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Medically Speaking

By Whitney Morgan, MD

Breast density has become a hot topic in breast cancer screening due to the growing breast density awareness movement and the enactment of breast density notification laws in many states. Colorado recently became the 31st state to pass legislation, effective Oct. 1, 2017, requiring that a woman be notified if her mammogram shows dense breast tissue.

Why all the fuss about breast density? Not only has dense breast tissue been shown to be a significant independent risk factor for developing breast cancer, it can also make it more difficult to see cancer on a mammogram. Here are the answers to some common questions:

What is breast density and how is it determined?

 Breast density is determined on a mammogram by the relative amounts of dense fibrous and glandular tissue to surrounding fatty tissue.

Why does breast density matter?

  There are two reasons: Dense breast tissue can make it more difficult to see cancers on your mammogram and, having dense breast tissue increases your risk for developing breast cancer.

Is a mammogram still effective if I have dense breast tissue?

  Yes. Although no test is perfect, mammography is still the only screening test proven to reduce breast cancer mortality. Even with dense breast tissue, many cancers can be detected on mammograms. Tomosynthesis, or 3D mammography, can help find additional cancers in women of all breast densities but can be especially helpful in women with dense tissue.

Should I get any other tests in addition to mammography if I have dense breasts?

  Dense breast tissue makes it more likely for a cancer to be hidden on a mammogram. While studies have shown that ultrasound and MRI can find additional cancers not seen with mammography, “false positive” findings (i.e., findings that require further evaluation or biopsy but turn out to be non-cancerous) are common with both MRI and ultrasound. Also, some insurance companies may not cover these tests.

If you have dense breasts, please talk with your doctor or breast imaging specialist about the pros and cons of supplemental screening with ultrasound or MRI to find out what is best for you.

  During Breast Cancer Awareness month (October), ask yourself: “Have I had my mammogram this year?” Screening mammography is the only imaging test proven to save lives and reduce breast cancer mortality, regardless of breast density. At Lutheran Medical Center, we offer annual screening mammography for all women starting at age 40.

  Dr. Whitney Morgan is the medical director of the Breast Care Center at Lutheran Medical Center.