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The FDA now requires mammography centers to share breast density results with patients.
Janelle Chavez reported for CNN Health that a new FDA guideline requires mammography centers to share with patients their breast density information. Chavez (2023) stated, “Dense breast tissue refers to breasts composed of more fibro glandular tissue than fatty tissue.” The National Cancer Institute (NCI, 2023) explains further that dense breasts are common among women and can be inherited. NCI (2023) reports that dense breast tissue cannot be felt during a self-breast examination but can be detected in a mammogram. The mammography centers utilize a “Breast Imaging Reporting and Data System (BI-RADS) to classify breast density,” (2023). NCI explained the four categories of breast density that the BI-RADS detects:
“Entirely fatty breast tissue: There is almost all fatty breast tissue. It is found in about 10% of women.
Scattered fibro glandular breast tissue: There is mostly fatty tissue with some areas of dense glandular and fibrous connective tissue. It is found in about 40% of women. Heterogeneously dense breast tissue: There are many areas of dense glandular and fibrous connective tissue, with some areas of fatty tissue. It is found in about 40% of women Extremely dense breast tissue: There is almost all dense glandular and fibrous connective tissue. It is found in about 10% of women.”
How does this information potentially impact the members of H4TG? Chavez explains further that dense breast tissue can lead to difficulty detecting breast cancer in a mammogram (2023). She reported that dense breast tissue “shows up as white on a mammogram, making cancer –which also appears white—more difficult to detect,” (2023). Further, Chavez reported on risk factors associated with dense breast tissue. In reporting on a study published by JAMA Network Open (2023), the results indicated that women did not know the risk factors associated with dense breast tissue. Chavez explains that “the level of breast cancer risk increases with the degree of breast density,” (2023). This has led to a change in FDA policy that will require doctors to discuss breast tissue density with patients after a mammogram.
BreastCancer.org has provided additional information that suggests when to have mammograms following surgical procedures. After having a lumpectomy, it’s suggested “to have a mammogram of the treated breast about 6 to 12 months after finishing treatment,” (BreastCancer.org, 2022). If an individual has had a mastectomy on one breast, then it’s recommended “to continue to have yearly mammograms as usual on the remaining breast unless you had a double mastectomy (both breasts removed).” (2022) Additionally, if an individual had a nipple-sparing mastectomy, where the nipple and tissue remain, then “Enough breast tissue remains to warrant the continued use of screening mammograms.” (BreastCancer.org, 2022) Lastly, after breast reconstruction, BreastCancer.org (2022) explains further:
“If you've had saline or silicone implants for reconstruction, you won't need mammograms of the affected side. No breast tissue remains, and the implant blocks the view of surrounding tissues. With an implant, however, you and your doctor can still do a careful physical examination of the breast area. In general, if you’ve had autologous reconstruction (reconstruction using tissue from another part of your body), typically you will not need mammograms of the affected breast. Again, this is because no breast tissue remains. Regular physical exams of the reconstructed breast will be performed. Under some circumstances, however, doctors may recommend mammography after this kind of breast reconstruction: if you're at high risk for local recurrence if a physical examination of the breast is difficult if there is a questionable abnormality.”
For additional information and resources:
Chavez, J. (10, March 2023). FDA to require mammogram reports include breast density information. CNN Health. https://www.cnn.com/2023/03/09/health/fda-mammogram-regulations-breast-density-wellness
Chavez, J. (23, January 2023). Many women underestimate breast density as a risk factor for breast cancer, study shows. CNN Health. https://www.cnn.com/2023/01/23/health/breast-density-cancer-risk-survey-wellness/index.html
Dense breasts: Answers to commonly asked questions. (29, March 2023). National Cancer Institute. https://www.cancer.gov/types/breast/breast-changes/dense-breasts
Mammograms after different types of breast surgery. (29, June 2022). BreastCancer. https://www.breastcancer.org/screening-testing/mammograms/mammography-after-surgery