Background Information:

What are the other Names for the Procedure?

• 3-D Mammography
• Digital Tomosynthesis
• Tomo

What is Breast Tomosynthesis radiology procedure? (General Explanation)

• Breast Tomosynthesis radiology procedure is an advanced imaging technique that uses low dose X-rays to generate 3-dimensional images of the breast, as part of breast cancer screening protocols
• The procedure is very similar to traditional mammography with computerized reconstruction of the images to produce a 3-D image

What part of the Body does the Procedure involve?

Breast Tomosynthesis radiology procedure specifically involves the tissues of the breast.

Why is the Breast Tomosynthesis radiology procedure Performed?

• Breast Tomosynthesis radiology procedure is an attempt to overcome some of the limitations of traditional mammography.
• A screening Breast Tomosynthesis procedure can replace annual mammograms and has been shown to improve the accuracy and reduce the false-positive rates for breast cancer
• Breast Tomosynthesis procedure can also be used in a more focused manner once an abnormality is noted on a screening protocol (i.e., diagnostic Breast Tomosynthesis)

What are the Alternatives Choices for the Breast Tomosynthesis radiology procedure?

Some potential alternatives to Breast Tomosynthesis radiology procedure include:

• Traditional mammography
• Breast ultrasound scan
• Breast MRI scan

What is the Equipment used? (Description of Equipment)

The equipment used for Breast Tomosynthesis is very similar to that used in a traditional mammography procedure. It involves the following:

• The mammographic unit, which is a large box that produces X-rays targeted towards the breast
• Digital film and a computer to reconstruct the images into 3-D
• Plastic compression paddles

What are the Recent Advances in the Procedure?

Breast Tomosynthesis radiology procedure is a relatively new procedure. It was approved by the (US-based) FDA in 2011.

What is the Cost of performing the Breast Tomosynthesis radiology procedure?

The cost of a Breast Tomosynthesis procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

• It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding a Breast Tomosynthesis procedure and what needs to be done
• If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
• Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

https://www.acr.org/Advocacy/Economics-Health-Policy/Managed-Care-and-Private-Payer/Common-Coverage-Issues-with-Private-Payors/Digital-Breast-Tomosynthesis (accessed on 2/14/2017)

Prior to Breast Tomosynthesis radiology procedure:

How does the Breast Tomosynthesis radiology procedure work?

Breast Tomosynthesis works on the same principle as traditional X-ray imaging.

• X-rays, produced by a machine, either pass through or are deflected by parts of the body
• If most of the X-rays pass through a structure, it appears black (such as air-filled lungs)
• If a majority of the X-rays are deflected, it appears white (as in bones)
• Many structures (tissues usually) will appear in shades of grey

In Breast Tomosynthesis radiology procedure the images are captured on a digital film, allowing a computer to reconstruct the data into 3-D images.

How is the Breast Tomosynthesis radiology procedure Performed?

The procedure is performed in the following manner:

• The breasts are positioned on or near the mammographic unit.
• The breasts are then gradually and gently compressed by the mammographic unit to attempt to evenly spread out the tissue, so that small abnormalities can be visualized and a lower dose of radiation used
• The mammographic unit begins capturing images of the breasts. The unit may rotate through different angles as it captures the images
• A radiologist reviews the initial set of images, to determine if more views/images are necessary. Additional views may involve compressing and targeting certain areas of the breast

Where is the Procedure Performed?

Breast Tomosynthesis radiology procedure is performed as an outpatient procedure at a hospital.

Who Performs the Procedure?

The procedure is performed by a radiology technologist under the supervision of a radiologist.

How long will the Procedure take?

The duration of the Breast Tomosynthesis radiology procedure may vary, but in general, should last less than 45 minutes.

Who interprets the Result?

A radiologist interprets and discusses the imaging study results with the healthcare provider, who will communicate them to the patient.

What Preparations are needed, prior to the Procedure?

