1. Roni Talukdar, MD

2. Topics
New screening recs and rebuttals
Tomosynthesis

3. Screening

4. US Preventative Task Forces
Screening mammogram women ages 50-74
Every other year
NO self breast exam
NO clinical breast exam
2009

5. US Preventative Task Forces
Screening mammogram women ages 50-74
Every other year
NO self breast exam
NO clinical breast exam

6. DO NOT support recommendations:
American Cancer Society
American College of Gynecologists and Obstetricians
American College of Radiologists
Society of Breast Imaging
Memorial Sloan Kettering
MD Anderson

7. Screening Guidelines:
Annual Mammogram at age 40
Clinical Breast Exam
Annually at age 40
Every 3 years ages
And continue until less than 5-7 years life expectancy

8. Who is the USPTF?
Very smart group of doctors that represent a “cross-section of doctors”
Some MDs, some PhDs, mainly in academics
No radiologists, breast surgeons, oncologists.
No physician that primarily deals with breast issues

9. Women Ages 40-50 1 in 6 Breast Cancers occur in this age range
Higher percentage of poor genotype cancers

11. Problems with Canadian trials
Not truly blinded
Poor image quality
Poor quality of interpretation

14. Tomosynthesis

20. Why Breast Tomosynthesis (3D mammography)?
Tissue superimposition hides pathologies in 2D 20

21. 3D Mammograms June 2015
Digital Mammograms

22. 3D Improves Visibility by Reducing Tissue Superimposition

23. Generating 3D/2D Images Perform a standard tomosynthesis scan
The first step to generating a 2D image is to perform the tomosynthesis scan
Click to display bullet & motion of x-ray tube
The image represents the x-ray tube moving to produce 15 low-dose projection images.

24. 55 Tomosynthesis Slices*
Generating 2D Images
55 Tomosynthesis Slices*
Perform a standard tomosynthesis scan
Reconstruct tomosynthesis slices
Reconstruction Algorithm
15 Projection Images
*Average slices based on 5 cm compressed breast
After the acquired scan, the projection images will be reconstructed into 1 mm slices. There are an additional 5 slices reconstructed due to paddle tilt.
Click to display up arrow & bullet

25. 55 Tomosynthesis Slices*
Generating 2D Images
55 Tomosynthesis Slices*
Perform a standard tomosynthesis scan
Reconstruct tomosynthesis slices
Synthesize 2D image
Available in any tomosynthesis view
Software
Algorithm
From the reconstructed slices, a software algorithm is applied and it creates the Generated 2D image
Click to display down arrow & bullets
Generated 2D Images

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