Many doctors say that regular mammograms are the best way to detect breast cancer; but some women’s cases prove otherwise. One woman, Nancy, told CBS her story.
Nancy said she got mammograms every year for a decade. She did not have any risk factors or close relatives who had breast cancer.
Nancy was shocked when a few weeks after her mammogram turned out normal her doctor told her there was a lump in her breast. The lump turned out to be invasive breast cancer. Nancy was fifty-one at the time.
Nancy’s doctors said the lump did not turn up on the mammogram, because she had dense breast tissue.
Statistics show that more than 40 percent of women have dense breasts but many are never told that their form of breast tissue makes cancer more difficult to spot on a mammogram.
CBS news explains,
“A woman's breasts are made up of fatty, fibrous, and glandular tissue, according to the American College of Radiology and the Society of Breast Imaging. Shape and size don't indicate density -- breasts are considered dense if a woman has a lot of fibrous or glandular tissue, but not much fat.”
Physicians use a four-category scale to categorize breast density.
Dr. Hooley, an associate professor of diagnostic radiology at the Yale School of Medicine, told CBS News that when it comes to a mammogram, trying to find a tumor in a dense breast is like making an effort to find a snowball in a snowstorm.
She said, “The dense breast tissue appears white on the mammogram. Cancers also appear as white spots on a mammogram.” Doctors often recommend a follow up screening using an ultrasound since it’s so hard to detect.
Dr. Hooley also said that for high-risk patients, physicians should also suggest magnetic resonance imaging (MRI). MRI’s are the most sensitive test, but also the most expensive, according to the American College of Radiology and the Society of Breast Imaging.
Nancy has since started a nonprofit organization. It is called, Are You Dense? The objective is to educate women and push for change when it comes to screening for breast cancer.
Nancy said, “We've got to do something better. We have too many women who are dying.” She is now regularly and closely monitored for any signs of cancer.
In 2009, Nancy’s work led her home state of Connecticut to pass a law requiring radiologists to tell women if they have dense breasts and mention ultrasound or MRI as ways to follow up. This action had a domino effect. Today around twenty-four states have density notification mandates and a federal bill is making its way through Congress.
Who faces dense breast tissue more?
It is more common in younger women, and the American College of Obstetricians and Gynecologists says women with dense breasts have a slightly increased risk of breast cancer.
Despite this concern, the group does not recommend routine use of additional tests beyond screening mammography in women with dense breasts who are asymptomatic and have no extra risk factors. But the organization does recommend that health care providers follow state laws that may mandate them to let women know of their breast density based on a mammogram test analysis.