Did you know that women with dense breasts have a higher risk of breast cancer? And, unfortunately, mammograms are not as good at spotting breast cancer in these cases.
It’s a “double whammy” that deserves a spotlight and education during pink ribbon month, said Jennifer Harvey, M.D., chair of Imaging Sciences at the University of Rochester Medical Center and an international expert on early detection of breast cancer.
Dense tissue on a mammogram looks like cumulonimbus clouds (storm clouds), and it can be difficult for radiologists to see tumors. On the other hand, lower-risk tissue resembles a blue-sky day with wispy cirrus clouds, and tumors stand out more clearly, Harvey said.
Her advice: Know your density level.
“Once you know what your risk is, you can decide whether a mammogram alone performs well for you or whether you need additional screening tests,” Harvey said.
Breast tissue density is often inherited, but it’s also influenced by weight (thinner women tend to have denser tissue), circulating hormones, age, and whether a woman has had children.
There are four categories:
Women who receive breast cancer screening at URMC or its affiliates can check MyChart for density information. Those with heterogeneous or dense tissue should strongly consider having an ultrasound following a mammogram, Harvey said.
Although additional testing sometimes uncovers suspicious lesions and requires a biopsy — which can be stressful — finding breast cancer early can afford more treatment options and a better outcome, she added.
Future research is focusing on how best to predict who will benefit the most from additional screening. Studies show, for example, that MRIs detect three times as many cancers, but MRIs are costly and time-consuming. The imaging field is moving toward developing faster MRI technology and other types of functional imaging, using contrast dyes, in cases where cancer is a concern, she said. Harvey is editor-in-chief of the Journal of Breast Imaging, and the holds the Dr. Stanley M. Rogoff & Dr. Raymond Gramiak endowed professorship at URMC.