I assumed I used to be doing the whole lot proper. I by no means missed my annual mammogram. I did self-exams, ate wholesome, and had no recognized danger elements for breast most cancers. But, at some point I felt a lump. I wasn’t notably anxious. I had just lately had a “regular” mammogram, which didn’t detect something. Then I used to be despatched for a diagnostic mammogram, which additionally didn’t detect something. However an ultrasound the identical day revealed the heartbreaking information: I had breast most cancers. Why didn’t it present on the mammograms? It was then that I used to be informed that I had extraordinarily dense breasts and the not-so-small, not-so-early-stage most cancers was hidden by the dense tissue. I had by no means earlier than been informed I had dense breasts, by no means been informed that breast density elevated my danger for breast most cancers, by no means been informed that breast density significantly reduces the effectiveness of a mammogram, and, sadly, by no means been informed that extra screening instruments had been obtainable which could have detected my most cancers at an earlier stage.
Mammography is more practical in detecting cancers in some ladies than others. For ladies with dense breasts, most cancers typically grows unseen on mammography and due to this fact, extra screening could also be wanted.
- Dense breast tissue is frequent: 40% of ladies age 40 and over have dense breasts.
- Breast density is decided by a lady’s mammogram and described as certainly one of 4 classes relying on the quantity of breast tissue compared to fats within the breast.
- Most cancers is 4 instances extra more likely to develop in ladies with extraordinarily dense breasts than in ladies with fatty breasts.
- Although mammograms discover some cancers not seen on different screening checks, in dense breasts, mammograms will miss as much as 40% of the cancers current.
- In dense breasts, different screening checks, resembling ultrasound or particularly breast MRI, along with mammography, considerably improve detection of early-stage breast cancers.
Why does breast density matter?
Dense breasts improve each the probability of growing breast most cancers and the chance of that most cancers being missed by mammography.
Dense breast tissue exhibits up as white on a mammogram, whereas fatty tissue is darkish grey. Sadly, cancers additionally show as white on a mammogram. If there may be quite a lot of dense tissue on a mammogram, a most cancers will be “hiding” among the many dense tissue. That is true even when the mammogram was performed with 3D/tomosynthesis. Searching for a most cancers in a dense breast has been in comparison with on the lookout for a snowball in a blizzard.
In dense breasts, a “regular,” “destructive,” or “benign” mammogram doesn’t essentially imply most cancers just isn’t current. Irrespective of how latest your final mammogram, a lump or any adjustments in your breast ought to be dropped at the eye of your well being care supplier.
Along with hiding most cancers, breast density can also be certainly one of many recognized danger elements for breast most cancers. The higher the density of the breast tissue, the upper the chance for growing breast most cancers.
How is breast density decided?
When you’ve got your mammogram, your breast density is rated as certainly one of 4 classes:
- Class A – Fatty
- Class B – Scattered areas of fibroglandular density
- Class C – Heterogeneously dense
- Class D – Extraordinarily dense
Breasts that are Class C – Heterogeneously dense, or Class D – Extraordinarily dense, are thought-about to be “dense” breasts.
How do I do know if I’ve dense breasts?
Typically, this data will likely be offered to you by your well being care supplier, who can have obtained it from the power that carried out your mammogram. It might even be included within the letter you obtain after your mammogram is carried out. Many states (38 and the District of Columbia), now have legal guidelines that require some stage of details about breast density be included within the letter ladies obtain after their mammogram. Nevertheless, the legal guidelines differ from state-to-state. To be taught the reporting necessities in your state, please see the legislative map on DenseBreast-info.org.
Early detection issues, so be an knowledgeable self-advocate. All ladies ought to know their breast density and particular person danger elements, focus on the advantages and dangers of extra screening with their well being care skilled, and pursue extra screening if acceptable for them, to make sure the earliest stage analysis potential.
Concerning the writer:
JoAnn Pushkin is government director of DenseBreast-info.org. The web site, cited because the “most recent and complete useful resource” on the subject, is the collaborative effort of world-renowned breast imaging consultants and medical reviewers.
Pushkin’s initiative and advocacy served as inspiration for New York State’s Breast Density Inform legislation. On the federal stage, she continues to guide efforts for a single nationwide “density” reporting customary by each the introduction of the Federal Breast Density and Mammography Reporting Act, in addition to the FDA’s Mammography High quality Requirements Act regulatory modification consideration.