Breast Density Awareness: What Every Woman Should Know

POSTED ON TUESDAY, OCTOBER 22, 2013 AT 12:09 PM  by Dr. Marc Liebeskind

October is Breast Cancer Awareness Month. All month long we are reminded of the strides we have taken as a nation towards improving detection and treatment of this disease. More survivors are among us than ever before, and early diagnosis is still the best protection in the battle against breast cancer.

Park Avenue Radiologists, P.C., we offer an array of breast imaging services in NYC including screening and diagnostic mammography, breast MRI, ultrasound, and image guided biopsies. These diagnostic tools are used to successfully find breast cancer in its earliest stages, giving the patient more effective treatment options. Raising awareness of the importance of screening and women being diligent about their breast health has contributed to a 34% decrease in death rates from breast cancer in the US since 1990, according to a new report from the American Cancer Society. In July of 2012, NYS Governor Andrew Cuomo signed a piece of legislation designed “to help improve breast cancer detection and prevention” by requiring that mammography patients in New York State be informed if dense breast tissue is found during their examination. In recent news, there is a push towards creating a national law requiring all states to inform patients if dense tissue is found during a mammogram. US Rep. Rosa DeLauro will introduce a breast density inform bill in the House later this month.[1]

  • Why is it important to know if I have dense breast tissue?

A mammogram uses X-ray technology to image the breast tissue and detect tumors. Dense breasts have a relatively high proportion of glandular or connective tissue, which can obstruct the X-ray increasing the odds that a tumor or other abnormality exists which may not be visible by mammography alone. Non-dense breasts have more fat, which X-rays penetrate easily. Dense breast tissue also may be associated with an increased risk of breast cancer.

  • Is it abnormal to have dense breasts?

No. It is not abnormal to have dense breasts. Approximately 40 percent of women who have mammograms have dense breast tissue. Younger women are more likely to have dense tissue, but as many as 25 percent of older women do, too.[2] The American College of Radiology has a 1-to-4 density grading scale. But only 10 percent of women have extremely dense breasts, and 10 percent have fatty breasts. The remaining 80 percent have a mixture.[3]

  • How can I tell if I have dense breasts?

Your breast density cannot be judged by touch, but is evident on the images acquired during a mammogram. If you have dense breasts, following your mammogram at Park Avenue Radiologists, P.C. you will receive a letter stating:

"Your mammogram shows that your breast tissue is dense. Dense breast tissue is very common and is not abnormal. However, dense breast tissue can make it harder to find cancer on a mammogram and may also be associated with an increased risk of breast cancer. This information about the result of your mammogram is given to you to raise your awareness. Use this information to talk to your doctor about your own risks for breast cancer. At that time, ask your doctor if more screening tests might be useful, based on your risk. A report of your results was sent to your physician."

  • Are there other screening options if I have dense breast tissue?

Breast MRI and Ultrasound are commonly used in conjunction with mammography. Your provider and you can discuss your risk of breast cancer and decide if additional screening is appropriate for you. Whether or not you have dense breast tissue, mammography is not a perfect study. Five to 10 percent of all screening mammography result in a "false positive finding". This means that results appear abnormal and additional studies are required (ultrasound, fine needle aspiration and biopsy) with the subsequent testing proving no cancer. Normal breast tissue appears different in each woman and the slightest movement or trace of deodorant, powder, lotion can compromise the image. Prior breast surgery, the presence of implants (silicone or saline) can block the view of tissue.

Breast MRI may be an appropriate test in addition to mammography for patients with a strong family history of breast cancer (i.e., mother/ sister with breast cancer before age 50).

Breast MRI may also be helpful in patients recently diagnosed with breast cancer who desire breast conservation therapy or where there is concern for tumor recurrence versus scar. Non contrast breast MRI is also the best test to evaluate breast implant integrity.

 

  • What advances are being made in dense breast screening tools?

Breast MRI is a possible alternative and, according to AuntiMinnie.com, a Michigan breast specialist believes he has changed the equation with a streamlined breast MRI screening exam that could be ready for widespread clinical use.[4]

Park Avenue Radiologists offers our patients state of the art Open 1.5 Tesla MRI’s in New York. The ultra-short bore on the machine provides for the maximum openness and patient comfort without compromising clinical results. Our MRIs are continually upgraded and are enabled for multiple specialized applications including Breast Imaging and MRI Breast Biopsy, Peripheral MRA and Cardiac Imaging. We provide MRI guidance for core biopsy of lesions only visualized on breast MRI, which is something very few outpatient facilities are able to provide.

At Park Avenue, continuing education is stressed to keep abreast of new developments in technology and medical research. We welcome you to contact our knowledgeable personnel with any questions or concerns regarding your imaging needs at info@parkavenueradiologists.com or 212-888-1000. Stay Connected. Join our discussions with patients on Facebook, Twitter, and Google+.

Additional Links:

Breast Imaging NYC

CT Scan NYC

MRI Biopsy Manhattan

New York Radiology



[1] Seegert, Liz . “A Push For A National Law On Breast Density Notification.” The Courant. 14 Oct. 2013. http://articles.courant.com/2013-10-14/health/hc-breast-density-20131014_1_dense-breast-tissue-breast-cancer-screening-cancer-detection. Retrieved 18 Oct. 2013.

[2] Grady, Denise. “New Laws Add a Divisive Component to Breast Screening.” New York Times. 24 Oct. 2012. http://mobile.nytimes.com/2012/10/25/health/laws-tell-mammogram-clinics-to-address-breast-density.html?f=19. Retrieved 18 Oct. 2013.

[3] McCullough, Marie. “States want patients to know breast tissue density for breast cancer screenings, but is that a good thing?” Med City News. 13 Oct. 2013. http://medcitynews.com/2013/10/latest-breast-cancer-screening-trend-states-want-patients-know-breast-tissue-density-good-thing/#ixzz2i6VmuQDb. Retrieved 18 Oct. 2013.

[4] Yee, Kate Madden. “New breast MRI exam ready to screen women with dense breasts.”  Aunt Minnie. 16 Oct. 2013. http://www.auntminnie.com/index.aspx?sec=sup&sub=mri&pag=dis&ItemID=105131. Retrieved 18 Oct. 2013.

 

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