This post can save your life...

Every year, thousands of young women go for a baseline mammogram, nervous and anxious due to this new experience, yet sure that they have nothing to worry about. They leave the medical office, and generally wait a few days to get a “happy gram” in the mail : a note that proclaims all is well, that there was “nothing suspicious”, and to remember to call for next year’s appointment.

But next year’s appointment may be too late. Sixty percent of young women’s breasts are often dense, and due to this, mammograms miss fifty percent of breast cancers. And, it’s not only young women (premenopausal) who need to be concerned: “dense tissue” describes breast tissue in 43% of the female population, including 40% of postmenopausal women.

Breast tissue is categorized four ways: almost entirely fat, mostly fat with some dense tissue, moderately dense, and predominantly dense. According to BreastCancer.org, women with dense breast tissue are six times more likely to develop breast cancer. And, if they have it in one breast, they are twice as likely to have it in the other. Surprisingly, 95% of all women are not familiar with their tissue type.

According to a JAMA Oncology report of 202,748 women “…breast density and body mass index had the largest individual population attributable risk proportion. Thirty-nine percent of premenopausal women and 26% of postmenopausal breast cancers could be prevented if breast density in women with dense breasts was reduced by scattered fibroglandular densities on the Breast Imaging Reporting and Data System scale.”

To be clear, mammography has its place, and is needed to determine the density of the breasts, but it shouldn’t be used as a stand alone for women who do have dense tissue. Ultrasounds, and MRI’s, in conjunction with mammograms, should be considered as standard screenings for women with dense breasts, especially those with a previous cancer diagnosis, or who are in another high risk group. Yet, they are not. Women who are unaware of density and its corollary cannot begin to advocate for themselves. Medical professionals, who are not mandated to inform patients of their density and possible ramifications, often don’t.

According to a 2012 RSNA Radiology review, a “Breast Density and Mammography Reporting Act was introduced in the 112th Congress and would require that every mammography report contain information regarding the patients breast density and language communicating that individuals with more dense breasts may benefit from supplemental screening tests.” The authors conclude by stating, “…a mandate to disclose the association increased risk for cancer directly to individual patients seems ethical, reasonable, and appropriate.’

Ethical, reasonable and appropriate - words spoken see six years ago that echo the importance of notifying women, but, currently no national standard to report or disclose breast density exists. Thirty states have worked on bringing laws forward, and a few have succeeded. Utah is not one of them.

Breast density is recognized as an established independent risk factor for developing breast cancer, in fact, it is a stronger risk than having a first degree relative with the disease (doubled risk), or two first degree relatives (five times risk). Simply put, dense breasts are more likely to develop cancer than if your sister and aunt have both have it.

Dr. Stacey Vitiello states on her website that the medical community is not fully informed about breast density, and suggests that the patient ask for her mammogram report. If you are not in an "inform" state, contact the radiologist who read your films and ask for this info. She stresses that if you are at high risk for breast cancer, "...your doctor should send you for an additional screening test each year in addition to the mammogram.”

Women have a right to know their breast density. They also have a right to know that MRI’s and ultrasound screenings should be employed to better detect breast cancers because the connection between dense breast tissue and failed mammograms is too high to ignore.

Resources:

https://jamanetwork.com/journals/jamaoncology/article-abstract/2599991

http://pubs.rsna.org/doi/full/10.1148/radiol.12120184

http://www.breastcancer.org/risk/factors/family_history

http://www.areyoudenseadvocacy.org/

http://www.breastcancer.org/research-news/breast-density-affects-contralateral-bc-risk

Trends in breast biopsy pathology diagnoses among women undergoing mammography in the United States: A report from the Breast Cancer Surveillance Consortium

journal = {Cancer},Dense breast tissue was associated with high-risk lesions and DCIS relative to nondense breast tissue

http://staceyvitiellomd.com/what-breast-density-means-to-you

http://densebreast-info.org/img/regina-hooley1.png

#densebreasttissue #densebreasts #breastcancer #breastcancerawareness #research