The High Authority for Health (HAS) now recommends using 3D mammography, by tomosynthesis, to detect breast cancer in patients aged 50 to 74 years.
- Breast cancer is responsible for more than 12,000 deaths per year in France.
- It is the subject of an organized national screening program for women aged 50 to 74.
- The Haute Autorité de Santé recommends the integration of mammography by tomosynthesis, provided that it is systematically associated with the reconstruction of a synthetic 2D image.
It is the most common cancer in France and represents the leading cause of cancer death in women. Each year, breast cancer causes more than 12,000 deaths in France, despite an improvement in the five-year survival rate over the past ten years. To be detected early and reduce mortality, it is the subject of an organized national screening program. The latter concerns all women between 50 and 74 years old, “without symptoms and having no particular risk factors for breast cancer, other than their age”, according health insurance.
Breast cancer: what is 3D mammography?
This screening, carried out every two years, consists of a clinical breast examination and a mammogram. As a reminder, this is an X-ray of the breasts using low-dose X-rays, which is carried out using a mammograph. Recently, the French National Authority for Health (HAS) recommended the integration of mammography by tomosynthesis in organized screening for breast cancer. As a reminder, tomosynthesis (3D) is a technique which makes it possible to obtain a digital image reconstituted in three dimensions from images of the breast obtained under different sections.
Use tomosynthesis combined with synthetic 2D image reconstruction
Before posting his opinion, the health authority compared the conventional mammography method (2D) to the tomosynthesis technique (3D) alone, then to the combination of the two methods (3D + 2D), and finally to the 3D technique associated with a reconstruction of synthetic image (2Ds). When analyzing the results, they took into account the cancer detection rate, the sensitivity and specificity of the screening, the rate of false positives, patient callbacks for additional examinations after the mammogram.
“Studies on 3D combined with 2Ds, a less irradiating method which also allows second reading, have shown encouraging results. This procedure makes it possible to improve the performance of organized screening, in particular its cancer detection rate, without however, increase the number of imaging procedures and the exposure dose”, explains the HAS, which recommends that the current procedure based on digital mammography (2D) be maintained.
