Imagine being told that the gold-standard technology that millions of women
depend on to detect breast cancer may not work for you.
For most young women, as well as a subset of older women, this scenario
played out March 1 when a new California law went into effect requiring
radiologists to inform women if they have “dense breasts.”
Breast density is not based on family history and cannot be determined
by the look and feel of the breast. About 75 percent of women in their
40s have dense breasts. This percentage typically decreases with age;
however, even some elderly women continue to have dense breasts. About
40 percent of the 50,000 women Hoag Breast Center screens each year have
radiographically dense breast tissue.
The significance of dense breast tissue is that it can hide an underlying
cancer on a conventional mammogram or, conversely, mimic a cancer when
Compounding this problem, women with dense breast tissue are actually
at a higher risk for developing breast cancer.
So what do you do if you are told you have dense breasts?
Mammography remains the gold standard for early detection of breast cancer,
and all women 40 and older are encouraged to have an annual mammogram.
For those women found to have dense breast tissue, two new advanced complementary
breast screening technologies are available at Hoag Breast Center:
Digital breast tomosynthesis: This is a 3D mammogram that was specifically
designed to address the limitations of conventional 2D mammography in
dense breasts. Hoag was one of only 11 sites selected in the United States
to participate in an initial clinical trial of tomosynthesis. Their breast
radiologists are considered nationwide experts, and Hoag remains one of
only a few breast centers in Southern California to offer the 3D mammogram.
Clinical trials published demonstrated that breast tomosynthesis (3D mammography)
is significantly better than a conventional 2D mammogram at finding breast
cancer, especially in women with dense breasts.
Automated whole breast ultrasound: We've just put the finishing touches
on a new suite at Hoag Breast Center that will offer this ultrasound,
a new technology that, like breast tomosynthesis, can find cancers hidden
within dense breast tissue. Ultrasound relies on sound waves to create
an image of the breast. When used in conjunction with mammography, studies
have shown that ultrasound can find tumors missed by conventional 2D mammography alone.
October is Breast Cancer Awareness Month, the time of year when radiologists
like me tout the virtues of the annual mammogram, and I am definitely
here to join the chorus: Early detection saves lives.
Deaths from breast cancer have dropped more than 30 percent since 1990
and most of this reduction has been attributed to mammographic screening.
So please don't skip your annual mammogram.
If you are informed that you have dense breast tissue, don't panic.
Speak to your physician about 3D mammography and automated whole breast
ultrasound. One or both of these new technologies may be right for you.
– Dr. Gary M. Levine is the director of breast imaging at Hoag Breast
Center and associate clinical professor at USC Keck School of Medicine.
He is the president of the National Consortium of Breast Centers.
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