Hello bOObs Bloggettes:
I’m re-posting this important info for those of missed it. It’s one of the first I blogged on. Hope it opens your eyes as it did mine researching it:
The dense breast tissue issue (DBT) is HUGE for breast cancer (BC) screening. Why? Because 90% of us have some degree of DBT.
Density levels are determined by what a radiologist sees on your mammogram’s X-ray. Degrees of density are broken down like this, in ascending order of density: 10% of us have “fatty” breasts (but I have yet to meet one woman who falls into this category), which are almost all fat; 40% have “scattered” density, which is considered “low” density by radiologists reading your mammography report; 40% have “heterogeneous” density, which is getting much higher; and an unlucky 10% are in the upper category of “extremely” dense tissue. For the latter, the mammogram misses up to about 50% of BC — and for this reason the mammogram is not very helpful for these women. For the lucky 10% of women who have all fatty tissue (again, whoever they are!), the mammogram works pretty darn well at finding BC, AND they don’t have to increase the radiation load in order to find BC.
But realize this (which I didn’t until I undertook this project): The higher the degree of dense tissue in your breasts, the more they have to crank up that radiation to see through the tissue. And it can reach pretty high levels pretty darn quickly. Why do they do this? Because dense breast tissue appears white on a mammogram — and so does the cancer. And the radiation apparently helps differentiate the two.
Who knew, right? I was never told this, were you? All I’ve heard at the time of screening has been: “Oh, you have dense breasts.” And I thought “Look, I don’t care if my breasts are made out of Play-Doh as long as I don’t have cancer. Can I get out of this god-awful ugly gown and get the heck out of here please??? My dense breasts are freezing!!!”
This brings me to my next point: Women in the higher density categories of “heterogeneous” and “extremely” should absolutely consult with their doctors and plead (if necessary) for an ultrasound in addition to the mammogram. In fact, I’d ask for one if I were in the lower “scattered” category too, because any DBT can mask a cancer.
Many of you have asked (and I addressed this in my last post) if you could get an ultrasound if you have dense breasts and skip the mammogram to avoid radiation — and the YEE-OOOWWW! of being squished like a pancake. Alas, the answer is “no”. Insurance, for the most part, will not cover an ultrasound unless you have a mammogram first. It’s medicine’s Standard of Care and the way the insurance reimbursement schedule is laid out.
To expand on that, I wanted to explain insurance and the Standard of Care a wee bit more than I had in my last blog. Mammography is the ONLY BC screening tool that has been deemed a “primary screening test” by medicine. It probably originated with Medicare (see last blog), if I had to bet. All the other screening devices (ultrasound, MRI, thermography) are called “adjunctive tests” to mammography. Thus, insurance won’t pay for an adjunctive test unless the primary test of mammography is performed first. And in the case of thermography, even then it won’t be covered … but that’s another blog for another time.
Also know this: Women with DBT have more chance of contracting cancer in their lifetime — and the denser your breasts, the more likely it is. We will look further at this issue in the near future — and you won’t believe what I uncovered in the medical literature on this topic.
You’ll be hearing a lot from bOObs blogs on DBT, but a good source for dense breast tissue information can be found on my dear friend Joe Cappello’s website for “Are You Dense”, an organization founded by his late wife Nancy; Joe is interviewed in my film where he tells the horrific story of mammography missing his wife’s cancer in her extremely dense breasts for over a decade: https://www.areyoudense.org
For any of the issues in my blogs, FYI, you can find medical literature citations in my film (see link below) so you can do further research.
Blog at you soon and thank you for reading and spreading the word!
Megan
Director, bOObs: The War on Women’s Breasts
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2 Comments
Carol · August 12, 2022 at 10:40 am
My first cancer was found on mammogram but then I asked for mri due to cancer and dense breasts and they found two more cancers in other breast. Never seen on mammogram. Don’t know how long there but they’re small. Crazy. Mammography just doesn’t work on these breasts.
Megan Smith · August 17, 2022 at 3:24 pm
Hi Carol. So sorry to hear about your health situation. Yes, this is a huge problem for women with dense breasts. And they don’t really explain it to us when we go into doc for a prescription. Or when we’re actually at the mammogram appointment, for that matter. If you live in a state (about 30 of them now) that requires them to say you have dense breasts, oftentimes they won’t tell the woman what that means, e.g., it could affect the mammogram results. Crazy, like you said. Good luck and best wishes, Megan