New View on Screening Dense Breasts: October 17, 2012

Up to 40% of women have dense breast tissue and there is a growing concern it may be harder for them to detect growing cancers with a traditional mammogram.

“What we are talking about is the ratio of fatty and fibro glandular elements within a particular patient’s breasts,” says Dr. Gail Santucci, diagnostic radiologist with Lee Memorial Health System.

Four basic categories classify breast tissue.

“The main one is mostly fatty tissue, which is very easy to see a small lesion on mammography.  Then there are people with scattered fibro glandular density, who have some density but there still is a lot fatty tissues. Then you move on to heterogeneously dense meaning that they have a lot of glandular tissue and then the final density category is predominantly fibro glandular,” says Dr. Santucci.

Here’s what doctors are facing.

“This patient has what we would describe as extremely dense breast tissue and the difference should be fairly readily apparent,” says Dr. Santucci.

In this mammogram, glandular elements make up most of the breast tissue, making it hard to spot small lesions.

“You might not be able to see something until it is bigger and can show through that dense breast tissue,” says Dr. Santucci.

Studies show adding ultrasound in women with dense breast tissue increases the likelihood of finding early cancer. Now the FDA approved a new automated technology, which scans the entire breast.

The automated breast ultrasound provides 3D images that can see through dense tissue.

“It is significant because besides the mammography it’s the only technology that’s been FDA approved for screening. That does not unfortunately mean your insurance will pay for it,” says Dr. Santucci.

Lack of insurance coverage and limited availability are obstacles during this transitional phase.

“As we move forward, we’ll be able to clarify what the best screening of women with different breast densities is,” says Dr. Santucci.

The goal is to find cancer early in everyone.