Until recently, breast density information was rarely given to women although it was routinely noted in the radiologist’s medical report to the doctor. Now women are receiving letters about their breast density because of state legislation. Studies indicate that women with dense breast tissue may be at higher risk for breast cancer because this thicker tissue can obscure the radiologists view of determining if there is a problem. Dense breast tissue shows up white on the scans as does tumors.
Dense breast tissue means that women have more connective and fibrous tissue than normal. It is a benign condition and it is estimated that this condition is common with over 50% of women having clear signs of dense breast tissue.
It is suggested that women use this information to talk to their doctors or practitioners about their personal risk of breast cancer. The question is…would more screening tests be useful?
In some states, such as Connecticut, women with dense breasts are told to consider getting an ultrasound or magnetic resonance imaging (MRI) test.
Unfortunately, there is no clear guidance on how women should proceed once they have been told they have dense tissue. The American College of Radiology acknowledge that other tests or scans may find tumors missed on mammogram but there is no data showing that women who add ultrasound or MRI to a mammogram live longer. Also, these additional scans can pick up other suspicious spots that may require intervention such as a biopsy to rule out cancer, even though most of them will turn out to be harmless.
According to Dr. Carol Lee, a diagnostic radiologist at Memorial Sloan Kettering Hospital, “mammograms pick up cancers in women with dense breasts everyday”.
Well, that may be so for some women but there are other risk assessment tools I recommend for my patients to help them identify if they are at higher risk for breast cancer.
Estrogen metabolite testing– A urine test that identifies the breakdown or metabolites of estrogen through the liver. This test determines which metabolites are more or less protective and how to shunt estrogen in healthy pathways.
Thermogram– Thermography looks for potential risk factors in the breasts such as lymphatic congestion, excess estrogen, and inflammation which can lead to the development of breast cancer. Thermogram uses a heat sensor versus radiation so it is very safe. This test can detect pre-cancer conditions up to 10 years earlier than a mammogram.
Low iodine levels are associated with fibrocystic or dense breast tissue. Have your practitioner check your thyroid levels.
Performing self-breast exams are important so you can let your practitioner know if there are any changes in your breast architecture.
Women who have fibrocystic or dense breast tissue (which again is more than 50% of women) should not worry, but they should know that there are things they can do to reduce their risk for breast cancer besides getting a mammogram.