Latest news with #densebreasts
Yahoo
15-06-2025
- Health
- Yahoo
Dense Breasts? You Need to Ask Your Doctor for This Type of Mammogram
For millions of women, the words 'you have dense breasts' can feel both vague and unsettling—especially when it comes after a routine mammogram. Breast density isn't just a technical term buried in a radiology report, it's a real risk factor that can make it harder to spot cancer early. Yet many women aren't told what that means for their health or what steps they can take next. One powerful, underused tool? Contrast-enhanced mammography, or CEM. Experts say it could be a game-changer for women with dense breasts, but only if they know to ask for it. More from Flow Space This Menopause Drug May Be the Key to Preventing Invasive Breast Cancer Despite growing awareness, many women still don't know what breast density means for their screening options. In most cases, they're simply advised to return in a year for another mammogram. But experts say that for women with dense breasts, especially those with additional risk factors, there's a powerful tool that could offer earlier, more accurate detection: contrast-enhanced mammography, or CEM. CEM is a relatively new imaging technique that combines the familiar process of a mammogram with an iodine-based contrast dye, similar to what's used in a CT scan. This allows radiologists to see blood flow to areas of the breast—highlighting suspicious areas that might otherwise be hidden by dense tissue. Studies show it can detect more cancers than standard mammography or even 3D mammograms, especially in dense breasts. So why isn't every woman with dense breasts getting one? Experts say it's partly due to lack of awareness—both among patients and healthcare providers—as well as uneven access and insurance coverage. But as more states pass laws requiring women to be notified about their breast density, and as clinical data continues to support CEM's accuracy, the message is becoming clearer: if you have dense breasts, asking your doctor about CEM could be a lifesaving conversation. Contrast-enhanced mammography is much simpler than it sounds. By injecting an iodine-based dye into the vein in combination with a traditional 2D or 3D mammogram, radiologists can have a better view of abnormalities that are more difficult to see on a regular mammogram. The dye serves as a contrast (hence the name) against healthy breast tissue, allowing your provider to more easily view any lesions and determine if they are benign or cancerous. 'Our breasts are made up of glands, connective tissue and fatty tissue,' Dr. Meleen Chuang, chief of obstetrics and gynecology at NYU Langone Hospital Brooklyn, told Flow Space. 'The density of breast is a term used to describe the amount of different types of breast tissue seen on a mammogram. Dense breast tissue has higher amounts of glandular tissue and connective tissue and low amount of fatty tissue.' Dense breasts are common, and almost half of women who are over 40 that get mammograms are found to have dense breast tissue. Doctors use the Breast Imaging Reporting and Data System (BI-RADS) to classify breast density. This system, developed by the American College of Radiology, helps doctors interpret and report back mammogram findings. 'Dense breasts are a risk factor for breast cancer compared to women with fatty breasts,' said Chuang. 'This risk is separate from the effect of dense breasts on the ability for the radiologist to read a mammogram.' There is not yet enough evidence to recommend for or against additional imaging tests, such as ultrasound or MRI to screen for breast cancer in women with dense breasts according to the Recommendation Statement on Breast Cancer Screening by the United States Preventive Services Task Force (USPSTF). 