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Korin Miller’s piece for SELF magazine focuses on why women with dense breasts may need more than a screening mammogram. Miller highlights the recent story in People magazine of Jill Goodacre, a former Victoria’s Secret model and the wife of recording artist and talk show host Harry Connick Jr. Goodacre told of her breast cancer diagnosis 5 years ago after having additional screening of her dense breast tissue following a normal
Screening and breast density concerns were in the news recently when former Victoria’s Secret model Jill Goodacre shared her story with People magazine about her breast cancer diagnosis. Goodacre says she went in for a routine
mammogram, and even though it came back clear, her doctor recommended additional testing. “They said, ‘Okay, looks good. Since you have dense breasts, just go across the hall for your sonogram,’” she said. But even though her mammogram didn't find anything unusual, the sonogram (ultrasound) found a suspicious-looking spot. Goodacre then had a biopsy, which determined that she had stage 1 invasive ductal carcinoma, a form of breast cancer. She underwent treatment and reported that now, 5 years later, she is doing well.
Breast density reflects how much of the breast consists of fatty tissue, and how much is comprised of glands, ducts, and other non-fatty, fibrous tissue. Dense breasts contain less fatty tissue. Because they don’t look or feel differently, without mammography, there's no way of knowing if your breasts are dense. On a
mammogram, fatty breast tissue appears dark, while denser tissue looks white.
Breast density varies greatly by age and weight. Dense breasts are more common in both young and thin women. High breast density is common,in the U.S., 40-50 percent of women ages 40-74 have dense breasts.
Medications that contain hormones can also affect breast density. For example:
Dense breasts and breast tumors both appear as white areas on a
mammogram, often making it difficult to differentiate between the two; if you have dense breasts, it can be easier for cancer to go undetected by routine mammograms. Having dense breasts is also thought to slightly increase a woman’s risk of developing breast cancer, but researchers don’t know why.
mammogram, you’ll get a report which may or may not mention breast density. According to the American Cancer Society, states have different laws about whether or not mammogram reports need to include information on breast density. Almost half of U.S. states include information on dense breasts with mammogram results. Depending on the density of your breasts and other risk factors, your doctor may recommend additional screening by 3-D mammogram, ultrasound, or MRI.
Dense breasts are common, but there are no set guidelines about additional testing for people who have them. “There’s no standard—the guidelines are all over the place,” Richard Reitherman, M.D., Ph.D., Medical Director of Breast Imaging at MemorialCare Breast Center, Orange Coast Medical Center in Fountain Valley, Calif., tells SELF.
The American Cancer Society also recommends that women talk to their doctors about additional testing. “At this time, experts do not agree what other tests, if any, women with dense breasts should get in addition to mammograms,” the organization says on its website. Research has shown that while ultrasounds and MRIs can help find some breast cancers that can’t be seen on mammograms, they can also result in false positive findings. As a result, a patient may undergo unnecessary biopsies and tests. The U.S. Preventative Services Task Force states that current evidence is “insufficient” to determine whether the potential benefits of an ultrasound, MRI, or digital breast tomosynthesis (a test that takes images from different angles of a woman’s breast) outweigh the harms (such as false-positives).
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American Cancer Society. Breast Density and Your
US Preventive Services Task Force. Breast Cancer Screening
Karla Kerlikowske, MD; Weiwei Zhu, et. al. Identifying Women With Dense Breasts at High Risk for Interval Cancer: A Cohort Study. Annals of Internal Medicine. 2015;162(10):673-681.
FORCE Risk Management: Breast Cancer Screening
Susan G. Komen: Breast Density On a Mammogram