Breast ‘density’ warnings make for a thick fog of fear and confusion

For millions of women across the U.S. having that “routine” mammogram is anything but.

I’m talking about women who receive a letter telling them they have “dense breasts” and that they should contact their doctor immediately.

Maybe a 3D mammogram, MRI or ultrasound is next. Many are even told to repeat that same mammogram every six months — or less!

Because of a law that first went into effect seven years ago, dense breast tissue has become a windfall for the medical testing industry like no other.

But a recent study has found that deciding whether your breasts are dense — or not — isn’t as easy or reliable as you might think.

A guessing game

If you have dense breasts will that increase your risk of breast cancer?

And the answer is — yes, maybe, sort of, it depends.

If that sounds confusing to you, well, join the club!

What we do know is that if you receive a letter telling you that you have dense breast tissue, you’re likely in for a lot more medical procedures.

This can include testing that may end up with you getting zapped with more radiation or even surgery — things that may not have been necessary in the first place.

First, you should know that having dense breast tissue is very common — and perfectly normal. Experts say that close to half of women over 40 will have it. If you’ve been told you’re one of them, remember, it’s not some kind of “condition” that needs treatment.

Back in 2009 Connecticut became the first state to pass legislation that required women who were determined by a radiologist after a mammogram to have dense breasts — that is, breasts with less fatty tissue — to receive a follow-up letter telling them that.

Since then, another 24 states have passed similar laws. Some, like California, actually require a woman to be offered additional tests. And that’s even when their mammogram is said to be absolutely fine.

But even the totally mainstream head of the American Cancer Society isn’t on board with this notification plan, saying that “we’re legislating something that we don’t totally understand.”

The “problem” with dense breasts, we’re told, is that it makes it harder to read a mammogram and your radiologist might not be able to see something suspect.

And that brings us back to the latest research I mentioned.

A study just published in the Annals of Internal Medicine found that determining breast density all depends on how a particular radiologist interprets the results.

Dr. Brian Sprague, the study author, said that women should know that “density is a subjective measure,” and only “one factor” that may up your risk of breast cancer.

But actually, calling it subjective is being kind. Because it looks more like a wild guess.

Dr. Sprague and his colleagues showed that when carefully examining over 200,000 mammograms, around 38 percent could be confirmed as showing dense breast tissue.

But, when they asked 83 radiologists around the country to rate them, the density calls were all over the board. They went from a low of 6.3 percent to a high of 84.5 percent.

Well, that’s certainly precision!

As an eAlert reader, you know how I feel about mammograms to begin with. This entire density issue is another reason why this test should have gone the way of the Edsel long ago.

Mammography is amazingly unreliable, producing many highly stressful false-positive results that lead millions of women chasing pointless follow-up tests, unnecessary biopsies and treatments.

And, as research has found, mammograms do not lower the number of women who are dying from breast cancer.

It’s about time that we stop referring to mammography as a life-saver and call it what it really is.

A wild goose chase that can turn dangerous in a hurry.

Sources:
“Got dense breasts? That can depend on who is reading the mammogram” Katherine Hobson, July 18, 2016, NPR, npr.org