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Mammograms: 3-D or 2-D? How Is Tomosynthesis Better at Detecting Breast Cancer? Dartmouth Expert Explains the Difference

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Steven Poplack, MD, understands the true benefits of 3-D mammography or tomosynthesis after a decade of research into the technology.

3-D digital mammography improves the accuracy of breast cancer detection and helps to reduce call backs for non-cancerous abnormalities. Tomosynthesis also appears to find the type of breast cancer that most often causes problems.

"Things are no longer hidden," says Poplack, codirector of breast imaging at Dartmouth-Hitchcock Medical Center, Lebanon, NH. "On a mammogram, the tissue can stack up to look like cancer and fool us into thinking there is a problem when there really isn't."

"It's really a double benefit. It allows us to detect early cancer that we might not be able to see and not go down the path of a false alarm," he says.

Poplack's team in radiology has been collaborating with Dartmouth researchers from the Norris Cotton Cancer Center and the Thayer School of Engineering since 1999 to develop new technologies to improve the diagnosis of breast disease.

To produce the 3-D images, a tube revolves around part of the breast in a short arc while sending out multiple x-rays in low doses. A computer reconstructs the data gathered in a way that allows viewing of thin layers of tissue. The radiologist views each individual layer of breast rather than a shadow of the entire breast.

At this point, tomosynthesis exposes the patient to slightly more radiation than a conventional digital mammogram, although well within the safety limits mandated by the federal government. Later this summer, Dartmouth-Hitchcock Medical Center will be getting new technology that reduces the x-ray dose back to the same level as the conventional digital mammogram.

Leading the way in earlier cancer detection
Dartmouth-Hitchcock was among the first institutions in the United States to research and develop the tomosynthesis technology, Poplack says, and it's one of five institutions that contributed data that led to approval from the federal Food and Drug Administration.
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STEVEN P. POPLACK, MD
Director of Brest Imaging Center, Associate Professor of Radiology and of Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth

Medical School:
MD, Boston University School of Medicine, Boston, MA, 1988

Internship:
Carney Hospital, Boston, MA, Medicine/Surgery, 1988-89

Residency:
Yale-New Haven Medical Center, New Haven, CT, Diagnostic Radiology, 1989-93

Fellowship:
Yale-New Haven Hospital, New Haven, CT, Body Imaging, CT, MRI, Ultrasound, Mammography, 1992-93

Board Certification:
Diagnostic Radiology, 1993

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