Are you getting the right breast cancer tests?

A potential breast cancer diagnosis is too important to wonder about clear and accurate results.

That’s why there is more than one breast cancer screening procedure. Even though 67 percent of people get a recommended two-dimensional screening mammogram each year, according to the American Cancer Society, for some, this may not be enough to catch the disease in its earliest stages. Additional procedures may be required depending on a person’s breast density.

Breasts are made up of a mixture of fibrous and glandular tissue and fatty tissue. Breasts are considered dense if they have a lot of fibrous and glandular tissue but not much fat. Density may decrease with age, but there is little, if any, change in most people. Breast density is determined by the radiologist, who reads your two-dimensional screening mammogram. The radiologist’s report informs patients who have dense breast tissue based on a four-level density scale used nationally.



Conventional screening mammograms are adequate for less dense, “almost entirely fatty” breast and a breast with “scattered areas of fibroglandular density.” But, according to the American College of Radiology, approximately 10 percent of people have breast tissue considered “extremely dense,” while another 10 percept are “heterogeneously dense.” This means about a quarter of people who go for a breast cancer screening may need something more than the standard two-dimensional mammogram.

More recent and advanced technology can help us screen dense breast tissue, but they do not replace standard screening mammograms, which studies still show have dropped breast cancer deaths by 30 percent. Instead, experts recommend women with dense breast tissue get the standard mammogram at their doctor’s request in conjunction with other imaging options.

Two additional screening options include:

Digital breast tomosynthesis: Also known as 3-D mammography, digital breast tomosynthesis takes multiple views of the breast and compiles them into a three-dimensional image. Early studies show the procedure offers better accuracy than 2-D images for women with dense breast tissue. However, this study is slightly more radiation than the 2-D mammogram and insurance providers may require customers to pay a higher deductible.

Breast magnetic resonance imaging: More commonly known as breast MRI, this study uses strong magnets and radio waves to detect images by capturing magnetic properties in the body. A radiologists will inject a contrast (dye) through an IV in the arm and the MRI machine can see increased blood flow, which is where cancers may occur. MRI is a highly sensitive test, which can cause a higher rate of false-positive readings. A false-positive reading means a test’s initial results may come back as detecting an abnormality, but further testing concludes no cancer in the body. The MRI can also be a pricey alternative compared to other screenings.

Patients should talk with their doctor about determining their breast density as well as increased breast cancer risk factors, such as family history, previous chest radiation treatment for cancer or breast biopsies that have shown you’re at high risk.

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