Hello bOObs Bloggettes:
Well, it’s October again and that means it’s Breast Cancer Awareness Month. Most of you probably heard that Katie Couric was recently diagnosed with a Stage 1A (the lowest grade) breast cancer (BC). She apparently has dense breast tissue (DBT) and was always instructed to get an ultrasound (US) in addition to her annual mammogram. She had a lumpectomy followed by treatment with tons of radiation…just in case.
Katie said a few things were a wee incorrect or incomplete on the Today Show so I thought I’d talk about those here. Her research said that roughly 50% of women have DBT. Well, actually, 90% of us have some degree of DBT, and roughly 50% of us are in the top two categories which make the mammogram practically useless as they will miss a lot of BC. Hence, these women should be getting US in addition to or (better yet) instead of the mammogram. If they skipped the mammogram and went straight to US instead, the woman wouldn’t be receiving radiation year after year after year, which would cut back her chances of a radiation-induced BC eventually from the mammogram. But alas, it’s not medicine’s Standard of Care.
Katie correctly pointed out that US is oftentimes not covered by insurance — even though the woman is in the top two categories of extremely dense or heterogeneously dense breast tissue. The mammogram will miss about 50% of BC in the former, FYI.
Because of this, Rep. Rosa DeLauro (D-CT) is introducing a bill soon that would get US covered by insurance, I’m assuming, for these top two categories. I used to lobby Congress and I don’t want to get women too excited about this as it has a long way to go for passage and enforcement. But it’s a step in the right direction.
I met with Rep. DeLauro’s office a few years ago with an MD who informed her office about the problems with DBT and mammograms and US and thermograms. I’d like to think that we paved the way, at least a little bit, for raising awareness in Rep. DeLauro’s office:))
FDA, incidentally, has been sitting on decisions surrounding BC screening since 2019. All that time went by and all those women remained uncovered for ultrasound. Makes you wonder about our federal government.
One thing that made the hair stand up on my back a bit watching the interview was Katie tossing out nonchalantly that some women should start getting a mammogram as early as 30 years old. But this should only be done if absolutely necessary. The reason is that the younger the woman, the denser the breast and, hence (as I’ve discussed ad nauseam in previous blogs), the more prone the woman is to radiation-induced BC from the mammogram. Remember, the glandular part of the DBT is the most radiation-sensitive tissue in the body so you don’t want to over-radiate it.
The Today Show threw up a slide of the American Cancer Society stating women should start getting screened at age 40 and then go to every other year eventually (I believe age 55). The two Today Show hosts and Katie all seemed perplexed by the controversy over differences in screening ages and recommendations — but that’s because they don’t read this blog:))
In short, it’s because the medical literature in 2009 started to reflect the fact that many women were getting over-diagnosed and hence over-treated for BC. This means they received treatments like mastectomies, radiation and chemo for cancers that were likely not going to become invasive. Most of these are the dreaded pre-cancer of DCIS (see my previous blog on this) that represents about 25% of all BC. Also, repeated mammograms were inducing BC in some women.
We need to change the way women are being screened. Full stop.
Blog at you soon, thanks for reading and helping to spread the word! (Please see the “share” links below.) And we’d love to hear comments from you! (see below as well)
Stay healthy,
Megan
Megan Smith, M.S.
Director, bOObs: The War on Women’s Breasts
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