3D Breast Tomosynthesis (Bilateral) is an advanced type of digital mammogram—often called a 3D mammogram—that images both breasts. During the exam, the X-ray tube moves in a small arc over each breast and takes multiple low-dose images from different angles. A computer then reconstructs these images into thin “slices,” creating a layered, three-dimensional view of breast tissue. Compared with standard 2D mammography, tomosynthesis helps reduce the problem of overlapping tissue that can hide small abnormalities or make normal tissue look suspicious—this is especially helpful in people with dense breasts.

This test does not measure something in your blood; instead, it looks for changes in breast tissue that could represent cancer or other conditions. A radiologist interprets the images and issues a report, typically using a standardized scoring system (often BI-RADS). In plain language, results generally fall into a few categories:

Normal/negative: No concerning findings; you continue routine breast screening as recommended.

Benign (non-cancerous) findings: Common changes like simple cysts or benign calcifications; usually no urgent action is needed.

Probably benign: Very low chance of cancer; a short-term follow-up mammogram or ultrasound may be recommended to confirm stability.

Suspicious or highly suggestive of malignancy: Additional imaging (such as diagnostic mammogram views, breast ultrasound, or breast MRI) and sometimes a biopsy are recommended to determine if cancer is present.

As with any breast screening test, a 3D mammogram can sometimes lead to a “callback” for extra imaging even when no cancer is present (a false positive). Its 3D view may lower callback rates and improve cancer detection compared with 2D mammography in many patients.

3D Breast Tomosynthesis is commonly used for breast screening (checking for breast cancer before you have symptoms) and for diagnostic evaluation (when there is a symptom or an abnormal finding that needs a closer look). Your clinician may recommend a 3D mammogram because it can detect some cancers earlier and can be particularly useful when breast tissue is dense.

It’s usually done for screening when you:

• Are due for routine mammography based on age and guidelines from your clinician.
• Have dense breast tissue on prior mammograms (dense tissue can make cancers harder to see on 2D images).
• Want a screening approach that may reduce overlapping-tissue “shadows,” which can lower the chance of needing extra views.

It’s often done for diagnostic reasons if you have:

• A new breast lump or thickening
• Nipple discharge (especially spontaneous or bloody), nipple inversion, or skin changes
• Breast pain that is persistent and localized
• A change seen on a prior mammogram that needs additional evaluation

It may be recommended sooner or more often if you have higher risk factors for breast cancer, such as:

• A strong family history of breast or ovarian cancer
• A known genetic mutation (e.g., BRCA1/BRCA2) or a close relative with such a mutation
• Prior chest radiation (for example, for lymphoma) at a young age
• A personal history of breast cancer or certain high-risk breast biopsies

Tell the imaging center if you are pregnant, might be pregnant, or are breastfeeding, and share any prior mammogram images when possible—comparison with earlier studies often improves accuracy.

• Breast cancer (including invasive ductal carcinoma and invasive lobular carcinoma)
• Ductal carcinoma in situ (DCIS)
• Benign breast cysts
• Fibroadenoma (benign breast lump)
• Benign calcifications and other non-cancerous breast changes
• Breast asymmetry or architectural distortion on mammography
• Mastitis or breast abscess (more commonly assessed with ultrasound, but may be part of evaluation)

• Routine breast screening to help detect breast cancer early
• Improving screening accuracy in people with dense breasts
• Clarifying an abnormal screening mammogram to decide whether additional imaging or biopsy is needed
• Monitoring breast health over time by comparing current results with prior mammograms
• Supporting personalized preventive care plans for patients with elevated breast cancer risk