Analog (Film) Mammography versus Digital Mammography & a New Digital Mammogram: 3-D Tomosynthesis

By: Lori Lea Garza, Mammography Technologist, Sr., RT (R)(M) at St. David’s Breast Center

Mammography continues to be the leading modality in the prevention and early detection of breast cancer. Throughout the years, mammograms have changed dramatically. In early times, analog (film) mammography was the standard, then digital mammography was introduced, and now we have 3-D technology. With all of these changes, patients often wonder what the difference is between the different technologies and which one is best for them.

Analog (film) mammograms were the standard of care for many years. However, as technology improved, analog image quality was not as reliable. In 2000, the FDA approved the first full-field digital mammography unit, which improved image quality dramatically. Digital mammograms decreased exam time and allowed us to store information on a computer.

In 2003, The Breast Center at St. David’s Medical Center became the first in Austin to obtain a digital mammography unit.

As of 2015, 95 percent of mammography facilities are digital.

While digital and film mammography both use X-rays, analog mammography stores the image directly on film, whereas digital mammography stores an electronic image as a computer file. It’s similar to the advances seen in photography—most people have shifted from film cameras to digital cameras, which means the images are often clearer and are produced faster. 2-D mammography, which entails taking four images of the breast, is considered a preventative study for the early detection of breast cancer. Along with the changes in image quality, 2-D mammography decreases the amount of radiation patients receive.

3-D mammography was introduced in February of 2011. This type of mammogram gave us a whole new spin on image quality and how we are able to view it. This technology, like the 2-D mammogram, takes four images of the breast, but it also incorporates a 1 mm image slicing of the breast, called tomosynthesis.

Tomosynthesis allows us to produce 30 to 60 images of the breast; therefore, it picks up 41 percent more breast cancers than the 2-D mammogram and reduces the patient’s call-back rate by 40 percent.

We at The Breast Center strive to maintain the best for our patients, so in July of 2013, we introduced the first Tomosynthesis 2-D/3-D mammography unit in the Austin area. Patients love the images and capabilities of the 3-D machine, but they’re often concerned about the radiation exposure. We assure them that the radiation dose is well within the acceptable range for screening mammograms—and even at the level of analog mammograms. We now offer Tomosynthesis HD 3-D mammography, which decreases the radiation dose to the equivalent of any other type of mammogram we’ve had in the past. Enhanced image quality and a lower radiation dose—need I say more? Well I will.

Since there are differences in these types of mammograms, the question we hear most often is which one is the best one for the patient. Truthfully, it is the patient’s decision. Statistically, 65 percent of females have dense breasts; this dense tissue can make it difficult to view the breasts. While mammography does detect cancer, it also detects abnormalities.

In this case, why not have a mammogram that will decrease the anxiety level of needing to be called back?

Since 3-D is a new type of mammography, it’s difficult to get a good census of which is better, as it depends on a number of factors.

In conclusion, when choosing which type of mammogram you want, choose the one you feel is best for you. Patients need to know their “normal” and decipher what’s going to work best for their breast health. The main goal is to get your recommended mammograms—and to do breast self-exams monthly. Let’s take care of ourselves, ladies, and understand that breast cancer affects all women, regardless of family history or age. The only person who can save you is you!


According to Susan G. Komen®, 246,660 new cases of breast cancer will be diagnosed in women and 2,600 cases of breast cancer will be diagnosed in  men in the U.S. in 2016. We recommend that you take action and get a mammogram! 

-Komen Austin


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