A picture is worth a thousand words. While that saying may be true, for the more than 50 percent of all women who have dense breast tissue, a picture from traditional, 2-D mammography may not tell the full story about whether they have breast cancer.
“Breast density is like the wolf in sheep’s clothing. Both tumors and dense breast tissue appear white on a mammogram. A traditional 2-D mammogram may not distinguish between the two. That’s why mammograms find as few as 40 percent of cancers in women with dense breasts,” says Deborah Rhodes, M.D., a Mayo Clinic Breast Clinic physician.
“If tumors are obscured by dense tissue on a mammogram, the tumor may go undetected for a year or longer during which time the tumor will grow – which is a significant problem when you consider how closely survival from breast cancer is linked to tumor size at diagnosis. If we discover a tumor when it is less than 1 centimeter, that patient has over a 90 percent chance of surviving. If we could reliably find tumors in dense tissue when they are small, more lives could be saved," adds Dr. Rhodes.
In addition to dense breast tissue masking tumors on a mammogram, research has shown that women with dense breast tissue have a higher risk of developing breast cancer. Many states have now passed legislation mandating that women found to have dense breasts on a mammogram be provided with information about the impact of breast density on breast cancer detection and risk.
Because both Minnesota and Arizona have this legislation, and because national guidelines on breast cancer screening differ, Mayo Clinic breast specialists developed consensus guidelines for breast cancer screening in women with dense breasts.
Bringing dense breast tissue into focus - 3-D mammograms and molecular breast imaging (MBI)
In order to provide the best screening to detect breast cancer, Mayo Clinic physicians recommend that women with dense breasts initially have a 3-D mammogram and be given the option to have further screening with molecular breast imaging (MBI).
Dense breast tissue – what you should know
Women with dense breast tissue have a higher proportion of dense tissue compared to fatty tissue in their breasts. You can find out whether you have dense breast tissue by talking with your physician and reading your mammogram report.
Factors that lead to women having dense breasts include:
Adjusting the lens – researchers work to refine screening tools
Mayo Clinic Center for Individualized Medicine has supported development of molecular breast imaging as an individualized approach to cancer screening and will continue to support research that refines this technology in order to provide patients with dense breast tissue the best care.
“Our goal is to identify the best tool to screen for and diagnose cancer at its earliest stages, when it is more treatable. By finding the best individualized care for women with dense breasts, I think we can greatly reduce the number of breast cancers diagnosed when they are already advanced - cancers that were not visible on an x-ray. We have already demonstrated that MBI can detect many cancers – including advanced cancers – that were not seen on traditional 2-D mammography. Our future research will continue to evaluate the effectiveness of 3-D mammograms and MBI. While this research is ongoing and important, MBI is available now as a tool for women who seek additional screening because they have dense breasts,” says Dr. Rhodes.
Learn more about individualized medicine
Join us at Individualizing Medicine 2017: Advancing Care Through Genomics. The Mayo Clinic Center for Individualized Medicine, with support from the Jackson Family Foundation, is hosting the sixth annual genomics conference, October 9–10, in Rochester, Minnesota.
Tags: #breast cancer screening, #dense breast tissue, #Dr. Deborah Rhodes, #MBI, #molecular breast imaging, #personalized therapies, #tomosynthesis, 2-D mammograms, 3-D mammograms, breast cancer, breast density, center for individualized medicine, mayo clinic, medical research, personalized medicine, Precision Medicine