By Aine Cryts
Dense breast tissue looks white on a mammogram. Cancer also looks white on a mammogram. That’s why it’s harder for a radiologist to determine if a woman with dense breast tissue has cancer. And this is a concern for approximately 50% of women 40 years of age or older who get mammograms, according to the National Cancer Institute.
To help these women get the screening and care that they need, radiology departments and radiology groups need to help educate both patients and their primary-care and Ob-Gyn clinicians about the issues that dense breast tissue can raise.
To address that goal, AXIS Imaging News recently got advice from Stamatia Destounis, MD, attending radiologist at Rochester, N.Y.’s Elizabeth Wende Breast Care and clinical professor at University of Rochester Imaging Sciences. Here is a lightly edited version of that conversation with Destounis, who’s also a founding member of DenseBreast-info.org’s medical advisory board.
AXIS Imaging News: Does breast density change over the course of a woman’s life?
Stamatia Destounis: Breast density can decrease with increasing age, but this may not necessarily be a big change for all women. Breast density can also fluctuate with weight changes so a woman who is postmenopausal may have less dense breasts than a woman who still has normal menstrual cycles.
AXIS: When a woman learns from a radiologist that she has dense breast tissue, what should she do?
Destounis: It’s recommended that she talk to her primary-care physician and decide what, if any, supplemental screening tests may be helpful.
AXIS: In their roles as educators for primary-care and Ob-Gyn practices, what can radiology groups and radiology departments do to support women who have dense breasts?
Destounis: Radiologists need to communicate with healthcare providers in their area about what it means when patients have dense breasts and what the recommendations are for them. A mammogram is still needed—despite the limitations that exist—because mammography is the only screening test proven to reduce breast cancer deaths.
However, patients with dense breast tissue may also benefit from supplemental screening, such as with breast ultrasound or breast MRI, if they are in a higher risk category based on family history of breast cancer or other risk factors. It’s important for primary-care and Ob-Gyn practitioners to be aware of the benefits of supplemental screening in this population.
AXIS: What resources are available for radiology departments and radiology groups in terms of treating women with dense breast tissue?
Destounis: There are many helpful resources available through the American College of Radiology.
AXIS: Radiology groups and radiology departments may participate in events attended by patients. What’s your advice for radiology professionals who are interacting directly with patients?
Destounis: Providing information in a way that patients can understand is important. It’s helpful to explain what breast density is, how women will be notified if they have dense breasts, and what needs to be done when a woman has dense breast tissue.
AXIS: Reception areas and waiting rooms are two physical spaces where patients can learn about breast density. What’s your advice for radiology groups and radiology departments in terms of providing literature that’s understandable to patients?
Destounis: My facility uses TV screens to play slides with information for patients. We also provide pamphlets and brochures in patient waiting rooms, in the exam rooms, and in every clinical area. In addition, our technologists and staff are educated in explaining breast density and its importance to our patients. The ACR literature was specifically designed to be understandable to patients, and it is available online for any radiology facility to use and share with other healthcare providers.
Aine Cryts is a contributing writer for AXIS Imaging News.