'However, for many women with dense breasts, the radiologist may often recommend spot compression images to redo a mammogram in certain areas after the screening mammogram and would often then review those areas with breast sonogram,' said Chuang. For those with dense breasts, supplemental imaging might be a requirement in your screening plan given your increased risk of breast cancer. What does it mean to have dense breasts? Having dense breasts increases a person's risk of developing breast cancer, and it can also make it more challenging for radiologists to detect cancer on a traditional mammogram. Nearly 50% of women have dense breasts, making it a common breast cancer risk factor. So, what are the most common types of screenings: Ultrasound: Breast ultrasound uses sound waves and their echoes to make computer pictures of the inside of the breast. It can be helpful to show certain breast developments that may be difficult to see on a mammogram, such as differentiating benign fluid-filled cysts from potentially cancerous solid masses. Ultrasound can be used for additional imaging if the patient has dense breasts. MRI: Breast MRI (which stands for magnetic resonance imaging) uses radio waves and strong magnets to make detailed pictures of the inside of the breast. It is typically used to screen high-risk patients or diagnose areas difficult to see under mammography. Like CEM, breast MRIs require a contrast dye to be injected into your vein before the pictures are taken. MRIs historically detect more cancers compared to traditional mammograms and ultrasound, so they're typically recommended for patients with dense breasts or other breast cancer risk factors. CEM: Contrast-enhanced mammography exams are conducted using the same mammography equipment as a traditional mammogram, but they also use contrast dye. Just like ultrasound and MRI, they can be used for additional imaging for patients with dense breast tissue. 3D Mammogram: A 3D mammogram, also known as digital breast tomosynthesis, is an advanced form of breast imaging that creates a three-dimensional picture of the breast using multiple X-ray images taken from different angles. Unlike traditional 2D mammograms, which produce a flat image, a 3D mammogram allows radiologists to examine breast tissue layer by layer, making it easier to detect small tumors that might be hidden by overlapping tissue. This technology is especially helpful for women with dense breasts, where distinguishing between normal and abnormal tissue can be more difficult. While 3D mammography has improved cancer detection rates and reduced false positives, it can still miss cancers that a contrast-based test like CEM might catch. Previous studies have shown that CEM offers a comparable diagnostic performance to contrast breast MRI. Most recently, a study was published that found that CEM is able to detect three times as many cancers in dense breast tissue compared to ultrasound, as well as smaller tumors compared to traditional mammograms. CEM has been gaining wider acceptance in recent years as a possible alternative to MRI, since it is a more comfortable and familiar experience compared to MRI and offers comparable detection rates. Not to mention, patients have reported that they significantly prefer CEM compared to breast MRI due to increased comfort, lower noise levels, decreased feelings of anxiety and greater procedure efficiency. CEM is also more cost effective compared to MRI (typically around 25% of the cost), and CEM patients receive their results within 8-10 minutes compared to 45 minutes with MRI. While standard and 3D mammograms rely solely on differences in tissue density to detect abnormalities, CEM uses an iodine-based contrast dye to illuminate areas where tumors may be growing and drawing blood. This functional imaging approach can reveal cancers that are otherwise hidden in dense breast tissue, which appears white on mammograms—the same color as many tumors. Studies have shown that CEM can detect more cancers than 2D or 3D mammograms alone and has accuracy comparable to breast MRI, which is considered the gold standard for high-risk screening. But unlike MRI, CEM is quicker, more widely available and less expensive. For women who need more sensitive screening but can't access or tolerate an MRI, CEM offers a powerful, accessible alternative that could catch cancer earlier—when it's most treatable. CEM provides a very appealing offer for those who need to get supplemental imaging but have concerns about detection performance with ultrasound or cost or claustrophobia with MRI.
WebMD
11-06-2025
- Health
- WebMD
Dense Breast Tissue Can Hide Cancer. Now What?
