"I think in terms of imaging the breast, the thing that is coming on the horizon is tomosynthesis, which potentially could become a significant screening tool," De Paredes says. "It's a form of mammography based off of digital mammography."

Digital tomosynthesis takes multiple X-ray pictures of each breast from many angles. The breast is positioned the same way it is in a conventional mammogram, but only a little pressure is applied-just enough to keep the breast in a stable position during the procedure. The X-ray tube moves in an arc around the breast while 11 images are taken during a seven-second examination. Then the information is sent to a computer, where it is assembled to produce clear, highly focused three-dimensional images throughout the breast.


According to Schroeder, this is very similar to breast CT. "Both use X-ray to create a three-dimensional set of slices of the breast tissue. They are very similar in theory but each may have pros and cons versus the other," he says. "Tomosynthesis is more similar to a conventional mammogram so the transition could be easier to integrate into current centers. However, tomosynthesis may have some challenges to overcome since it uses only a portion of the three dimensional information available to CT scanners. Both modalities will need to be developed with attention to limiting radiation doses."

"GE has done much of the pioneering work in making digital mammography the new standard and is a leader in the race to bring tomosynthesis to market," Schroeder says. "Even as digital mammography is ultimately replaced by a new tool, whatever that may be, it was a necessary step in the evolution of breast cancer screening."

"I think tomosynthesis has a lot of potential," De Parades says. "There are a number of facilities testing it, but it is not FDA approved yet, so it's still in the investigational stage."

Researchers believe that this new breast imaging technique will make breast cancers easier to see in dense breast tissue, and will make breast screening more comfortable.

"What all these improvements in imaging really do is to refine image," Schmitt says, "but once you see something, you're already in trouble. In the ideal future, the goal will be to find it without imaging. What you want to do is find it before it turns into cancer. Whether that can be done through blood testing or some other type of testing, I don't know. What you want to do is predict and interdict the cancer, to stop it before it starts, because once you can image it, it's too late."

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