As a breast imaging radiologist at Montclair Breast Center, fellowship trained at Yale, with over 12 years of experience practicing in my field, I can tell you based on voluminous evidence in the scientific literature as well as from clinical experience that if you have dense breast tissue (determined from a mammogram, not from physical exam), the odds of finding a cancer on your mammogram are about equal to a coin toss.
Even with the best digital technology and the most experienced reader, a cancer will not be detected mammographically in up to half of women with dense breasts, when there is actually a cancer present. In addition, breast density is an independent risk factor for developing breast cancer, meaning that even greater diligence is warranted when screening these women.
When I give a woman with dense breasts a “normal mammogram” report, I am only 50 percent certain that there is no cancer in her breast. This is ineffective screening by any definition, and by not routinely informing women with dense breasts that their mammogram is limited, as only a few progressive radiology practices do (and I proudly include Montclair Breast Center on that short list), and that they have a choice to pursue second-level screening with breast ultrasound, MRI or gamma imaging, we are poorly serving the 40 percent of women with dense breasts. Women who are diligent about their health and come to me yearly for their mammograms expect to be effectively screened for breast cancer. We do not provide effective screening if breast density is ignored.
Due to the tireless efforts of grassroots patient advocates many of whom became involved with this issue when their own breast cancers were found at advanced stages because they have dense breasts and had never been told this essential fact after years of “negative” mammograms, laws have been passed in Connecticut, Texas, and Virginia, requiring that women are informed of their density when they have a mammogram. Now New Jersey is poised to join these states; NJ State Senators Nia Gill (Essex and Passaic) and Loretta Weinberg (Bergen) have sponsored a Senate bill, S792, which requires that mammogram reports contain information on breast density, and requires insurers to cover breast ultrasound screening if a mammogram demonstrates dense breast tissue.
This Thursday, May 17, the Senate Commerce Committee will be hearing statements and voting on this bill; this is the first step toward the bill becoming law. If you would like to attend this meeting and make your voice heard, contact NJ advocate Laurie Scofield, at laurieascofield@gmail.com.
Can you spare just a few minutes to help support this effort? Click here to send a quick email to Senator Nia Gill (Essex, Passaic) to let her know you stand in support of NJ Bill S792; or Click here to email Senator Loretta Weinberg your support. Passage of this bill would represent a great advance in early detection for the women of our state. Your help is needed to make it a reality!
If you are interested in learning more about breast density and what it means to you, read a short article and see images at www.staceyvitiellomd.com. Knowledge is power when it comes to your health. Women deserve to have the information they need to make truly informed decisions about breast cancer screening. This bill is a step in the right direction.
My wife had mammograms each year and dense breasts. I wish we had lived near the Montclair Breast Center. 4 years ago when my wife was diagnosed with this huge tumor, breast density was not a known risk factor except to MBC, AreYouDense.org and a few other organizations. We have financially supported AreYouDense.org so other women will not be betrayed by their medical providers and not informed they have dense breasts. Thanks to Dr. Vitiello for supporting this law that will inform women how dense their breasts are. It will save lives and heart ache. With this law tumors will end up being discovered when they are much smaller than the 5 cm tumor my wife had.
I must give a shout-out to Montclair Radiology for this very reason. A few weeks ago, I went there for a mammography. Within a week of my exam, they called my doctor, left me a voicemail, and sent me a letter to tell me I had “dense” breasts and they recommended a follow-up ultrasound for a better look. Mind you, I’ve had at least 4 other prior mammographies at different places with no add’l testing recommended. Thank you, Montclair Radiology, for such impressive follow-through.
Yes, Montclair Radiology did the same for me last month. This is my question: Is there any point for me to get a mammogram if I already know I will need and ultra-sound?
Yes, the mammogram can show areas that could be questionable that they will pin point with a sonogram.
One of the reasons I became a patient at Montclair Breast Center is because there is never any waiting. They tell you the results of your mammogram and ultrasound right after the pictures are taken. It’s so wonderful and stress free. Everyone gets to meet with the radiologist right afterwards, eliminating the time they have to wait and worry about their results.
Dr. Vitiello, you are absolutely correct. Upwards of 90% of women do not know their breast density and how it effects the reading of their mammograms. Talk with your doctor; find out your breast density; discuss supplemental screenings that are available.
SonoCine is an automated whole breast ultrasound screening designed specifically for women with dense breast tissue. Visit http://www.sonocine.com to find out more information.