Have Dense Breast Tissue? Don't Miss This Potentially Life-Saving Breast Cancer Advice
While breast cancer mortality rates have steadily decreased across the board, breast cancer incidence rates are still trending upward, especially in women under 50, per recent American Cancer Society data. Plus, disparities in breast cancer care access and mortality rates persist in Asian American and Pacific Islander women, Black women and Native American women.
Because of the uptick in diagnoses, experts have recommended changes in breast cancer screening and mammogram guidelines over the past year.
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Rising Breast Cancer Risks Among AAPI Women Demand Urgent Attention
Here are some of the biggest changes you should know about.
Dr. Thaïs Aliabadi, an OB-GYN and co-host of the SHE MD Podcast, has been at the forefront of this conversation since encouraging celebrity patients of hers like Olivia Munn to take a breast cancer risk calculator test (which led to her breast cancer diagnosis at 44). At the first annual Flow Space Women's Health Summit LA last week, she emphasized the importance of knowing your risk and testing as early as possible.
'The technology is changing. We're getting better and better at diagnosing patients earlier,' Aliabadi explained.
One factor that has changed more recently is stronger awareness around having dense breast tissue, a potential risk factor of breast cancer (which is about half of women over 40, Flow Space previously reported). The FDA now requires providers to notify anyone who's been shown to have dense breast tissue, in which breast tissue is thicker and less fatty, sometimes obscuring mammogram results, after screening. On top of that, the new guidelines advise mammograms start at age 40 instead of 50.
If you're one of those many people with dense breast tissue, there's one major life-saving precaution you can take, according to Aliabadi.
'We now have 3D imaging that has artificial intelligence,' she explained. Talk to your doctor about the possibility of a 3D mammogram, if it's available in your area. The 3D mammogram is more likely to catch any cancerous lesions than a regular 2D mammogram because it allows the radiologist to see more layers of breast tissue, said Aliabadi.
Anyone with dense breast tissue can get this 3D test covered by their insurance, Aliabadi pointed out. However, additional precautions are still recommended. 'Even with [the] 3D mammogram, if you have dense breasts, you still need to go for an ultrasound,' said Aliabadi.
If you don't have diagnosed dense breasts, a standard 2D mammogram done via X-ray should be just fine. It may obscure the radiologist's view of the breast tissue, if you do have dense breasts, which would require further more detailed screening, according to Aliabadi.
Another key to preventing breast cancer is knowing your genetic risk.
'When you do something like a genetic test or risk assessment, it gives you so much control,' emphasized panelist Dena Goldberg, a genetic counselor and content creator.
Having the testing done is nerve-wracking, but people often feel relief after they have a better understanding of their risk or know that they don't have increased risk, even if a family member had breast cancer or a genetic predisposition.
'Just giving you that information gives you a path forward, and that is so life changing for so many people,' added Goldberg.
About 85% of people who get breast cancer don't have a family history of it, Aliabadi pointed out. She still recommends genetic testing if you have a family history of any cancers (including pancreatic, colon and ovarian cancers); they'll be covered by insurance if you have a known history. Otherwise, each test costs about $250.
But that could be a life-saving $250, especially if you don't know much about your family history because of factors like estrangement, adoption or donor conception, added Goldberg.
One other preventative measure you can take at home is a Tyrer-Cuzick Risk Assessment Calculator, of which Aliabadi is a strong advocate. It calculates all types of factors to determine your lifetime risk, and you can interpret the results with a clinician's help.
'If your lifetime risk of breast cancer is 15% or less, you fall into the low-risk category. So, you can start your mammogram at age 40, or 10 years before your first-degree relative was diagnosed with breast cancer,' explained Aliabadi. 'And if you have dense breasts, you do an ultrasound [too].'
For anyone with a lifetime risk over 20%, it's a good idea to start breast imaging as early as 30, alternating mammograms and ultrasounds with an MRI. Anyone identified to have the BRCA mutation based on genetic testing can begin imaging even earlier—at age 25. According to Aliabadi, 40 is just the baseline age for low-risk women.
The experts also recommended keeping up with your genetic testing regularly, since there are more tests available for various cancer-causing genes than there were even three to five years ago. That knowledge is power when it comes to early breast cancer diagnosis and prevention.
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