Hologic IMPACT Spring 2014 | Page 14

Trial to inform BreastScreen Australia on potential future use of 3D mammography Kylie Whetton, Communications Manager, Australia/New Zealand Maroondah BreastScreen is responsible for the provision of mammography screening and assessment services to women living in the eastern suburbs of Melbourne. It is one of eight reading and assessment services within BreastScreen Victoria—an accredited part of the national breast cancer screening program, jointly funded by state and federal governments. It provides all clinical services from the initial screening mammogram to any further procedures required to the point of diagnosis. Maroondah BreastScreen employs a multidisciplinary team of health professionals, including radiologists, radiographers, surgeons, pathologists, and nurse/counsellors, who are highly trained in the detection and assessment of the early signs of breast cancer. Images are read from multiple sites in the catchment area, including those visited by the Mobile Screening Service, and where necessary assessment is conducted for all women in their region. Annually it performs around 2,000 mammographic assessments from the screening population. The BreastScreen service forms an important part of the integrated breast service and centre of excellence in diagnosis and treatment of breast conditions located at Maroondah Hospital, Victoria. Commitment to research Maroondah BreastScreen is conducting a stand alone research trial to evaluate the role of 3D mammography in breast screen assessment and to determine whether it can replace other more traditional mammography views and reduce the number of benign biopsies. Designated radiologist Dr Darren Lockie says: “We have so far seen about six clients for whom 3D mammography has detected malignant change that was not the primary reason for assessment. A tumour was detected coincidently. This has been the case for both single focus lesions and those with multiple foci.” Four of its radiologists and four of its radiographers are involved in the project. At present, the research is focussing on the diagnostic component at the 14 | IMPACT APRIL 2014 assessment clinic. All women, regardless of breast density or lesion type, who require assessment for any screen-detected abnormality, are invited to participate in the trial and after details are provided on informed consent, they can choose to opt in or out. For those clients who opt in to the trial, 3D mammography is incorporated as part of their normal work-up process followed by standard focal compression views. If a client opts out, they receive standard 2D FFDM plus focal compres-sion views. Both groups then move on to further tests, such as ultrasound or biopsy, depending on the outcome of mammographic assessment and clinical need. Dr Lockie reports that over 300 women have been recruited into the trial. “Prior to the trial, we had already used 3D mammography on approximately 100 women, so over 400 women have undergone 3D mammography procedures at Maroondah BreastScreen to date. Approximately 90% of women who come to the clinic are opting into the trial. This is about 10 women per clinic. Depending on the outcome of the trial, it may be that 3D mammography has a role for all women who require assessment