An annual screening mammogram is proven to be the best way to detect breast cancer, but the type of mammogram you choose can be important.

Shadie Majidi, MD, radiologist and chief of breast imaging with the Froedtert & MCW health network, was one of the first physicians trained to read 3D mammograms and was involved in the initial research that led the FDA to approve the technology. She offers some explanations on the differences between 2D vs 3D mammograms.

Image Clarity

A mammogram is an X-ray that radiologists use to find cancers in the breast tissue. Today, most of the images are digital, but the X-ray technology is different depending on if you choose 2D or 3D mammography.

2D mammograms offer a two-dimensional picture of the breast. 3D mammograms, also known as tomosynthesis, were approved by the FDA in 2011. This newer technology uses multiple low-dose X-ray images from different angles to create a mammogram picture that allows the radiologist to view the tissue in thin "slices."

“It allows us to look at multiple layers of breast tissue, one layer at a time,” Dr. Majidi said. “It is like flipping through the pages of a book.”

Having a 3D mammogram is similar to having a 2D mammogram, including the amount of compression of the breasts and the time in compression. The Froedtert & MCW health network uses technology that creates synthetic 2D and 3D images with an equivalent radiation dose when compared to a 2D mammogram. The radiation dose is very low.

Breast Density

Breasts are made of glandular tissue and fat. Dense breast tissue looks white on a mammogram, but so does cancer. If you have a lot of dense breast tissue, it may mask cancers.

“It is like trying to find a snowball in a snow storm,” Dr. Majidi said. “It can be challenging.”

A 3D mammogram makes it easier for radiologists to detect cancer because they can look at the breast from different angles. This is particularly important for women with dense breasts, who are at a slightly increased risk of developing breast cancer.

Fewer False Alarms

Sometimes, a mammogram can appear to show an abnormality in the breast, but further testing reveals it is not cancer. These types of false alarms can be stressful because they require patients to come back for a second test. Because of the improved technology, the call-back rate for women who get 3D mammograms is lower than for those who get 2D mammograms.

“The 3D mammogram can often prevent that short-term anxiety,” Dr. Majidi said.

Cancer Detection

Multiple studies show that 3D mammography improves cancer detection. 3D mammograms can detect up to 40 percent more cancers than 2D mammograms.

“We are able to find cancers that we would not have been able to find with 2D,” Dr. Majidi said. “The 3D exam will often detect cancers at an earlier stage, which typically gives women more treatment options and improved outcomes.”

Who Will Benefit From a 3D Mammogram?

Any woman can benefit from a 3D mammogram. Given multiple studies showing the benefits of 3D mammograms in finding more cancers and reducing the number of false positives, the Froedtert & MCW health network now recommends 3D mammograms for all women as a standard of care for breast cancer screening — and they are now covered by most insurance plans.

It is important for all women to talk to their doctor about getting a mammogram annually beginning at age 40. Early detection matters: It can save your life.

Learn more about Froedtert & MCW mammograms.


Jessica Motl

This article should be sent to patients when they schedule a mammogram. I was completely caught off guard when the technician asked me, while in the exam room, which type of mammogram I would like. Patient at least should be allowed to be prepared to answer the question.

Bryan Buckley

My husband and I 2q.