Name of the Procedure:

Diagnostic Digital Breast Tomosynthesis; Bilateral
Common Name: 3D Mammography, Digital Tomosynthesis

Summary

Digital Breast Tomosynthesis (DBT) is a type of advanced breast imaging technique that creates a three-dimensional picture of the breast using X-rays. In a bilateral DBT, both breasts are imaged to screen for or diagnose breast cancer and other abnormalities.

Purpose

DBT is used to detect breast cancers, distinguish malignant from benign lesions, and investigate symptoms such as lumps or unusual findings from a physical exam or previous imaging studies. The goal is to provide clearer and more accurate images, which can improve cancer detection rates and reduce false-positive results.

Indications

• Presence of a palpable lump or mass in the breast
• Abnormal findings on a prior mammogram or ultrasound
• Breast pain or nipple discharge
• High-risk patients based on family history or genetic predisposition

Preparation

• Patients should avoid using deodorant, powders, or lotions under the arms or on the breasts on the day of the exam as these can interfere with image quality.
• Wear a two-piece outfit for convenience.
• Inform the technician if you are pregnant or breastfeeding.
• No fasting or specific medication adjustments are generally required.

Procedure Description

1. The patient stands in front of a specialized DBT machine.
2. Each breast is compressed between two plates one at a time to spread out the tissue.
3. The machine takes multiple low-dose X-ray images from different angles.
4. A computer reconstructs these images into a three-dimensional model of the breast tissue.
5. The entire process typically involves two views of each breast.

Duration

The procedure typically takes about 30 minutes, though the exact time may vary.

Setting

DBT is performed in a hospital radiology department, outpatient imaging center, or specialized breast clinic.

Personnel

• Radiologic Technologist: Performs the imaging procedure.
• Radiologist: Interprets the images to provide diagnostic information.
• Healthcare provider: Orders the test and discusses the results with the patient.

Risks and Complications

• Slight discomfort or pain due to breast compression during the procedure.
• Minor exposure to radiation, though the dose is generally low.
• False positives or negatives, requiring additional testing or biopsies.

Benefits

• Improved detection rate of breast cancer, especially in dense breast tissue.
• More accurate characterization of breast lesions, potentially reducing the need for follow-up imaging.
• Enhanced ability to detect small tumors that may not be visible with standard mammography.

Recovery

• Most patients can resume normal activities immediately following the procedure.
• No specific post-procedure care is required.
• Follow-up appointments may be scheduled to discuss the results or to perform additional tests if needed.

Alternatives

• Traditional 2D mammography: Less detailed imaging but widely available.
• Breast ultrasound: Useful for further evaluating abnormalities seen on mammography.
• MRI of the breast: Highly sensitive but more costly and not typically used for initial screening.

Patient Experience

• Patients may experience brief discomfort from the compression but can expect the technologist to minimize discomfort as much as possible.
• No sedation or anesthesia is used, so patients remain fully awake.
• Results are generally discussed during a follow-up appointment with the patient's healthcare provider.