A cone beam breast CT scanner that produces three-dimensional images without painful compression is being introduced in Australia, offering doctors another way to investigate cancers that may be difficult to see in dense breast tissue.
The Koning Vera system scans each breast in about 10 seconds while the patient lies face down. Its approval for inclusion in the Australian Register of Therapeutic Goods in September allows commercial supply in Australia and could lead to wider use in clinics.
Brisbane Radiology was the first Australian clinic to introduce the technology. Clinic owner Angela Sclavos said women can now attend with a GP referral.
Belinda Yates, who has undergone mammograms and breast MRI after finding a lump, said the experience was markedly different from her previous imaging.
“This scan has been a game changer for me. I have very dense breast tissue. There’s no pain. The discomfort was non-existent,” she said.
She described her earlier mammogram as “very crushing and quite painful”.
How the cone beam breast CT scanner may help
Breast surgeon Dr Beth Campbell said dense tissue could make it difficult to distinguish cancers on a mammogram. She compared the challenge with trying to see stars through cloud cover.
“What the contrast does is it gets rid of that cloud cover so we can actually see behind to detect cancers when they’re smaller,” she said.
Campbell recalled treating a patient whose mammogram appeared normal despite the presence of a large lump. Further imaging with the cone beam scanner showed seven breast cancers in the affected breast, which were identified when the patient later underwent surgery.
She said the scanner should be viewed as an additional option rather than a replacement for existing tests.
“I think it’s not going to replace mammography. It’s not going to replace MRI. It’s going to be another tool in our toolbox for picking up cancers early,” Campbell said.
Breast MRI remains useful for some patients, although Dr Ben Green said it can take between 20 and 40 minutes and may be difficult for people with claustrophobia.
Green said the detailed images could also help surgeons identify disease that was more extensive than initially indicated by a mammogram.
“We can see that extra disease and in a single operation we can change the actual nature of that surgery and reduce that need for a second operation,” he said.
He said some women had previously refused imaging because of the pain caused by compression, leaving them without a diagnosis. The new system, he added, was giving those patients access to earlier detection.
Green said a wider national rollout could eventually follow, although he acknowledged it was too early to say the technology would replace mammograms.
Cost and access in Australia
Sclavos said eligible patients could receive a Medicare rebate, with the out-of-pocket cost around 300 Australian dollars — a similar price to a private mammogram — provided they qualified under the Medicare Benefits Schedule.
Free screening mammograms remain available through BreastScreen Australia and do not require a GP referral.
Campbell said she hoped the prospect of imaging without compression would encourage women who had been avoiding checks to come forward.
“The earlier we pick up breast cancers, the easier they are to treat,” she said.