June 11, 2025 — Have you checked your annual mammogram off your health to-do list? That's a relief, for sure — but there's one more critical step to take after you get your results. Go over your report to see if you have dense breast tissue. For more than 40% of women, the answer is yes. And that means you may want to consider supplemental testing. The next step isn't always clear. But two new studies compared your options. Here's what to know. 1. Having dense breasts increases your risk of breast cancer. Why it matters: Not only is the risk higher, but it's also harder to detect cancer in dense breasts. What to know: Dense breasts have more fibrous tissue and milk glands than fat tissue. On a mammogram, the dense areas show up as white — the same color as cancer. That can make cancer harder to see, particularly when it's small. Federal law (since last fall) requires that you be notified whether your mammogram shows you have dense breasts. To be certain, check your patient portal report or call your doctor's office. You'll also want to find out if you have 'heterogeneously dense' or 'extremely dense' breasts. What's the difference? "Heterogeneously dense" means most of the breast is dense with some areas of fat, and "extremely dense" means the breast has almost no fatty tissue. Even if you don't have dense breasts now, they could become more dense as you age, so you need to recheck your report every year. Dense breasts can only be diagnosed with imaging — a physical exam can't tell. Bottom line: 'Women should know that if they have dense breasts, the mammogram might not see their cancer,' said Ruth Etzioni, PhD, a biostatistician at Fred Hutchinson Cancer Center in Seattle who specializes in analyzing benefit-harm tradeoffs in cancer screening tests. 2. If you have dense breasts, consider supplemental screening. Why it matters: Between 25% and 30% of cancers in heterogeneously dense breasts are missed on a standard mammogram. That number for extremely dense breasts is even higher, potentially topping 40%. What to know: Knowing your breast density type can help you understand how likely a mammogram would be to miss cancer in your breast. But that's only one part of the decision-making equation. For those with heterogeneously dense breasts, 'we typically will consider other risk factors in addition to breast density in order to decide whether to recommend supplemental screening,' said Pittsburgh-based radiologist and dense-breast expert Wendie A. Berg, MD, PhD. A list of risk factors, including family history and high BMI after menopause, is available at Bottom line: If you have extremely dense breasts, you should get supplemental screening, Berg said. If you have heterogeneously dense breasts, you should know your risk factors and talk to your doctor about what makes sense for you. 3. There are three types of supplemental screenings. Why it matters: Researchers compared these techniques — ultrasound, MRI, and contrast-enhanced mammogram — by randomly assigning them to women ages 50 to 70 with dense breasts whose mammograms didn't detect cancer. Results showed that MRI and the contrast-enhanced mammogram (using an iodine -based dye that helps reveal cancers) each found nearly five times as many cancers as ultrasound. What to know: Contrast-enhanced mammogram detected 19.2 cancers per 1,000 people scanned; MRI detected 17.4 per 1,000 scans; ultrasound detected 4.2 per 1,000. These detection rates were somewhat higher than in past studies, Berg and Etzioni said. They noted that women who get the scans repeated annually often see those detection rates drop over time. (That's because you're more likely to have an undetected past cancer than to develop a new one in the next year.) A separate study in JAMA Oncology recently showed that among women with a family history of breast cancer, just getting a slightly better scan than a standard mammogram — called a 3D mammogram — offered improved detection of advanced cancer in women with extremely dense breasts. 'That was compelling that we should really be doing [3D mammogram] as the routine screening, at least for the basic screening,' Berg said. Bottom line: If you have a family history of breast cancer, request a 3D mammogram for your initial annual screen, and when considering supplemental scans, know that some are better than others. 4. Your doctor may not automatically suggest supplemental screening. Why it matters: Berg's own doctor questioned her request to get an MRI after Berg learned that she has dense breasts. Ultimately, she got the MRI, which showed a small cancer that she said was easily treated and she has recovered. What to know: An advisory group called the U.S. Preventative Services Task Force that typically influences what insurance will cover doesn't recommend supplemental screening for people with dense breasts. Their reason: There is no multi-year clinical trial data examining whether extra screenings have drawbacks. Bottom line: It's OK to request supplemental screening, and knowing your risk factors will help during that conversation with your doctor. 