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

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.

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.

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.)

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