This concerns Carol H. Lee, chair of the American College of Radiology's breast imaging communications committee, who says that "the jury's still out" on whether it's worth exposing women to more radiation in order to decrease the recall rate for a few of them.
"We have a tendency in this country to adopt new modalities before they're fully validated because they're something new and we like to think they're an advance," says Lee, a radiologist at Memorial Sloan-Kettering Cancer Center in New York. She does not use tomosynthesis.
Robert Ochs, a physicist who served as the lead reviewer for the FDA panel that approved the 3-D machine, said that even a double dose of radiation is still very little. A 2-D/3-D combination of mammograms produces about a tenth of that from a CT scan of the chest, or 160 times the "negligible" amount in a dental X-ray, according to the American College of Radiology.
"The potential immediate benefit for cancer detection greatly outweighed the potential for cancer from the radiation that would occur many, many years down the road," Ochs says.
Having a 2-D/3-D screening every year is estimated to increase a woman's lifetime cancer risk by less than 1 percent compared with the risk from 2-D exams alone, according to Ochs. The National Cancer Institute recommends that women age 40 and older have a mammogram every one to two years. The U.S. Preventive Services Task Force (USPSTF), an independent, government-appointed panel that makes recommendations to policymakers, doctors and others, in 2009 recommended that women wait until age 50 years to start routine mammography.
Lillie Shockney, the administrative director of the Johns Hopkins Breast Center and a breast cancer survivor, said she receives about 1,400 emails a week about breast cancer on the center's website, and probably two of those are queries about tomosynthesis.