October is Breast Cancer Awareness Month, and this fact bears repeating: Breast cancer is the most commonly diagnosed cancer among Asian American women, according to the U.S. Department of Health and Human Services.
But did you know this:
* Asian women historically have denser breasts than other demographic populations.
* Dense breast tissue makes it more difficult to detect cancer on a mammogram.
* Having dense breast tissue is considered a “moderate” risk for getting breast cancer, according to the American Cancer Society. Some studies show that dense breast tissue increases breast cancer risk four to six times.
So what are dense breasts and how do you know if you have them? Read on.
What are dense breasts?
Breasts consist of varying proportions of fat and glandular tissue. When there is more than 50 percent glandular tissue, a mammogram looks white and is considered dense. You cannot tell whether your breast is dense by feel or appearance or size. (In fact, more than 40 percent of all women in the U.S. have dense breasts, and women with large breasts are less likely to have dense breasts.) It can only be evaluated by mammogram.
Why are masses more difficult to detect in dense breasts?
Since masses or lumps also appear white on a mammogram, they are difficult to detect in dense breasts. However, that doesn’t mean you should stop getting mammograms if you have dense breasts. Experts emphasize that mammograms regularly find cancers in dense breasts.
What detection method works for dense breasts?
Mammogram remains the gold standard for breast screening for all women, according to Dr. June Chen, medical director of breast radiology at Breastlink at the Breast Care and Imaging Center of Orange County. Two additional screening options for women with dense breasts include a screening breast MRI for women at high risk (family history, etc.), or an automated screening breast ultrasound (ABUS) for average risk women.
Though studies have shown that an ultrasound or MRI scanning, in addition to a mammogram, is a better detection method for those with dense breast tissue, such MRIs and ultrasounds may also show more findings that are not cancer, which can result in more tests and unnecessary biopsies, according to the American Cancer Society.
So why won’t my doctor give me an ultrasound or MRI instead?
You should talk to your doctor. According to Chen, health insurance covers the cost of a screening MRI for patients with a high risk for breast cancer, but may not cover ultrasounds and MRIs for women not at high risk. Additionally, experts do not agree what other tests, if any, should be done for women with dense breasts.
A recent federal bill, called the Breast Density Mammography and Reporting Act, was introduced this summer in the Senate, which would require physicians to notify patients if they have dense breasts and discuss their risk and additional screening options. It would also support research for improved screening options for women with dense tissue. The bill was assigned to a congressional committee, which will consider it before possibly sending it on to the House or Senate as a whole, and is supported by nonprofit and advocacy organizations, including the American Cancer Society Cancer Action Network, Breast Cancer Fund, Susan G. Komen for the Cure, and Are You Dense Advocacy.
In the meantime, what should I do?
Talk to your doctor about your risk factors and a plan for screening. While new federal guidelines now recommend screening to begin at age 50, most doctors still recommend annual mammograms starting at age 40. Continue to do a monthly breast self-exam, get regular exercise, quit smoking (or never start) and cut down on alcohol.