Breast Density and Risk of Breast Cancer – What’s the Scoop?
By: Brandy (Korman) Haslam
There has been a lot of talk recently about breast density and how it affects breast cancer screening.
After California, Texas and several other states enacted new legislation this week that requires docs to inform women of a mammogram that reveals dense breast tissue, some physicians have voiced concern.
Much of this concern is over part of the legislation that also requires the physician to tell the patient that dense breasts are linked to higher risk of breast cancer, that they make mammograms harder to read and that there are alternatives to breast screening options.
PRMA surgeon Dr. Oscar Ochoa says that the legislation may cause unwarranted concern for patients as there has not been a definitive link between breast density and breast cancer. “Certainly this is an issue that has not been settled by the currently available clinical studies thus is not widely accepted across the board,” Ochoa says.
Dr. Otis Brawley of the American Cancer Society agrees and says that the law concerns him because even if there were a direct link, breast density scores that are currently used are not yet precise. “One radiologist’s eyes may be different from another radiologist’s at this point,” Brawley said. He also believes that the legislation will lead to an increasing number of women being referred for additional tests, which may not be necessary.
In most cases an MRI would be recommended for those patients determined to have dense breast tissue. Dr. Ochoa says that that the problem with the MRI is that it is not designed to be a screening tool for the general population.
“Although MRI may in fact detect early cancerous lesions in a dense breast that may not have been detected by mammogram, MRI is extremely sensitive and may detect small irregularities in breast tissue that may not be cancerous,” says Ochoa.
This may ultimately lead to numerous other tests and expenses for the patient.
Dr. Ochoa says that although he agrees that patients should be aware of dense breast tissue, the breast density score needs to be more precise and a plan of action in place for physicians on how to proceed with those patients that have a higher density score.