Women who have dense breasts and get a mammogram every year were advised during the 17th Tyler Breast Cancer Conference they should at least also have an ultrasound and may need an MRI to aid in the detection of breast cancer.
Women should find out if they have dense breasts and if they have a significant lifetime risk and then decide whether or not they should have an ultra sound or MRI, the most common tools that are being used to supplement mammograms, Dr. John A. Larrinaga said Saturday at Harvey Convention Center.
“In my opinion, if they are motivated enough to get yearly mammograms, those women (with dense breast tissue) should be getting ultrasounds, too,” Larrinaga, medical director of The Ross Breast Center in Trinity Mother Frances Health System, said.
A new law in Texas known as Henda’s law, which went into effect in January 2012, requires mammography providers to notify women that dense breast tissue can affect the accuracy of mammography in detecting breast cancer and that women with dense breasts may benefit from supplemental screening.
The law is named for Henda Salmeron, a Dallas Realtor, whose cancer was detected on a self-exam after she had been getting regular mammograms. When she found out she had a large breast cancer that had been missed on her mammograms, she asked why and found out she had dense breasts, Larrinaga said.
She was then instrumental in organizing the effort to get the law passed.
Very dense or very thick breasts can obscure or hide small breast cancer, another conference speaker, Dr. Svetislava J. Vukelja, associate director for breast cancer for Texas Oncology, said.
Because of the new law, women are sent a letter about the issue after their mammogram, Dr. Vukelja said.
She urged women with dense breasts not to ignore the letter and to contact their doctor.
Patients may not understand the significance of dense breasts and that they may have a small cancer hiding in a mammogram, which an ultrasound could pick up, she said.
The average at-risk woman — or even a woman at low risk of cancer — who has dense breasts should consider adding an ultra sound, Larrinaga said.
If they are at high risk for breast cancer, Ross Breast Center tells them they need an MRI, he said.
“If they have dense breasts and are not at extremely high risk for breast cancer, then we tell them they should get an ultrasound in addition to their yearly mammogram,” he added.
Some studies have shown that the cancer detection rate goes up twofold and that they find twice as many clinically significant cancers by adding ultrasound rather than just giving the mammogram by itself, Larrinaga said.
“My recommendation is women need to find out about their breast density,” he said.
Going beyond what the law requires, Ross Breast Center sends letters to women who have dense breasts letting them know their mammogram showed they have dense breasts and advising what type of additional study the center thinks would benefit them.
Women getting mammograms at other places may need to ask their doctor or ask the facility where they get their mammogram, he said.