Dr. Olena Weaver of MD Anderson Cancer Center in Houston looks at mammogram imagery. The regular mammogram on the left shows a woman with dense breast tissue; on the right is a contrast-enhanced mammogram.
Brett Coomer/Houston Chronicle via Getty Images
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Brett Coomer/Houston Chronicle via Getty Images
Joy, a 46-year-old in Pittsburgh, recalls being the same age as her teenage boys, when her own mother diligently got cancer screenings. “She had her mammograms every year,” Joy says.
But, Joy thinks her mother likely had “dense breasts,” as she does. That means more concentrated clusters of glands and tissue, as opposed to fat. So the 2D, black-and-white images of a typical mammogram x-ray likely didn’t catch the tumor her mom had until it had grown big enough to feel.
“She was diagnosed at age 43 and by 48 she was gone,” says Joy, who asked that NPR use only her first name as she hasn’t shared her health information widely with friends and family.
When Joy herself turned 43, she enrolled in a breast-imaging study, which gave her a mammogram that came back showing nothing of concern. But then, after researchers followed up with more high-contrast imaging, Joy got a call back: “We think we see something.”
About 40% of women fall into the categories ranging from dense to extremely dense breasts — putting them at higher risk of developing cancer, which is also harder to detect on 2D or even newer 3D mammograms.
New information, but still a tough question
As of September 2024, federal regulations began requiring all mammogram reports to include information about breast density, including language saying, “in some people with dense tissue, other imaging tests in addition to a mammogram may help find cancers.”
But with 40% of women falling under these dense breast categories, when is magnetic resonance imaging, known as MRI, or other follow-up imaging a good idea?
It is a tough question to answer, and there is not a one-size fits all approach.
The U.S. Preventive Services Taskforce is the expert body that makes recommendations for primary care doctors and sets which screening tests should be fully covered by insurance.
The article mentions that there is not enough evidence to determine the benefits and risks of supplemental breast cancer screening for women with dense breasts. These additional screenings, such as ultrasounds and MRIs, could lead to further testing like biopsies and increased exposure to radiation if follow-up x-rays are required.
Cost is identified as a significant barrier for many women in accessing follow-up MRIs after an initial screening. The majority of eligible women currently do not receive these screenings due to limited availability of MRI machines and the out-of-pocket expenses, which can be around $1,000 and are often not covered by insurance.
Various tools and questionnaires are available online to help women assess their individual cancer risks, but determining the need for a follow-up MRI can be complex and should start with a discussion with a healthcare provider. Factors such as family history, genetics, weight, and lifestyle all play a role in assessing risk.
Dr. Wendie Berg, a radiology professor, emphasizes the importance of self-advocacy in seeking additional screenings. Her research shows that MRIs can detect significantly more cancers at earlier stages compared to mammograms and ultrasounds, without exposing patients to radiation.
Despite the proven benefits of MRIs in early cancer detection, a small percentage of eligible women actually undergo these screenings due to various factors such as cost, complexity, and lack of awareness among healthcare providers. Dr. Berg encourages women to take charge of their health, advocate for themselves, and discuss the possibility of getting an MRI with their doctors.
Ultimately, the responsibility lies with women to educate themselves on their risk factors, initiate conversations with healthcare providers, and push for necessary screenings like MRIs to ensure early detection and successful treatment outcomes. sentence: Please rewrite the sentence so that it is easier to understand.
