Nov 13, 2012 1:35 PM by KSBY News, Carina Corral
For a certain population of women, mammograms do not always detect cancer. A new, California law has been passed that aims to help these women by changing the way their mammogram results come back.
The law requires women to be notified about their breast density and possible follow up care.
"It's almost like a warning label for mammograms that if you have dense breasts you should not rely on them exclusively," said Santa Barbara Radiologist Judy Dean who helped to push this new legislation along by consulting with lawmakers.
She said research shows women with dense breasts have five times the risk of breast cancer and that the condition also runs them 17 times the chance a mammogram will miss the cancer.
Dr. Dean provided examples of mammograms when cancer was missed in dense breast tissue. The example showed mammograms of a fatty breast tissue compared to a dense breast tissue. Cancer was more visible in the fatty tissue, whereas in the dense tissue it was almost invisible.
"On a mammogram, glandular and fibrous tissue looks white and so does cancer. It's been described as trying to see a snowball in a blizzard, you just can't see it," said Dr. Dean.
The law would require mammography providers to inform the patient if their test came back negative for cancer, but shows they have dense breast tissue. The notification also comes with recommendation for additional screening such as ultra sound or magnetic resonance imaging (MRI).
The notice will read as follows:
"Your mammogram shows that your breast tissue is dense. Dense breast tissue is common and is not abnormal. However, dense breast tissue can make it harder to evaluate the results of your mammogram and may also be associated with an increased risk of breast cancer.
This information about the results of your mammogram is given to you to raise your awareness and to inform your conversations with your doctor. Together, you can decide which screening options are right for you. A report of your results was sent to your physician."
Some doctors fear this law will lead to panic and unnecessary tests.
Dr. Dean whose has been practicing this approach since 2005 said that has not been the case. "We published those results and showed we can double the amount of cancer detected."
She agreed MRI should only be used in high risk women because of the potential for false positives and that there is also 3D mammography and thermography available who are not at high risk.
It should be noted, dense breast tissue is not related to size and that, in fact, many women with large breasts have less dense tissue overall.
California is the fifth state with a breast density notification law. It takes effect April 1, 2013.