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A more accurate test than a mammogram

Radiologist Debra Somes Copit is committed to making a dent in the number of dangerous false negatives in 20 percent of all mammograms. (APRIL SAUL/Staff Photographer)
Radiologist Debra Somes Copit is committed to making a dent in the number of dangerous false negatives in 20 percent of all mammograms. (APRIL SAUL/Staff Photographer)Read more

Radiologist Debra Somers Copit looked critically at the mammogram of her patient, a co-worker at Einstein Medical Center, and saw nothing out of the ordinary.

At this point, the patient would have been sent home worry-free until next year's screening. But using a 3D imaging technique called digital breast tomosynthesis, Copit was able to find the small tumor hiding in the woman's right breast.

"I felt really, really bad because that Sunday was her birthday," recalls Copit. "But I do believe tomosynthesis saved her life."

At 20 percent of all mammograms, such dangerous false negatives are far too common. Which is why for almost four years, Copit has made it her mission to improve screening accuracy with tomosynthesis.

With a mammogram, the breast gets compressed between two plates to even out the shape as much as possible, and an X-ray picture is taken. But sometimes a dense lump of flattened tissue looks too much like a tumor, or vice versa.

Tomosynthesis uses the same machine but takes multiple X-rays at different angles. A computer algorithm reconstructs a 3D model from these images, giving radiologists a millimeter-by-millimeter view of the breast.

They can more accurately see whether what looks tumor-like actually is, without more testing. Meaning less radiation dose, cost, and anxiety for the waiting patient.

Copit recently led a joint study with Penn to compare tomosynthesis to mammography in 500 cancer-free subjects, to prove that 3D images can reduce the number of false positives. Results will be published within the next year.

Copit believes that tomosynthesis will replace mammography as standard procedure within five years, and is already in discussions with insurers to guarantee that women will have their 3D imaging covered.

Research adds immensely to her job satisfaction, and she squeezes it in between patient visits and caring for her family. Copit, 48, and her husband, Steven, a plastic surgeon at Thomas Jefferson University Hospital, live with their two sons in Wynnewood.

Research is "hearing about things that sound potentially exciting and thinking, 'Can this help my patients?' " she said. "What drives me is the patient, and that's why I became a physician."

   - Meeri Kim