The following preparations are needed prior to a Breast Tomosynthesis radiology procedure:

• The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are currently being taken
• Do inform the medical professional if you have a history of any medical conditions, such as a heart disease, asthma, diabetes, or kidney disease
• Patients should inform their physician, if they are allergic to any medication
• Women should inform their physicians if they are breastfeeding, pregnant, or if there is a chance that they might be pregnant

What is the Consent Process before the Procedure?

A physician will request your consent for a Breast Tomosynthesis procedure using an Informed Consent Form.

Consent for the procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied with the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks for this Procedure?

Following are the benefits of the procedure:

• Improved detection rate and lesser false-positive rates compared to traditional mammography
• Less “call-backs” than traditional mammography
• Early detection of cancer to improve outcomes

Following are the risks of the procedure:

• A potential for false-positives that may result in unnecessary biopsy and testing, as well as fear and anxiety on the patient’s part
• As with any examination that uses X-rays, there is a small risk of developing cancer with excessive and repeat exposure
• X-rays can harm a developing a fetus and should be avoided during pregnancy

What are the Limitations of the Breast Tomosynthesis radiology procedure?

• Even with the advancement of Breast Tomosynthesis radiology procedure, it is possible to miss small abnormalities in the breast
• It is also possible to receive a false-positive diagnosis, which can lead to unnecessary biopsy and additional testing

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

• What is a Breast Tomosynthesis procedure?
• Why is this procedure necessary? How will it help?
• How soon should I get it done? Is it an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the procedure performed?
• What are the risks while performing the procedure?
• What are the complications that might take place during recovery?
• What are the possible side effects from the procedure? How can I minimize these side effects?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any lifestyle restrictions or modifications required, after the procedure is performed?
• Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
• Is there any medication that needs to be taken for life, after the procedure?
• What are the costs involved?

During the Breast Tomosynthesis radiology procedure:

What is expected during the Breast Tomosynthesis radiology procedure?

• During the Breast Tomosynthesis radiology procedure, some women may feel pain and discomfort during compression of the breast
• If possible, women should schedule the procedure at a point in their menstrual cycle when the breasts are less sensitive

What kind of Anesthesia is given, during the Procedure?

No anesthesia is administered during a Breast Tomosynthesis radiology procedure.

How much Blood will you lose, during the Procedure?

There is no blood loss involved in the Breast Tomosynthesis radiology procedure.

What are the possible Risks and Complications during the Breast Tomosynthesis radiology procedure?

• As with any examination that uses X-rays, there is a very small risk of developing cancer with repeated and excessive radiation exposure. Nevertheless, this effect is minimized by the use of low-dose radiation in the procedure
• With screening protocols, there is a chance of a false-positive diagnosis that can lead to unnecessary biopsies and such procedures, including fear and anxiety for the patient

What Post-Operative Care is needed at the Healthcare Facility after the Breast Tomosynthesis radiology procedure?

There is no post-operative care needed following a Breast Tomosynthesis radiology procedure.

After the Breast Tomosynthesis radiology procedure:

What is to be expected after the Breast Tomosynthesis radiology procedure?

The Breast Tomosynthesis radiology procedure is an uncomplicated procedure. individuals should be able to resume normal activities immediately following the procedure.

When do you need to call your Physician?

A Breast Tomosynthesis radiology procedure is an uncomplicated procedure and the risks to the average individual are minimal.

What Post-Operative Care is needed at Home after the Breast Tomosynthesis radiology procedure?

There is no post-operative care needed following a Breast Tomosynthesis radiology procedure.

How long does it normally take to fully recover, from the Breast Tomosynthesis radiology procedure?

There is no recovery period necessary following a Breast Tomosynthesis radiology procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The Breast Tomosynthesis radiology procedure does not involve the removal of any body tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Breast Tomosynthesis radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

• The hospital, where the procedure is performed
• Healthcare providers, physicians, and radiologists, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Breast Tomosynthesis procedure is performed.