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 threat elements for breast most cancers. Yet, one day I felt a lump. I wasn’t notably apprehensive. I had not too long ago had a “normal” mammogram, which didn’t detect something. Then I used to be despatched for a diagnostic mammogram, which additionally didn’t detect something. But 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 instructed 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 instructed I had dense breasts, by no means been instructed that breast density elevated my threat for breast most cancers, by no means been instructed that breast density tremendously reduces the effectiveness of a mammogram, and, sadly, by no means been instructed that extra screening instruments have been obtainable which could have detected my most cancers at an earlier stage.
Mammography is simpler in detecting cancers in some girls than others. For girls with dense breasts, most cancers typically grows unseen on mammography and subsequently, extra screening could also be wanted.
- Dense breast tissue is widespread: 40% of ladies age 40 and over have dense breasts.
- Breast density is decided via 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.
- Cancer is 4 occasions extra prone to develop in girls with extraordinarily dense breasts than in girls with fatty breasts.
- Though mammograms discover some cancers not seen on different screening exams, in dense breasts, mammograms will miss as much as 40% of the cancers current.
- In dense breasts, different screening exams, similar to ultrasound or particularly breast MRI, along with mammography, considerably enhance detection of early-stage breast cancers.
Why does breast density matter?
Dense breasts enhance each the probability of creating breast most cancers and the chance of that most cancers being missed by mammography.
Dense breast tissue reveals up as white on a mammogram, whereas fatty tissue is darkish grey. Unfortunately, cancers additionally show as white on a mammogram. If there’s loads of dense tissue on a mammogram, a most cancers could be “hiding” among the many dense tissue. This is true even when the mammogram was carried out with 3D/tomosynthesis. Looking for a most cancers in a dense breast has been in comparison with searching for a snowball in a blizzard.
In dense breasts, a “normal,” “negative,” or “benign” mammogram doesn’t essentially imply most cancers isn’t current. No matter how latest your final mammogram, a lump or any adjustments in your breast needs to be dropped at the eye of your well being care supplier.
In addition to hiding most cancers, breast density can be certainly one of many recognized threat elements for breast most cancers. The better the density of the breast tissue, the upper the chance for creating breast most cancers.
How is breast density decided?
When you might have your mammogram, your breast density is rated as certainly one of 4 classes:
- Category A – Fatty
- Category B – Scattered areas of fibroglandular density
- Category C – Heterogeneously dense
- Category D – Extremely dense
Breasts that are Category C – Heterogeneously dense, or Category D – Extremely dense, are thought of to be “dense” breasts.
How do I do know if I’ve dense breasts?
Generally, this data will probably be offered to you by your well being care supplier, who could have acquired it from the ability that carried out your mammogram. It may additionally 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 girls obtain after their mammogram. However, 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 girls ought to know their breast density and particular person threat elements, focus on the advantages and dangers of extra screening with their well being care skilled, and pursue extra screening if applicable for them, to make sure the earliest stage analysis doable.
About the creator:
JoAnn Pushkin is government director of DenseBreast-info.org. The web site, cited because the “most up-to-date and comprehensive 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 commonplace via each the introduction of the Federal Breast Density and Mammography Reporting Act, in addition to the FDA’s Mammography Quality Standards Act regulatory modification consideration.