Tomosynthesis improves breast cancer detection

Tomosynthesis Machine. Photo: TRG Imaging
Tomosynthesis Machine. Photo: TRG Imaging

Every three hours a woman in New Zealand is diagnosed with breast cancer.

Approximately 650 die per year from the disease in this country alone.

While the number of people who lose their battle against it has remained constant, the diagnosis of breast cancer has risen.

Statistics show that five years ago, one in ten women were diagnosed – now the rate is one in nine.

Developments in science and technology have had a big part to play in earlier and more frequent detection of breast cancer. Tomosynthesis, a form of breast screening, has been a huge help. This advanced technology has enhanced the detection of cancer masses, which regular mammography may not pick up.

While mammograms have helped reduce the number of breast cancer deaths, the method has also been criticised for excessive false-positive results, limited sensitivity and the possibility of minor lesions being over diagnosed. The cancer gets into folds and tissue that mammograms can’t always pick up.

Tomosynthesis produces a three-dimensional image of the breast by using several low-dose x-rays obtained at different angles, which can pick up cancer masses quickly.

During Tomosynthesis, the breast is positioned and compressed in the same way as for a mammogram and only takes an extra 20 seconds.

The Tomosynthesis CT tube moves in a circular arc around the breast. It takes around 60 pictures, which are approximately 1mm apart from each other – compared to a regular mammogram’s four shots. The information from the x-rays is sent to a computer, which produces a focused 3D image of the breast.

In New Zealand, Tomosynthesis is only offered by a limited number of providers, due to its high cost.

The process of Tomosynthesis costs the provider a lot more than just a regular mammogram.

An ordinary mammogram machine costs around $250,000. The additional piece of the machinery, which attaches to the top of the mammogram to produce Tomosynthesis screening, roughly costs an extra $100,000. Plus, with more pictures and data generated, radiologists need more time to look through multiple images – which costs money, too.

In New Zealand, we are just starting to learn about Tomosynthesis, but the technology has been around in US and Europe for over 10 years.

TRG Imaging Auckland was the first private institution to bring Tomosynthesis screening to New Zealand.

The original research for Tomosynthesis for TRG Imaging New Zealand started in Melbourne approximately 18 months ago.

The head radiologist and the CEO were shown a 2D mammogram picture of a woman, who was screened two days earlier. This looked clear for breast cancer, and the woman would have been told to return one year later for a check-up. They were then shown exactly the same woman, but this time she’s had a 60 image Tomosynthesis screening.

Top radiologists and the CEO were horrified at what they saw. There was an ugly lesion and a hideous dark mass detected from the 3D shots. They were now highly concerned about this woman’s health.

Tony Moffatt, CEO of TRG Imaging Auckland Breast Centre, and Chairman of The Breast Cancer Cure Charity says, “That’s when I knew I would, without a doubt, spend $100,000 for TRG’s first Tomosynthesis machine for New Zealand. It was for a great cause and all women deserve that.”

Most women only need to be screened every two years. Mammograms are free for women aged between 45 and 69.

Tomosynthesis screening costs approximately $250, “which is the equivalent to roughly two decent nights out, that you would have to give up, but which could possibly then go on to save your life,” adds Moffatt.

“And interestingly, you would expose yourself to more radiation on a plane from New Zealand to Europe than a Tomosynthesis screening.”

Most good health insurances cover Tomosynthesis. Insurers would rather pay out early for Tomosynthesis than get stuck with lots of later costs in worst case scenarios.

Emily Patrick