Stage of Tumor at Discovery Influences Prognosis
Dense breast tissue is comprised of less fat and more connective tissue which appears white on a mammogram. Cancer also appears white thus tumors are often hidden or masked by the dense tissue. As a woman ages, her breasts usually become fattier. However, 2/3 of pre-menopausal and 1/4 of postmenopausal women (40%) have dense breast tissue. Additionally, as the density of the breast increases, the risk of breast cancer also increases.
Radiologists have been reporting a woman's dense breast tissue to her referring doctor for twenty years. Most often, that information is not conveyed to the patient. Displaying heterogeneously or extremely dense breast tissue on a mammogram is considered dense (BIRADS C, D).
A radiologist determines the density of a woman's breasts by examining a mammogram. Request a copy of your mammography report from your referring doctor. Make sure it is the report that is generated from the radiologist and not a form letter. Read the report carefully and look for descriptions of your breast tissue.
Talk to your doctor about having added screening such as an ultrasound or breast MRI. Connecticut General Statute Sections 38a-503 and 38a-530 requires insurance companies to provide coverage for comprehensive ultrasound screening of an entire breast or breasts if a mammogram demonstrates heterogeneous or dense breast tissue based on the BIRADS (Breast Imaging Reporting and Data System) established by the American College of Radiology (ACR). Additional legislation requires that women in Connecticut are informed of their breast density when they receive their mammography report.
To determine the laws in your state, contact your state representatives or public health department and visit AreYouDenseAdvocacy.org.
A Handy Guide to Screening Patients with Dense Breasts is available as you discuss your personalized screening plan with health care providers. Click LEARN MORE below.
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JACR study by Are You Dense, Inc. & Are You Dense Advocacy Inc. shows Dense Breasts Laws Increase Breast Density Awareness, Conversations Between Patient & ProviderRead More »
Dr. Cappello presents spirited lecture on Breast Health at National ConferenceRead More »
Joseph Cappello at the Chamber of Commerce receiving the 2019 Stephen Sasala Health Advocate AwardRead More »
On March 28,2019 the Department of Health and Human Services, the FDA announced changes to the MQSA (Mammography Quality Standards Act) to include reporting of dense breast tissue to the patient. Are You Dense Advocacy, Inc has been working on the proposed rule changes for over ten years.Read More »
"On February 3, 2004, I was diagnosed with Stage 3c breast cancer six weeks after receiving a "normal" mammography report. Less than 48% of women with Stage 3c breast cancer are alive after five years."
– Nancy M. Cappello, Ph. D.
Breast density is one of the strongest predictors of the failure of mammography screening to detect cancer.
Two-thirds of pre-menopausal women and 1/4 of post menopausal women have dense breast tissue.
Adding more sensitive tests to mammography significantly increase detection of invasive cancers that are small and node negative.
American College of Radiology describes women with "Dense Breast Tissue" as having a higher than average risk of Breast Cancer.
While a mammogram detects 98% of cancers in women with fatty breasts, it finds only 48% in women with the densest breasts.
A woman at average risk and a woman at high risk have an EQUAL chance of having their cancer masked by mammogram.
Women with dense breasts who had breast cancer have a four times higher risk of recurrence than women with less-dense breasts.
A substantial proportion of Breast Cancer can be attributed to high breast density alone.
Cancer turns up five times more often in women with extremely dense breasts than those with the most fatty tissue.
There are too many women who are unaware of their breast density, believe their “Happy Gram” when it reports no significant findings and are at risk of receiving a later stage cancer diagnosis.