The History of Mammography
Mammography is a type of breast imaging that uses low-dose x-rays to detect cancer at an earlier stage, when it’s the most treatable. Before the discovery of x-rays, most if not all cancers of the breast, could only be detected when they had become large enough to be “palpated” or felt during a physical examination.
The Discovery of 3D Breast Imaging Technology
Over the past 100 years, there have been significant advances to better assist physicians with early breast cancer detection to increase the chances of long-term survival for patients. Eighteen years after the discovery of x-rays in 1895, a German surgeon began a study of 3,000 mastectomies and wondered if by using these newly discovered rays, he could correlate known cancerous tissue of breast specimens to radiographs taken of the same breast. He discovered microcalcifications on the images associated with those specimens with known breast cancer pathology. In 1913 he wrote, “Roentgen photographs (x-rays) of excised breast specimens give a demonstrable overview of the form and spread of cancerous tumors.” In 1949, Raul Leborgne, a radiologist in Uruguay, introduced the medical community to the compression technique in breast imaging, ushering in the modern mammogram. In the late 1950s, a physician in Houston, Texas detailed a new technique using fine-grain intensifying screens that produced even clearer images of the breast. Finally, in 1969, dedicated mammography units became available for use around the world. As technology advanced, digital imaging became the preferred method of breast imaging. In the year 2000, the FDA approved the first digital mammography unit, followed 11 years later by the approval of the first (Hologic) 3D breast imaging technology which quickly proved superior to digital imaging.
Also known as digital breast tomosynthesis, this new 3D technology takes multiple images of each breast, allowing the radiologist to view the breast layer-by-layer rather than viewing a single flat image. Fine details of the breast tissue were now visible and not hidden by the tissue immediately above or below. In 2014, a study in the Journal of the American Medical Association (JAMA), concluded the addition of tomosynthesis with digital mammography finds significantly more invasive cancers than traditional mammography alone, while reducing the number of women called back for false positive readings.
The Future of Breast Imaging
Learning about these latest technologies, a person cannot help but ponder the future. What does the horizon hold for breast imaging? Recent areas of concentration include: molecular breast imaging (MBI), which specifically looks to address the issue of dense breast tissue imaging, and breast specific gamma imaging (BSGI), which targets women with high risk factors who receive negative mammograms. In early trials, when combining high-risk lesions and cancers in women with negative mammograms and increased risk factors, BSGI detected 33.0 high-risk lesions and cancers per 1,000 women screened. One day, perhaps we will finally win the war against cancer President Nixon announced we were officially waging in 1971. Until that time, it is exciting to know that we have created an arsenal of weapons to identify and fight the enemy living within breast tissue, saving men and women from untimely death.