Can Anyone Get a 3D Mammogram, and Does Insurance Cover It?

The Short Answer from a radiologist

Q: Can anyone get a 3D mammogram, and is it covered by insurance?

A: Three-dimensional mammograms can be used for routine screening mammography. They are gaining popularity and are widely covered by most insurance providers, including Medicare and Medicaid.

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Many research studies show that 3D mammography — technically called digital breast tomosynthesis — offers better results than conventional 2D mammography. It may be particularly effective for women with dense breast tissue or who are at high risk for breast cancer.

Three-dimensional mammograms can better pick up invasive cancers and avoid the false alarms common with 2D mammography, particularly when breast tissue is dense.

Both 2D and 3D mammograms use X-rays to create detailed images of the breast, in order to detect masses or other abnormalities.

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But in 3D mammography, an X-ray tube moves in an arc around each breast, capturing multiple imaging “slices” at different angles. These images are sent to a computer and reconstructed, to create a 3D rendering of the breast tissue in 1-millimeter slices that the radiologist reviews.

For women, the comfort level for 3D mammograms is similar to that of 2D mammograms. After positioning the breast tissue, a technician gently compresses it between a plate and a comfort paddle. The gradual, even compression creates a sense of pressure.

The radiation dose for breast tomosynthesis is slightly higher than the dose used for standard mammography but falls within FDA-approved safety levels for mammography radiation. (Some 3D systems use doses similar to conventional mammography.)

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Any woman who is interested in having 3D mammography should check with her provider to see if it makes sense for her ― as well as her insurer to confirm that it is covered in her state. Some states mandate that insurers cover 3D mammograms; others may not.

— Breast imaging specialist Nidhi Sharma, MD

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