PITTSBURGH (KDKA) — Sometimes a mammogram shows a woman’s breasts are dense – a reflection of the hormone estrogen.
“In the pre-menopausal woman, you see that very commonly,” says Dr. Thomas Julian, a breast surgeon at Allegheny General Hospital. “In post-menopausal women who might be taking hormone therapy for multiple reasons, the breast tissue can be dense.”
Women who have very dense tissue are at greater risk for developing breast cancer and it can be harder for mammograms to show a tumor.
“It’s more worrisome if a woman has dense breasts and a strong family history of breast cancer,” Dr. Julian adds.
On a mammogram, fatty tissue looks dark whereas milk ducts and connective tissue look white and having lots of whiteness is what’s considered dense. Since signs of cancer can also look white, they might blend in.
Some states have legislation compelling doctors to tell their patients if their mammogram shows they are in this group. But then, that could lead to ultrasounds or MRI scans — unchartered territory as screening tests, with no clear evidence it would save lives.
With up to two in 10 women having the finding, more testing has economic implications.
“By telling the person you have dense breast tissue, you may have to find, you may have to go on to have another test, and then who is going to pay for that other test. Now, you get into an insurance issue,” Dr. Julian points out.
While women with dense breasts have a higher risk of breast cancer, they are not more likely to die of it.
Pennsylvania has proposed legislation to inform women of their breast density on mammograms because of the increased cancer risk.
California vetoed density notification last year due to the added cost of additional tests and more false alarms leading to needless biopsies.