Thanks to 3-D mammography, Leanne Kitano’s doctors were able to detect a tiny, cancerous spot in her left breast and remove it quickly before it spread.

Mammograms using traditional 2-D imaging had produced inconclusive results during her annual breast cancer screenings in 2014 and 2015, and a follow-up ultrasound turned up nothing. But when Kitano, 53, of Kaneohe, opted for 3-D mammography for her last screening in August, a 4-millimeter lesion was identified, and a biopsy determined it to be cancerous.

Kitano, a mother of two who works as a budget analyst, was surprised since her family has no history of breast cancer. She was also relieved.

“The technology was able to find (a spot) as small as a grain of rice,” she said. “They caught it very early, so I didn’t have to go through chemotherapy. … It hadn’t spread to my lymph nodes.”

After surgery to remove the tissue, Kitano went through four weeks of radiation treatment and is recuperating. “The outlook is great,” she said.

Most Hawaii hospitals — including Kapiolani Medical Center for Women & Children, Pali Momi, Straub, Kaiser Permanente’s Moanalua Medical Center, the Queen’s Medical Center, Castle Medical Center and Wilcox Medical Center on Kauai — offer 3-D mammography, also known as digital breast tomosynthesis. Many major insurers do not yet cover it, so patients have to pay out of pocket if they opt for the service. Fees vary, depending on the facility, and range anywhere from $68 to $116.

Digital breast tomosynthesis takes multiple X-ray images of breast tissue in an arc to create a three-dimensional image. Traditional mammography takes a single image from the top and side.

Radiologists recommend digital breast tomosynthesis for a more accurate screening, particularly for patients with dense breast tissue.

Kapiolani Medical Center for Women & Children invested in a Hologic Selenia Dimensions System capable of 3-D images in the summer of 2012, a year after the U.S. Food and Drug Administration approved its use.

“The machine actually creates multiple, 1-millimeter slices throughout the entire breast,” said Kapiolani radiologist Bryan Gushiken. “Now you get 50 to 100 images of that breast. Instead of having just one image, we can sort through all those images slice by slice, and we can look and see if there are lesions on any of those slices.”

Tracy Buscher, lead mammography technologist at Castle Medical Center, said studies report a 41 percent increase in detection of invasive breast cancers using 3-D mammography, which also eliminates up to 40 percent of “false positives,” reducing medical costs and stress when patients are called back for further examination.

Buscher likens the 3-D images to a deck of cards that radiologists can examine one layer at a time.

“It’s going to be able to pick up any subtle changes a lot sooner,” she said.

Aside from taking a few seconds longer to get the full range of images, Buscher said the 3-D imaging experience is much the same for patients.

At Castle, which began offering 3-D mammography in the summer of 2013, patients enter a spa-like setting with personal changing rooms and bathrobes. The machine is outfitted with a cushion for additional comfort.

While some patients express concern over slightly higher radiation exposure for 3-D due to the seconds-longer exposure, both Gushiken and Buscher said it remains well within FDA safety standards. Gushiken said newer machines offer lower radiation doses, and Kapiolani expects to have one by the end of the year.

Two-dimensional mammographies remain a proven option for detecting breast cancer, according to Buscher. Castle, however, lets patients know it offers digital breast tomosynthesis, and she hopes one day more insurers will cover it.

“The key to this whole thing is early detection,” she said.

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GET CHECKED

The American College of Radiology recommends annual mammograms for women starting at age 40. The American Cancer Society recommends women ages 45 to 54 at average risk for breast cancer get mammograms every year, while women 55 and over can switch to mammograms every other year or continue yearly mammograms. Talk to your doctor about your breast cancer risks and mammogram frequency.

Funding for underinsured patients is available:

>> Kapiolani Women’s Center’s Breast and Cervical Cancer Control Program offers free mammograms for high-risk women ages 40-49 and women ages 50 to 64 with little or no medical insurance or who cannot afford the copayment. Must be a U.S. citizen or permanent resident. Call 973-3015.

>> Castle Medical Center’s Susan G. Komen Foundation grant provides free mammograms to underserved or underinsured Native Hawaiian/Pacific Island women over the age of 40 in Laie and Waimanalo, with a doctor’s referral. Call 263-5166, option 1.