Letters have started going out from radiologists to women, after normal mammograms, to alert them to a condition that might make it harder for doctors to find breast cancer. A state initiative called the "Breast Density Inform" bill ultimately may force women to have a deeper discussion with their doctors about their risk factors for breast cancer.
As radiologists pore over X-rays of breast tissue following a normal mammogram, they can sometimes miss signs of cancer if that breast tissue is dense. In other words, if the breast tissue is made up of more fibroglandular tissue than fatty tissue, according to SUNY Upstate radiologist Ravi Adhikary.
"The sensitivity drops off of our mammogram -- sensitivity meaning how good is the exam as a screening exam, how early to we catch the cancer,” said Adhikary. “It's been known to drop off with women with dense breasts."
Adhikary says the letter isn't meant to scare anyone, because dense beasts are common, especially among younger women. But it should be a jumping-off point for a discussion with a patient’s doctor.
"Perhaps the starting point is to look at their lifetime risk and risk factors for getting breast cancer, and then going from there to see if it's necessary to do additional testing," said Adhikary.
That additional testing can include 3-D mammograms, sonograms or MRIs. Adhikary admits that added screening and stress is the trade-off for finding more cancer at an earlier stage.
"We'll do additional biopsies, we'll do additional imaging, and we will find additional cancer, but we'll do a lot of things that find benign disease as well," he said.
About 40 percent of women have dense breast tissue, and New York joins other states now requiring notification if they have dense breasts.