Some describe it as trying to find a snowball in a snowstorm. On a mammogram, cancer and dense breast tissue both appear white. Because of this, having dense breast tissue is considered a risk factor for breast cancer.
“It can increase the chance that breast cancer can go undetected by a mammogram, since dense breast tissue can mask a change in the breast – like a potential cancer,” explains Spring Piatek, APN, CBCN, an advanced oncology clinical nurse specialist with the Northwestern Medicine Breast Risk Assessment Program and High Risk Clinic at Northwestern Medicine Central DuPage and Northwestern Medicine Delnor Hospitals. “Dense breast tissue means there’s a greater amount of breast and connective tissue compared to fat. Being notified that you have dense breast tissue is a common and normal finding.”
Approximately 50 percent of women have dense breast tissue. Younger women are more likely to have dense breasts, but some women can have dense breasts at any age. Under a new Illinois law, doctors are now required to tell patients (after a mammogram) if they have dense breast tissue, and then refer them to a provider or breast imaging center for more information or additional testing.
“We have been recommending tomosynthesis (also known as 3D mammography) especially for this group of women,” says Karen Hou, MD, breast radiologist at Central DuPage Hospital. “The technique allows us to view the breast tissues in 1 mm slices, giving us a three-dimensional picture of the breast. We also offer supplemental automated screening ultrasound exams as an adjunct exam to the mammogram for those with dense tissue. Ultrasound provides another safe way of imaging dense tissue using sound waves.”
The Northwestern Medicine Breast Risk Assessment Program and High Risk Clinic is a central point of contact for those patients who may be at increased risk for developing breast cancer. Women are able to have a conversation with a breast specialist and understand what’s best recommended for screening based on their breast tissue density, family history and other risk factors. Genetic counseling is also available, along with social work and emotional support services.
“At Central DuPage and Delnor Hospitals, we’ve been proactively informing and educating our patients and providers about breast density for the last few years via conversations, handouts and lectures,” says Dr. Hou. “For us, the new law is affirmation of how important it is for women to be equipped with knowledge to best understand and optimize their breast cancer screening options based on individual needs.”
When a patient receives a mammogram at Central DuPage or Delnor Hospitals, the radiologist uses a reporting system to notify patients and providers of how dense the breast tissue is. The levels of density range on a scale from 1 to 4; with level 1 meaning the breast tissue is almost entirely fatty, and level 4 meaning the breast tissue is extremely dense. Women who fall into a level 3 or 4 are considered to have dense breast tissue and are notified of the results. That’s when a provider will recommend a 3D mammogram or additional breast imaging, to help pick up what a mammogram may be limited at viewing due to the density of a woman’s breasts. 3D mammography is available at all Northwestern Medicine immediate care centers and hospitals in the west region.
“The more women know about the specifics of personalized cancer screening recommendations, the more they are able to be proactive about their care,” adds Piatek. “This new law allows an opportunity for women to be informed about improved screening measures for their breast health, and to feel more confident that they’re doing what’s most recommended for breast cancer early detection.”
The Northwestern Medicine Breast Risk Assessment Program and High Risk Clinic is located at 25 N. Winfield Road, Suite 410 at Central DuPage Hospital, and 351 Delnor Dr., Suite 200 at Delnor Hospital. An evaluation can be requested by calling 630.933.RISK (7475). To schedule a 3D mammogram in the west region, visit westbreasthealth.nm.org for more information.