How did your interest in digital mammography evolve?

It began during my research fellowship at a lab devoted to developing digital detectors. My early collaborators were actually astronomers looking to develop better digital detectors to image stars in the sky. A variation of this detector was used to develop the first stereo-tactic breast biopsy table that used digital imaging. This small detector imaged only the lesion of interest to obtain tissue as an alternative to standard surgical biopsy. Since then, image-guided biopsies have mostly replaced surgical biopsies. This small detector was then enlarged and improved to enable imaging of the entire breast.

Why is digital mammography important to women?

Digital imaging is better in 3 groups of patients we commonly encounter: women with dense breast tissue; women under the age of 50; and perimenopasual and premenopausal women.

What in your opinion is the future of digital mammography?

The next generation under development is digital tomosynthesis, which images the breast in “slices” so that thinner sections of the breast can be evaluated for early, small cancers better by removing tissue located above and below  a lesion that might overlap or obscure the detection of the lesion. We are evaluating this technology at UI Hospitals and Clinics in a clinical trial. The next step may likely be a type of breast CT. We are working with collaborators to develop a system based on very high resolution flat panel digital detectors that will image the breast—also in "slices"—with no more radiation that standard mammography and without breast compression, which many women find uncomfortable during standard mammography.

Laurie Fajardo, MD