On March 9th, the FDA amended its mammography regulations to require breast imaging facilities to notify patients about the density of their breasts. So what does this mean going forward?
The Mammography Quality Standards Act (MQSA) is a law created in 1992 to ensure greater access to quality mammography. It authorizes FDA oversight at mammography facilities such as certification, annual inspection, accreditation, and more. Since the law’s inception, it has been amended to uphold the changes in science over the past twenty years. The latest amendment now requires facilities to provide their patients with information on their breast density.
So what exactly is breast density?
The breast is composed of two types of tissue: glandular tissue and fat. Glandular tissue contains the milk ducts. Breasts that contain more glandular tissue are considered to be dense. Dense breast tissue is normal and approximately half of the women have dense breasts. Breast density is measured with the Breast Imaging Reporting and Data System (BI-RADS) which has a density classification that ranges from A, almost entirely fatty, to D, extremely dense. According to Dr. Susan Love’s Breast Book, approximately 80% of women have the BI-RADS Density Classification B or C. and only about 10% of women are extremely dense.
Why is breast density important?
While having dense breast tissue does not cause breast cancer, it does put you at a slightly increased risk for developing breast cancer compared with those with fatty breasts.
Breast density is also important when it comes to having a mammogram. Mammogram pictures of dense breasts are more of a challenge for radiologists to read than those of fatty breasts because some small breast cancers can hide in dense breast tissue.
You’ve been told you have dense breasts – now what?
Let’s say this again together – dense breasts do NOT mean you have breast cancer! Risk factors such as a personal or family history of breast and certain other cancers, as well as some genetic mutations, are still considered to have a much greater impact on breast cancer risk than breast density.
Depending on your breast cancer risk factors, your doctor could recommend supplementing your screening mammogram with either ultrasound or MRI in order to help your radiologist see through your dense breast tissue to find cancer. Ultrasound is the most common follow-up to mammograms. MRI and other contrast imaging tools are other options that involve an injection.
I am hopeful that this FDA ruling will help the early detection of breast cancer. Figuring out the right steps for you could require a second, third, or fourth opinion! Listen to your doctors and weigh your options before deciding what is best for you.
