Breast Cancer Awareness Month 2012: Why Breast Density Matters
As a breast imaging radiologist at Montclair Breast Center with over 12 years of experience practicing in my field, I can tell you based on voluminous evidence in the scientific literature as well as from clinical experience that if you have dense breast tissue (determined from a mammogram, not from physical exam), the odds of finding a cancer on your mammogram are about equal to a coin toss.
Even with the best digital technology and the most experienced reader, a cancer will not be detected mammographically in up to half of women with dense breasts, when there is actually a cancer present. In addition, breast density is an independent risk factor for developing breast cancer, meaning that even greater diligence is warranted when screening these women.
When I give a woman with dense breasts a “normal mammogram” report, I am only 50 percent certain that there is no cancer in her breast. This is ineffective screening by any definition, and by not routinely informing women with dense breasts that their mammogram is limited, as only a few progressive radiology practices do, and that they have a choice to pursue second-level screening with breast ultrasound, MRI or gamma imaging, we are poorly serving the 40 percent of women with dense breasts. Women who are diligent about their health and come to me yearly for their mammograms expect to be effectively screened for breast cancer. We do not provide effective screening if breast density is ignored.
Due to the heroic efforts of grassroots patient advocates, many of whom became involved in this cause when their own breast cancers were found at advanced stages because they have dense breasts and had never been told this essential fact after years of “negative” mammograms, laws have been passed in Connecticut, Texas, Virginia, New York, and California, requiring that women are informed of their breast density when they have a mammogram. Now New Jersey is poised to join these states; NJ A2022, Breast Density Inform, passed unanimously in the NJ Senate in June, and is now in a holding pattern in the Assembly, back in session after the summer.
October is a good month to not only be “aware” of breast cancer, but to actually do something about it. If you live in NJ, contact NJ Health and Senior Services Committee Chairman, Assemblyman Herb Conaway, Jr., to voice your support for Bill A2022 and to ask him to put it on the committee’s calendar: http://www.njleg.state.nj.us/members/BIO.asp?Leg=186. If you live in another state, you can access information on the activity in your home state regarding the density issue here: http://areyoudenseadvocacy.org/dense . Know your own breast density, and if you have dense breasts, talk to your doctor about what this means, and ask to have a second-level screening test. Awareness is important, but action is essential.