'You still can't count on your doctor to provide all the information that you might need to make a decision for yourself about supplemental screening,' Berg said. 5. Not all supplemental screenings are covered by insurance. Why it matters: Not every state requires insurance to cover supplemental screenings — and in those that do, the law may not apply to every type of insurance. maintains a list of which states and plan types are required to cover it. What to know: Without coverage, out-of-pocket costs for an MRI can reach thousands of dollars, but a type called 'abbreviated' or 'quick' MRI can be lower — between $300 and $600 total. Contrast mammography and ultrasound are usually even less, and a 3D mammogram can sometimes cost an extra $40 or $50. MRIs where Berg works in Pittsburgh are booking six months out. A contrast-enhanced mammogram isn't a usual method used in the U.S., but Berg said some places are starting to offer it and testing the waters to see if insurance will cover it. The procedure only takes about 15 minutes, including the contrast dye injection, and uses a standard mammogram machine. Bottom line: 'If you have heterogeneously dense breasts, I think it really does come down to your own tolerance of other risk factors and whether your insurance will cover it, so it is more of a personal choice,' Berg said. 6. Think through your benefit/harm tradeoffs. Why it matters: Getting extra scans can be stressful, potentially expensive, and require a lot of time researching and communicating with your provider — not to mention taking time off work for appointments. What to know: Your risk calculation is complex, including the risk of missing a cancer detection. For example, ultrasound does have advantages (it's quick, noninvasive, and inexpensive), but tends not to spot cancer until the tumor is larger. There's also about a 10% risk of a false positive with most screening types. 'You have to poke a lot of people to find the people that you can help,' said Etzioni, who is an expert in data-driven medical decision-making, particularly when it comes to diagnostic testing and early cancer diagnosis. Bottom line: Deciding whether to get additional screening is personal and involves weighing your comfort with risk and the potential stress and cost of a false positive, Berg said. 'I think it's hard — you don't want to have any regrets either way. I don't know anybody who has regrets that their cancer was found too small. It's always better — if it's going to be there — to find it as early as possible.'
Yahoo
24-05-2025
- Health
- Yahoo
Julia Bradbury praises breast cancer study
Television presenter Julia Bradbury has said a new study which concluded women with very dense breasts should be offered additional scans "could not come soon enough". The 54-year-old, who was best known for presenting BBC One's Countryfile, was diagnosed with breast cancer in 2021 after a year and a half of tests. A study led by the University of Cambridge said that other scans - not just traditional mammograms - could treble the number of cancers detected in these women. "It is like looking for a snowball in a snowstorm, so this research could not come soon enough," Bradbury said. Bradbury said she "found a lump" when she was travelling and got it checked. After having a mammogram, Bradbury said she was "advised there was nothing to worry about". "I was sitting in the chair about to leave the office with my consultant," she recalled. "He said I am going to give you another ultrasound before you leave. "Thank goodness I had that consultant." Bradbury said a 6cm (2.4in) lump was found during the ultrasound, and she was sent for further tests. "When I was having the biopsy I knew in my heart there was something seriously wrong, and those were the first tears I shed. "I then had that horrible conversation of you have got cancer." The trial, co-ordinated from Addenbrooke's Hospital in Cambridge, tested different scanning methods on women with very dense breasts who had only been given a mammogram and had originally been told they did not have cancer. More than 9,000 women were involved in the study. About one in 10 women have very dense breasts and have a higher risk of developing breast cancer. Researchers said the cancers were harder to spot as they look whiter on the X-rays, the same colour as early-stage cancers. "I did not think there was anything untoward about having dense breasts. However, there is a slight risk of breast cancer," added Bradbury, speaking to the BBC this week. The Department of Health and Social Care said its screening advisory body had been looking at ways to improve detection rates in women with very dense breasts for a number of years. It said it would be reviewing the findings of this trial, but it was determined to "fight cancer on all fronts" to improve survival rates. A new national cancer plan for England is expected to be published later this year. "This study has show that thousands of undetected cancers could be caught," Bradbury said. "We have to try and be our own advocates and understand our body a little bit more." Follow Cambridgeshire news on BBC Sounds, Facebook, Instagram and X. Call for NHS to give women with dense breasts extra cancer scans Permanent home approved for cancer support centre Breast cancer survivors 'at risk' of second illness University of Cambridge Cambridge University Hospitals NHS Foundation Trust
Yahoo
24-05-2025
- Health
- Yahoo
Julia Bradbury praises breast cancer study
