Recently, we wrote about the challenges that women with dense breasts face with mammograms — the primary tool used to screen for breast cancer. Dense breasts make it difficult to detect abnormalities in the tissue. We spoke with ACSH advisor and radiology expert Dr. Robert Bard on the topic [watch our story here], who says identifying dense breasts remains largely subjective. What's more, the presence of dense tissue alone is an independent risk for breast cancer.
We suspected some may take note; but the facts haven't reached as many women as they should. According to a recent study, most women are still unaware that dense breasts are a risk factor for breast cancer. In fact, only 1 in 8 women were aware that density is a risk factor, and just 1 in 5 women were aware that dense tissue reduces the sensitivity of mammograms to find tumors.
Why is this so? When breast cancer is responsible for the second highest rate of cancer deaths among women (lung cancer is the first), why hasn't there been more emphasis — perhaps between doctor and patient — on the risk factors of dense breasts?
Perhaps the biggest reason is that currently only 27 U.S. states require that women be notified if their breast density is classified into one of the two high-density categories. In some states, like Illinois, Indiana, and Maine, it's only suggested that physicians notify and/or educate patients on the topic. A total of 18 states do not have a bill on the horizon to address the limitations of mammography as it pertains to breast density. [interactive map]
"Unfortunately, for years and years they didn't do it. They would simply say that there's nothing showing up on the mammogram, which means you could have extremely dense breasts — very high risk of cancer — and the mammography report would simply say, 'We don't see any cancer,' which is a horrible misuse of these technologies," Dr. Bard, a leader in the field of radiology, says.
Women whose breasts have been identified as being highly dense are now notified [at least in 27 states] of the findings, though other methods of visualizing breast tissue [sonography, MRI] are not discussed routinely enough.
It Falls On The Physician
Physicians should be responsible for making sure women with dense breasts understand what the findings mean. In the study — from the University of Virginia School of Medicine — researchers found that the strongest factors in knowing about breast density was whether a physician informed a woman about the density of her breasts, and what alternative screening tools should be used to determine whether or not there are abnormalities in the tissue. The sonogram, for instance, can see things under the skin which can't be felt or are unclear in a mammogram. An MRI (magnetic resonance imaging) of the breast and/or ultrasound are also techniques that can be utilized when necessary.
As trusted guides, physicians have a duty to leave no stone unturned — especially in the field of breast cancer, where Dr. Julianna LeMieux, says there is a serious concern that's not being addressed quickly enough.
"However, dense breasts are too frequently not communicated to the patient, or reported in a manner that leaves the patient confused and, therefore, not able to seek further treatment appropriately. The breast cancer field is ineffective in its current state when it comes to early detection of breast cancer in women with dense breasts, putting them at a higher risk for breast cancer," LeMieux says.