A Clear Picture: What women need to know about breast density
Once a woman turns 40, the American Cancer Society and most recognized medical authorities recommend she start getting yearly mammograms. But mammograms aren’t uniformly sensitive in all women. Between 40 and 50 percent of women have dense breasts—fibrous tissue as opposed to mostly fatty tissue—and that density can obscure potential problems.
Most women probably don’t realize breast density is an issue. As a result, the state of New York is now requiring doctors to notify women in a letter when their mammogram reveals this is the case. Do not become alarmed if you get this letter… all it really means is that you should have a conversation with your doctor about your overall risk.
You and your doctor will want to thoroughly vet your risk factors. Dense breasts can make mammograms less sensitive, and they may also contribute to cancer risk. You’ll need to speak with your doctor about your individual lifetime risk. Your doctor will use factors to determine your risk such as your family history of breast and ovarian cancer, your age when you had your first period, whether you have children, when you had your first child, and any history of chest irradiation, among other potential risk factors. The good news is that for many women with dense breasts, their risk won’t be elevated enough to warrant any changes in screening.
Women who are at high risk (greater than a 20-25% lifetime risk) and who have dense breast tissue should have annual screening breast magnetic resonance imaging (MRI) in addition to a mammogram. MRIs are very sensitive and can pick up some cancer missed on mammogram. Why wouldn’t all women, regardless of their breast density, get an MRI? There are many false positives with Breast MRI. Therefore, screening breast MRI is recommended for those women who are at high risk because they will derive the most benefit.
The main thing is not to panic if you get this letter. Dense breasts are normal by definition. And regardless of your breast density, make sure you get your yearly mammogram and discuss your risk factors for breast cancer with your physician.
Editor’s Note: Bonnie Litvack, MD, FACR, is Director of Women’s Imaging at Northern Westchester Hospital.
Schedule your yearly mammogram at the Women’s Imaging Center at NWH or in Yorktown. Or call 914.666.1445. For Yorktown Imaging please call 914.302.2880.
Take a virtual tour of The Breast Institute at Northern Westchester Hospital.