Medical Moment: Breast cancer risk and tissue density

Across the county, several states are passing laws that make it mandatory for women to be notified they have dense breast tissue after getting a mammogram. While there is debate on how important it is for women to know, one doctor thinks it could change how breast care is provided for in patients like Carolyn Achenbach, who have battled multiple bouts of cancer.

"I found out that I had breast cancer, it was pretty scary,” said Achenbach. Over the course of nine months she went through a lumpectomy, radiation and chemotherapy to help her beat it. But, the battle was not over for Carolyn, she soon found out she had a second cancer.

Carolyn is among the 10-percent of American women with dense breast tissue. A recent study by the National Cancer Institute shows that those with dense breasts were no more likely to die than patients whose tissue was not as dense.

However, dense tissue has been associated with a four- to six-fold increase in a woman’s risk of developing breast cancer because it is harder to spot tumors with a mammogram if a woman has dense tissue.

According to Dr. Jennifer Harvey, a professor of radiology at the University of Virginia, "Mammography is the most effective tool that we have for detecting breast cancer. The way we measure breast density is not very good."

Dr. Harvey is a breast imaging expert, she says right now there is no easy way to measure breast density and is working to develop something to help women better understand their cancer risk until technology can catch up.

"Our goal in this study is that we are going to include breast density into a risk model. It will be here is your result and here is you risk of breast cancer."

The doctor believes the personalized model could help women determine how often they should get mammograms instead of relying on age-based recommendations.

Carolyn fought her second battle with cancer and won, now she continues getting a mammogram every year to make sure she does not have to battle a third.

The first phase of Dr. Harvey’s risk model study is funded by a $5.5 million government grant. The study will continue to develop over the next three years, and if it is successful, it could be available for widespread use within six years.

RESEARCH SUMMARY-CANCER RISK FACTOR: BREAKING DOWN BREAST DENSITY

MAMMOGRAPHY: A mammogram is a tool used to screen women for breast cancer by taking x-ray pictures of the breasts. When a mammogram is done before signs or symptoms of breast cancer, it is called a screening mammogram. It recommended that women over the age of 40 get screening mammograms every one to two years because regular mammograms have shown to reduce the number of deaths from breast cancer in women between 40 and 70 years old. Mammograms that are performed after a lump or other sign of breast cancer have been found is called a diagnostic mammogram. Diagnostic mammograms have more x-ray pictures of the breast than screening mammograms do, and they may also focus on and magnify the suspicious area or lump to help determine if a biopsy is necessary. (Source: www.cancer.gov)

RISKS: Risks associated with getting a mammogram are false-positives, false-negatives, over diagnosis and overtreatment, and radiation exposure. False-positives will sometimes happen if doctors believe the mammogram to be abnormal when no cancer is actually present. For women a false-positive can cause a lot of worry and anxiety, as well as unnecessary tests and biopsies being done. False-negatives, when a mammogram seems normal but cancer is actually present, can be harmful in that a person may not receive treatment until much later on because the cancer was unknown. Over diagnosis and overtreatment refer to cancer diagnoses that will actually never threaten a woman's life, but they are treated for breast cancer all the same because doctors cannot tell a difference. The final risk, radiation exposure, is not very threatening. Although there is some radiation exposure during a mammogram, it is a very small amount and should not be harmful. The only time radiation exposure is cause for concern is if a person has repeated x-rays more often than usual. (Source: www.cancer.gov)

BREAST DENSITY: Breast density has been found to play a significant role in a person's risk of developing breast cancer. Breast density is the amount of white area on a breast that is shown on a mammogram, and women with exceptionally high breast density have a three- to fivefold increase in their risk for breast cancer. Certain women will naturally have denser breasts than others. In general, white women have higher breast densities and breast density will decrease as a woman enters menopause. However, some women's breast density continues to be high even after menopause and they are at a particularly high risk for breast cancer. It is not yet clear why breast density is related to a person's risk of breast cancer, but there are currently studies aimed at finding a better method for assessing breast cancer risk using breast density. (Source: www.cancer.gov)


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