2-D or 3-D?
“If we find a cancer by a mammogram, whether that’s a 2-D or 3-D mammogram, the odds are with us that it will be a curable cancer,” says Ursa Brown-Glaberman, MD. “The vast majority of women with breast cancer have completely curable breast cancers as long as they’re detected early.”
That’s great news for most women — but not for all. In Brown-Glaberman’s estimation, about 30% of women diagnosed with breast cancer have a life-threatening cancer. As a medical oncologist who specializes in breast cancer, she wants to catch those cancers earlier, when these women have many more treatment choices and a much better chance of beating the disease.
Brown-Glaberman co-leads the Breast Team at the UNM Comprehensive Cancer Center and serves as the New Mexico principal investigator for the landmark Tomosynthesis Mammographic Imaging Screening Trial (TMIST). The UNM cancer center a member of the ECOG-ACRIN Cancer Research Group, which designed the TMIST trial and is conducting it with funding from the National Cancer Institute, part of the National Institutes of Health.
The TMIST study compares tomosynthesis, which is 3-dimensional mammography, with 2-dimensional digital mammography for breast cancer screening. The study is designed to determine which type of mammography is better at finding tumors that could be life-threatening.
“Both choices on this study — 2-D or 3-D mammogram — are excellent in terms of screening for breast cancer,” Brown-Glaberman says. She explains that women on the study will be chosen at random to get one type of mammogram or the other and adds that most insurance covers both.
To find enough women who might eventually be diagnosed with life-threatening breast cancer, the TMIST study must enroll more than 160,000 women intentionally. Women ages 45 to 74 who are planning to get a routine screening mammogram are eligible for this trial. In the United States, more than 82 million women are older than 40, the recommended age at which to begin annual screening mammograms. The American Cancer Society estimates that 268,600 women will be diagnosed with breast cancer of all types in 2019.
The study defines life-threatening breast cancer as cancer that has spread to other organs or to lymph nodes, or cancer in which the tumors are large or have aggressive features. To be a site for TMIST, the UNM Radiology Breast Imaging clinic certifies its mammogram machines weekly to ensure the highest quality of images.
To join TMIST, the clinic had to demonstrate that it can safely and securely send mammography data without transmitting patient-identifying data. And, the UNM radiologists who read mammograms for this study, all of whom have completed fellowship training in Breast Radiology, had to complete additional special training.
Brown-Glaberman’s team has streamlined the process to join the study. “You can sign the consent and enroll the day you come in for your mammogram, most of the time,” she says. And, the team is actively searching for women in New Mexico who may be eligible to join. Clinical researchers will follow each woman on the study for eight years and will closely watch each woman’s follow-up care.
“[The TMIST study] is a once-in-a-lifetime clinical trial that’s going to answer a really important question for women,” Brown-Glaberman says. She adds that women who join the study are “contributing to the knowledge for the millions of women undergoing breast cancer screening.”
To learn more about TMIST, visit ecog-acrin.or/tmist and https://www.cancer.gov/about-cancer/treatment/clinical-trials/nci-supported/tmist\
To learn more about the TMIST study at the UNM Comprehensive Cancer Center, call 505-272-7412 or email TMIST-Scheduling@salud.unm.edu.