to a traditional mammogram. These mammograms are imaging tests that healthcare professionals use to check for any breast diseases, such as breast cancer.

A standard 2D mammogram creates a flat image of the breast, while a 3D mammogram produces a three-dimensional image.

The mammogram machine sends small X-ray signals through the breast tissue from different angles. It then compiles all the images into one 3D image.

The final 3D picture gives a complete, detailed impression of the breast. Doctors can use this to detect signs of any atypical growths or cancer.

Doctors may recommend 3D mammograms to investigate growths that may characterize cancer or help identify the reason for any symptoms a person may be experiencing.

Using a 3D mammogram may give doctors and individuals more confidence and certainty in their diagnosis and any necessary follow-ups.

Traditional 2D mammograms are currently the industry standard for imaging breast tissue and one of the best screening methods for breast cancer.

During a 2D mammogram, the technician will compress the breast tissue to make it as uniform as possible. The machine then creates simple X-ray images of the tissue, from the sides and top to bottom.

In a 3D mammogram, the process is similar, except that the technician takes multiple X-rays of the breast from many different angles. They then compile these images to create a complete digital representation of the breast.

The process allows doctors to look at small, individual sections of the breast tissue. This level of detail may help specialists detect some forms of atypical growth in the tissue more accurately.

Doctors may recommend 3D mammograms to investigate unexpected growths or help identify the source of any symptoms a person may have.

The American Society of Breast Surgeons recommends that all females over the age of 40 undergo annual 3D mammography breast screening. It also adds that females with a higher-than-average risk of breast cancer should undergo annual screenings from the age of 35.

Performing a 3D mammogram can be especially useful for those with dense breast tissue. This is because dense breast tissue may make images from 2D mammograms more cloudy or unclear.

Malignancies and signs of tumors appear dense and white on an X-ray image. Dense breast tissue can also appear white, which may obscure any signs of unusual growth.

As 3D mammograms use many images of various layers of tissue, it makes it easier for a doctor to detect unexpected growths even in dense breast tissue.

People with atypical symptoms or signs of breast disease may also require a 3D mammogram.

Additionally, 3D mammograms can reduce the need for follow-up imaging.

Doctors may have some recommendations for the days leading up to a mammogram.

For instance, they may recommend that individuals schedule the appointment just after their menstrual cycle, as breast tissue may be less tender at this time.

A person may also need to avoid wearing perfumes or deodorants on the day of their mammogram, as some of these products may interfere with the procedure.

Additionally, people should inform the healthcare professional of any medications or hormones they are taking. They should also advise of any previous surgeries or possible pregnancy.

The 3D mammogram procedure is similar to that of a standard mammogram. The technician will ask the person to remove their shirt, bra, and any jewelry and change into a temporary garment.

The technician will place an individual’s breast on one compression plate of the machine, using a second plate to flatten the breast tissue to create a uniform thickness throughout.

The imaging arm of a 3D mammogram machine moves in an arc over the breast, taking many X-rays from different angles. The X-ray can generally take 11 images in 7 seconds. A computer then processes the images to form a clear 3D image.

The whole procedure may take around 30 minutes. People may experience some temporary discomfort from the pressure on the breasts when they are under the compression plate.

Radiologists will scan the images, looking for signs of atypical growth, calcification, or lumps in the breast tissue. They will interpret the results before sending them to the individual’s doctor.

The testing facility will let a person know when their results are available, and they can then make an appointment with their doctor to discuss the results. If the mammogram indicates a potential health issue, people may require further examinations.

Next steps after unexpected results

If a mammogram shows an atypical result, people may need further examinations to diagnose the issue. However, atypical results do not mean a person has breast cancer. Doctors may need to examine a specific area in more detail or examine any cysts, masses, or calcifications, which are deposits of calcium.

Healthcare professionals will need to analyze any unusual signs in the breast tissue to check if they are noncancerous or could indicate breast cancer. A follow-up examination may include one or more of the following:

If the results show nothing of any concern, people may not need further testing until their next routine checkup. If further testing shows any atypical indications, people may require a biopsy to confirm the findings. A biopsy is a tissue sample that doctors study under a microscope to check for cancerous cells.

A 3D mammogram aims to detect disease by screening breast tissue for possible abnormalities. It also helps healthcare professionals diagnose breast conditions. A 3D mammogram may have a higher disease detection rate than standard 2D mammograms and can reduce the need for follow-up imaging.

People may require a 3D mammogram as a screening or diagnostic test for breast disease. A screening mammogram helps with the early detection of breast cancer when there are no symptoms. It is an annual, routine test for females over the age of 40 years or those at higher risk of breast cancer.

A diagnostic mammogram helps diagnose a condition if people have any atypical signs or symptoms, such as a lump or nipple discharge.

If a person fits the criteria for breast screening or has unusual breast symptoms, they should talk with a doctor about having a 3D mammogram.

The cost of a 3D mammogram may vary between states. They can depend on the insurance provider and whether the test is for screening or diagnosis. Some insurance providers may cover the costs of a mammogram. For example, Medicare Part B insurance covers the following:

  • one baseline mammogram for females aged 35–39
  • an annual screening mammogram for females aged 40 and above
  • as many diagnostic mammograms as medically necessary

A person who qualifies for original Medicare pays nothing for a screening mammogram if a healthcare provider accepts the payment from Medicare. And for a diagnostic mammogram, they would need to pay 20% of the Medicare-approved amount and any deductible Part B amount.

Medicare Advantage plans cover the cost of screening mammograms, as long as a person uses a Medicare-approved facility. These plans also cover diagnostic mammograms, but a person needs to pay part of the cost.

However, not all healthcare facilities offer 3D mammography. People can consult a doctor about their closest facility and find out from their insurance providers about any costs they may cover.

Find out more about Medicare coverage for mammograms.

For those without insurance

The Centers for Disease Control and Prevention (CDC) run the National Breast and Cervical Cancer Early Detection Program, which helps people without adequate healthcare insurance access breast screening and diagnostic services.

Individuals may be eligible for support if they:

  • have no insurance
  • have insurance that does not include breast screening tests
  • have an annual income at or below 250% of the federal poverty level
  • are female and aged between 40-64 years, although other females outside of this age bracket may also be eligible for screening services

People can search for low cost or free services here.

There is minimal risk from a 3D mammogram, and the benefits typically outweigh any risks. The radiation dose for a 3D mammogram can vary but may be slightly higher than a 2D mammogram. However, these dosages are still within Food and Drug Administration (FDA)-approved safety levels.

However, mammograms may produce a false-positive result, meaning they can show an abnormality when there is no disease present. Despite this, 3D mammography for screening and diagnosis reduces the chance of false-positive results.

No imaging tests are perfect, and there is always a chance that a mammogram will fail to detect disease, particularly in areas that are difficult to capture. This is called a false-negative result.

Additionally, all forms of mammograms may be uncomfortable. That said, 3D mammograms may cause less discomfort, as it only uses minimal pressure to keep the breast in place during the test.

Mammograms using 3D technology are fairly new, but many health facilities are adopting the technology. The process is similar to that of a standard mammogram, but 3D mammograms offer a more complete image of the breast tissue than 2D mammograms. This makes it easier to see unexpected growths and other issues in the breast.

Doctors recommend that all people who need mammograms receive 3D mammograms where possible, but undergoing these screenings is especially important for those with dense breast tissue.

Health insurance usually provides partial or full coverage for diagnostic 3D mammograms. A person should check their insurance provider’s terms and conditions to find their coverage level.