Breast cancer is a major health concern for women globally, and early detection is crucial for effective treatment.
However, dense breast tissue presents significant challenges in cancer detection through mammography due to a phenomenon known as the “masking effect.”
Facts: Connection between dense breast tissue and breast cancer
- The prevalence of dense breast tissue is high, affecting about 40% of women.
- Dense breast tissue can ‘mask’ or obscure visualization of cancer in mammography
- In one study, mammography missed detecting cancer in nearly 19.320% of patients with dense breasts, whereas about 7.9% of cancers were missed in fatty breasts.
These facts highlight the critical need for alternative screening methods. Without these, many women with dense breasts face delayed diagnoses, which can adversely affect their treatment outcomes.
The masking effect on mammograms
Dense breast tissue, characterized by a higher proportion of glandular and connective tissue compared to fatty tissue, appears white on mammograms. Unfortunately, cancerous tumors also appear white, creating a masking effect that can obscure malignancies.
The overlap in appearance significantly complicates distinguishing between healthy dense tissue and potential tumors, leading to missed diagnoses. The masking effect makes it challenging for radiologists to detect cancer early when it is most treatable.
FDA ruling on breast density
In light of the challenges posed by dense breast tissue, the FDA made informing patients of their breast density a federal mandate.
The ruling requires facilities to inform their patients whether or not their breasts are dense and explain the implications for cancer detection—ultimately aiming to empower people to make informed decisions about their health. By understanding their breast density, women can discuss with their healthcare providers whether additional screening options like ultrasound or MRI might be appropriate.
Additional imaging techniques: Ultrasound and MRI
Additional imaging techniques, such as ultrasound and breast MRI, are recommended to improve cancer detection in women with dense breasts. These modalities are not impacted in the same way by the masking effect of dense tissue, but can come with additional costs and lower specificity.
So how do you know which patients would benefit from these more sensitive modalities? You need an objective, consistent way to measure breast density and triage the appropriate patients.
A study published in Radiology, known as the DENSE trial, found that triaging patients based on their Volpara breast density and adding MRI to the screening process for those with dense breasts significantly increased the detection rate of breast cancers that mammography alone missed.
The Volpara Health suite of services offers numerous ways to standardize measurement and assess breast density with precision. Contact us today to consult with one of our breast density experts.
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