Spokane Journal of Business

Mammograms go 3-D at Inland Imaging

Radiology practice hopes for better results, fewer false positives

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-—Linn Parish
Inland Imaging breast imaging manager Lesley Dykman says the company started using the new units last month.

Inland Imaging LLC is going 3-D in its mammography imaging units, installing new breast tomosynthesis machines that it hopes will find cancer earlier and reduce false positives. 

Lesley Dykman, breast imaging manager at Inland Imaging, says the Spokane-based radiology practice has installed eight 3-D mammography units at four of its imaging centers and plans to add its ninth unit at a fifth imaging center next month. Once that machine is installed, Dykman says, Inland Imaging will be using the 3-D technology for all of mammograms it performs. 

“Every woman deserves the best available testing,” she says. 

Inland Imaging received U.S. Food and Drug Administration approval to use the new machines in mid-May and began using the first devices in early June. In all, Dykman says, the company invested $3.4 million in the new technology. 

Last year, the Journal of the American Medical Association published a study finding that providers using breast tomosynthesis detected 41 percent more invasive, early-stage breast cancers than those using conventional, two-dimensional mammogram technology. The same study found that practices using the 3-D technology reduced false positives by 40 percent while lowering the need to call patients in for additional testing by 15 percent. 

Dykman says one reason for the improved detection is that the new technology is better at detecting potential tumors in dense breast tissue. Typically, younger women have dense breast tissue, she says, and 3-D mammography is more effective at finding potential cancers earlier. 

Dr. Florence Gin, co-chief of breast imaging services at Inland Imaging, says the practice hasn’t been using the technology long enough to know whether the 3-D technology is improving its cancer detection and reducing its false positives, but she’s bullish on that possibility. 

“You don’t call as many women back, but you find as much or more cancer,” Gin says. “That’s huge.”

Already, she says, the breast cancer detection rate in Washington state in general and Inland Imaging specifically is higher than the national average. 

Also, breast cancer deaths nationwide have been on the decline, according to American Cancer Society statistics. The organization says such deaths have decreased by more than 30 percent since their peak in 1991, and it attributes that in large part to early detection and treatment made possible by annual mammograms for women over 40 years old.

Inland Imaging conducts about 55,000 mammograms at the five centers annually. In all, mammograms account for about 25 percent of all imaging procedures at the five centers. Dykman says those screens result in 2,500 to 2,800 breast biopsy procedures a year. 

Breast tomosynthesis has a similar look and feel to the previous mammography equipment that Inland Imaging used. Dykman says the distinguishing feature of the new technology is that it has an imaging arm that takes multiple images of a breast within seconds, and those images are converted into a digital stack so that they can be read much like a CT scan. 

Because each mammogram exam generates so many more images, 3-D mammograms typically take at least twice as much time for a radiologist to analyze than a 2-D mammogram, Gin says. 

“In the world of pros and cons, it will be worth it, but it’s still substantially more time,” she says. 

Dykman says the new imaging devices have some design tweaks that make them more comfortable for patients. 

The machine is designed to stabilize a woman’s breast during imaging in a way that it doesn’t need to be compressed as tightly. 

While the new device is taking more images, it’s doing that much more quickly than the old units could do it. A 3-D mammogram takes seven seconds to complete per breast, Dykman says, compared with 14 to 30 seconds per breast using the previous technology. 

“When you’re under compression, any number of seconds improvement is huge,” she says.

Inland Imaging currently is operating three 3-D mammography units at its imaging center on the Holy Family Hospital campus, on Spokane’s North Side; two at its offices in the Sacred Heart Doctors Building, on the lower South Hill, two in its office at the Providence Medical Park, in Spokane Valley; and one in its Spokane Valley center, near Valley Hospital. The device yet to be installed will be in its South Cowley office, on the lower South Hill. 

Headquartered at 801 S. Stevens, Inland Imaging has about 680 employees in all, including about 560 in Spokane County. 

Linn  Parish
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Editor Linn Parish has worked for newspapers and magazines since 1996, with the bulk of that time being at the Journal. A Montana boy who has called Spokane home for some time now, Linn likes Northwest trails, Deep South foods, and lead changes in the ninth inning.

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