Thanks to a new state law, if your next mammogram shows that you have dense breasts, you’ll be notified. What does this mean?
In April of 2013, California passed a law that requires that patients with heterogeneously dense breasts or extremely dense breasts be notified of their density score and possible risk for breast cancer. It is estimated that nearly half of all women who have mammograms can expect to get such a notification.
Breasts are composed of fatty tissue, milk lobules, milk ducts and connective tissue. The greater the amount of milk ducts, milk lobules and connective tissue, the denser the breast. On a mammogram, denser breast tissue appears white, while fatty tissue is gray. Typically, when a cancer is found on a mammogram, it is also white.
With very dense breasts, it can be difficult to clearly see cancer. It’s like trying to find a white snowflake against a white background.
Although knowing your breast density score is important, this is only part of a comprehensive breast cancer risk assessment strategy. Other factors should be taken into account as well. Typically, risk-modeling software is used to gain a better understanding of an individual patient’s overall risk by determining if common risk factors are present.
The average risk for a woman to develop breast cancer in her lifetime is 12 percent. Risk factors, such as beginning menstruation before the age of 12 or beginning menopause after the age of 55, can increase breast cancer risk.
A family history of a first-degree relative developing breast cancer before the age of 50 can increase breast cancer risk by greater than two times.
The Modified Gail Risk Model is the most commonly used tool to determine a patient’s risk. It can be found online at the National Cancer Institute’s website at www.cancer.gov/bcrisktool/Default.aspx. The tool is free and can be used by patients and physicians alike.
Women in Solano County now have a new tool to help in the diagnosis of women with dense breasts, the 3-D mammogram.
Solano Diagnostics Imaging in Vacaville is the only facility in Solano County to offer breast tomosynthesis, a new form of breast imaging that aids in cancer detection. Rather than taking two images, as is done in standard mammography, breast tomsynthesis takes multiple low-dose images of the breast and synthesizes them into a three-dimensional image. This allows radiologists to examine the breast in very thin layers.
If a woman knows she has dense breasts, going directly for a 3-D mammogram could save the need for a follow-up.
The digital image allows the radiologist to rotate the tissue in front of or behind an abnormality, making detection easier. In addition, overlapping tissue that may appear abnormal on a standard mammogram can be determined to be benign in a 3-D image.
For the patient, this translates into fewer “call backs” for additional mammographic views, fewer unnecessary biopsies, detection of concerning masses that may have been obscured by surrounding breast tissue and fewer sleepless nights.
You don’t have to be a NorthBay Healthcare patient to get a 3-D screening at SDI in Vacaville. Just ask your doctor for a referral.
NorthBay Healthcare is hosting a breast cancer conference Oct. 17 at the Green Valley Administration Center. I’ll be there along with a number of my colleagues to answer your questions and present information on the latest diagnosis and treatments.
The event is free. Call 646-3280 for information.
Dr. Jason Marengo is a oncoplastic surgeon in the NorthBay Center for Specialty Care in Fairfield.