I was fortunate that when I went in on January 2, 2013 that dense tissue has been in the media during the fall of 2012 -- and now, in 2013 in California it is a law that doctors (the radiologist is one of the doctors) must inform a patient if she has dense tissue and the next levels of testing must be performed.
For me, my radiologist informed me that day so an additional ultrasound was performed that day. The ultrasound confirmed the radiologist's suspicions so then a biopsy under local anesthesia was performed with the radiologist during the next available appointment. For me this was the following Monday, January 7, 2013. A few days later, on Thursday, January 10th, 2013, I learned that I have an aggressive and invasive cancer.
In so many ways I was blessed that I was caught. I could be upset that it was not caught earlier at a stage when my cancer was in situ (within a duct or within a lobule) and was not already spread to other areas. But, without this public attention and legislation, my cancer could have been much advanced, caught even later -- and it would be too late.
I'm writing this post for a friend of a friend who has learned that she has dense tissue. In her case, a biopsy is performed every 6 months which is traumatizing. From what I understand, it is possible to remove tissue that is not cancerous and yet still be cancerous. I wonder if every six months biopsy is the solution -- or is the MRI the better choice. The MRI is not invasive, can detect cancerous cells -- but it is more expensive. In this friend's case, the MRI is covered by insurance. So I wonder why the MRI is not the solution used. Perhaps it's best to find a second and third opinion in this case.
The links below have more information about dense tissue:
New York Times Article. (This October 2012 article came out before cancer doctors met at their annual conference. Important studies came out of this conference regarding dense tissue in favor of more testing beyond the mammogram screen).
http://www.nytimes.com/2012/10/25/health/laws-tell-mammogram-clinics-to-address-breast-density.html?pagewanted=all&_r=0
Key quotes from the above NY Times article:
- "...the journal Radiology and in April in The Journal of the American Medical Association found that for every 1,000 women screened, adding ultrasound found three to five cancers that mammograms missed. But in one study, 63 biopsies or other invasive procedures were performed to find three tumors".
- "The National Cancer Institute calls dense breasts “a strong risk factor for developing breast cancer.”
- “Dense” breasts have a relatively high proportion of glandular or connective tissue, which blocks X-rays. Non-dense breasts have more fat, which X-rays penetrate easily. Over all, about 40 percent of women who have mammograms have dense breast tissue. It is not abnormal, just one of nature’s variations. Younger women are more likely to have dense tissue, but as many as 25 percent of older women do, too. Density cannot be judged by touch; it shows up only on mammograms."
- "This year, 226,870 new cases of breast cancer and 39,510 deaths from the disease are expected in the United States."
The LA Times released this article in September 2012. It states that the new CA law takes effect April 1, 2013.
Key notes from the above LA Times article:
- "...the American College of Radiology supports including information about breast density in the mammogram report sent to physicians, it doesn’t come out and support mandatory notification to patients".
- This article seems to support doctors choices of no extra testing.
The Radiological Society released the following November 27, 2012 study regarding women's willingness to undergo the additional ultrasound/MRI if they had dense tissue:
Key quotes from the above Radiological Society study:
- The study revealed 76 percent of the women did not know if they had dense breasts. Most of the women, the researchers noted, were open to additional breast cancer screening even if it involved out-of-pocket costs or a biopsy.
- "Our study highlights the need for patient education regarding breast density," Dr. Jafi Lipson, an assistant professor of radiology at Stanford University School of Medicine in California, said in an RSNA news release.
Overall, at least to someone like me, I'm in favor of the extra testing. My radiologist educated me in this process and found the cancer with the extra tests. I'm lucky in this respect.
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