Dense Breasts? Here's What You Need to Know
Dr. Wendy Levin, a medical oncologist and hematologist, talks about the challenges of breast cancer screening with dense breasts and why women should be advocating for advanced screening.
Transcript:
Jamie Forward: For women that have dense breasts, should they be asking for something other than a standard mammogram? 3D, for example?
Dr. Wendy Levin: Yeah. So, there is a challenge with dense breasts, and this is important because over 50 percent of women that are in the mammogram screening age actually have dense breasts. So, it’s very, very common. It’s a common problem. And the issue is that dense breasts actually look white on a mammogram, and that’s the way actually a breast cancer would also look. So, it is confusing. So, what we now know is that dense breasts can actually mask or hide a developing tumor.
So, we are aware of that, and we have recommendations around that. The standard recommendation for women with dense breasts should absolutely ensure that they’re getting a 3D mammogram rather than a standard 2D, again, because 3D is vastly superior. Peeling back those dense layers and allowing us to really see the tissue layer by layer to discern whether that’s a malignancy or just increased in the density of the breast. And there’s also supplemental imaging rules that that are incorporated into the ASCO and the NCCN practice guidelines that follow the federal FDA density notification mandate where dense tissue alone in an average risk woman does not automatically mandate supplement imaging. So, there is a component here of meeting the patient where they are, and looking into the risk factors to see if there’s an indication for supplement imaging. And there are guidelines around that, as well.
Jamie Forward: Okay. And so, if you’re someone with dense breasts, and you know it, how can you get the – do you have to ask for it? Or, will your doctor suggest it? How does that work exactly? How can you access it?
Dr. Wendy Levin: Yeah. So, in the best of all possible worlds, this should be an automatic trigger in your healthcare. So, when you undergo a standard mammography, part of the readout from the radiologist will call out dense breasts. And so, if that is called out by the radiologist on the initial read, you should be automatically triggered to come back and perform additional testing. And if that doesn’t happen, you should ask your provider why not, and you should understand why perhaps they haven’t triggered those additional studies. Again, this is understanding what is standard of care. How it should be implicated and advocated for, for your particular circumstance.