Television presenter Julia Bradbury has said a new study which concluded women with very dense breasts should be offered additional scans "could not come soon enough". The 54-year-old, who was best known for presenting BBC One's Countryfile, was diagnosed with breast cancer in 2021 after a year and a half of tests. A study led by the University of Cambridge said that other scans - not just traditional mammograms - could treble the number of cancers detected in these women. "It is like looking for a snowball in a snowstorm, so this research could not come soon enough," Bradbury said. Bradbury said she "found a lump" when she was travelling and got it checked. After having a mammogram, Bradbury said she was "advised there was nothing to worry about". "I was sitting in the chair about to leave the office with my consultant," she recalled. "He said I am going to give you another ultrasound before you leave. "Thank goodness I had that consultant." Bradbury said a 6cm (2.4in) lump was found during the ultrasound, and she was sent for further tests. "When I was having the biopsy I knew in my heart there was something seriously wrong, and those were the first tears I shed. "I then had that horrible conversation of you have got cancer." The trial, co-ordinated from Addenbrooke's Hospital in Cambridge, tested different scanning methods on women with very dense breasts who had only been given a mammogram and had originally been told they did not have cancer. More than 9,000 women were involved in the study. About one in 10 women have very dense breasts and have a higher risk of developing breast cancer. Researchers said the cancers were harder to spot as they look whiter on the X-rays, the same colour as early-stage cancers. "I did not think there was anything untoward about having dense breasts. However, there is a slight risk of breast cancer," added Bradbury, speaking to the BBC this week. The Department of Health and Social Care said its screening advisory body had been looking at ways to improve detection rates in women with very dense breasts for a number of years. It said it would be reviewing the findings of this trial, but it was determined to "fight cancer on all fronts" to improve survival rates. A new national cancer plan for England is expected to be published later this year. "This study has show that thousands of undetected cancers could be caught," Bradbury said. "We have to try and be our own advocates and understand our body a little bit more." Follow Cambridgeshire news on BBC Sounds, Facebook, Instagram and X. Call for NHS to give women with dense breasts extra cancer scans Permanent home approved for cancer support centre Breast cancer survivors 'at risk' of second illness University of Cambridge Cambridge University Hospitals NHS Foundation Trust
BBC News
24-05-2025
- Health
- BBC News
Julia Bradbury says cancer study 'could not come soon enough'
Television presenter Julia Bradbury has said a new study which concluded women with very dense breasts should be offered additional scans "could not come soon enough".The 54-year-old, who was best known for presenting BBC One's Countryfile, was diagnosed with breast cancer in 2021 after a year and a half of tests. A study led by the University of Cambridge said that other scans - not just traditional mammograms - could treble the number of cancers detected in these women."It is like looking for a snowball in a snowstorm, so this research could not come soon enough," Bradbury said. Bradbury said she "found a lump" when she was travelling and got it having a mammogram, Bradbury said she was "advised there was nothing to worry about"."I was sitting in the chair about to leave the office with my consultant," she recalled."He said I am going to give you another ultrasound before you leave."Thank goodness I had that consultant."Bradbury said a 6cm (2.4in) lump was found during the ultrasound, and she was sent for further tests."When I was having the biopsy I knew in my heart there was something seriously wrong, and those were the first tears I shed."I then had that horrible conversation of you have got cancer." The trial, co-ordinated from Addenbrooke's Hospital in Cambridge, tested different scanning methods on women with very dense breasts who had only been given a mammogram and had originally been told they did not have than 9,000 women were involved in the one in 10 women have very dense breasts and have a higher risk of developing breast cancer. Researchers said the cancers were harder to spot as they look whiter on the X-rays, the same colour as early-stage cancers."I did not think there was anything untoward about having dense breasts. However, there is a slight risk of breast cancer," added Bradbury, speaking to the BBC this week. 'Fight cancer' The Department of Health and Social Care said its screening advisory body had been looking at ways to improve detection rates in women with very dense breasts for a number of said it would be reviewing the findings of this trial, but it was determined to "fight cancer on all fronts" to improve survival rates.A new national cancer plan for England is expected to be published later this year."This study has show that thousands of undetected cancers could be caught," Bradbury said."We have to try and be our own advocates and understand our body a little bit more." Follow Cambridgeshire news on BBC Sounds, Facebook, Instagram and X.
