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Digital mammograms are similar to traditional mammograms. Both use x-rays to produce a 2-dimensional picture of the breast, which makes finding abnormalities challenging. While traditional mammograms produce images on film, digital mammograms create electronic images that are saved as computer files, making it easier for radiologists to find and zoom in on abnormalities, just as you can use your computer to zoom in on a section of a digital photo.
Breast tomosynthesis, also known as 3-D mammography, is the newest form of digital mammography. During a 3-D mammogram, a digital camera moves over the breast, taking multiple pictures from different angles and generating a series of images that give a more complete, layer-by-layer picture of the breast. Because of this, 3-D mammograms are more sensitive and can find cancers earlier than traditional 2-D mammograms. They are also less likely to give a false positive result, when a woman is called back for an abnormality that turns out to be cancer.
Many women worry about radiation with mammograms. The total radiation (3-D alone or in combination with a 2-D mammogram) is well below the maximum level set by the FDA, and is only a fraction of the radiation we receive from just being outside. There is no proof that this low level of radiation has any major effect on the breasts or future cancers. However, for women who have a BRCA mutation, exposure to diagnostic radiation before age 30 has been associated with an increased risk of breast cancer.
As of January 1, 2015, Medicare covers 3-D mammograms for annual and high-risk screening. While many private insurers also cover 3-D imaging, you may want to contact your insurance provider to determine if breast tomosynthesis is covered by your plan.