Name of the Procedure:

Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) (G0279)

Summary

Diagnostic digital breast tomosynthesis (DBT) is an advanced form of mammography that uses low-dose X-rays to create a three-dimensional image of the breast. This procedure provides a clearer and more detailed view compared to traditional two-dimensional mammograms.

Purpose

DBT is used to detect breast cancer and other abnormalities in breast tissue. It aims to provide more accurate diagnosis and reduce the need for follow-up imaging. The main goals are early detection of breast cancer and clarity in areas that appear abnormal on traditional mammograms.

Indications

• Abnormal findings on a conventional mammogram
• Dense breast tissue that can obscure results in a standard mammography
• Family history of breast cancer
• Previous breast cancer diagnosis
• Unexplained breast pain or lump

Preparation

• Do not apply deodorants, perfumes, powders, or lotions under the arms or on the breasts on the day of the exam, as these can appear as spots in the images.
• Wear a two-piece outfit for easier undressing from the waist up.
• Inform the technologist if you are pregnant or breastfeeding.

Procedure Description

1. The patient stands in front of the mammography unit.
2. Each breast is positioned and compressed gently between two plates.
3. Multiple low-dose X-ray images are taken from different angles.
4. The images are sent to a computer, which reconstructs a detailed 3D image of the breast.
5. The radiologist examines the images to identify any abnormalities.

Duration

The procedure typically takes about 15-30 minutes.

Setting

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

Personnel

• Radiologic technologist (performs the imaging)
• Radiologist (interprets the images)
• Support staff (assist with patient comfort and logistics)

Risks and Complications

• Slight discomfort or pain from breast compression.
• Minimal exposure to radiation, which is generally considered safe but slightly higher than conventional mammography.
• Rarely, false positives or negatives may occur, necessitating additional testing.

Benefits

• Enhanced detection of small breast cancers that might be missed on traditional mammograms.
• Improved visualization of dense breast tissue.
• Can reduce the number of unnecessary follow-up tests and biopsies.

Recovery

• No recovery time is needed; the patient can return to normal activities immediately.
• Follow any specific guidelines given by the radiologist based on the results.
• A follow-up appointment may be scheduled to discuss the findings.

Alternatives

• Standard 2D mammography: less detailed but lower radiation dose.
• Breast ultrasound: useful for distinguishing solid masses from cysts.
• Breast MRI: provides detailed images but is more expensive and less widely available.

Patient Experience

• The patient might feel brief discomfort during breast compression.
• The environment is usually calm and designed to ensure patient comfort.
• Technologists guide the patient through each step to ensure proper positioning and minimize discomfort.