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Becky Tackett, RN, MSN, St. Luke's Hospital

Informing women about breast density

Several states have recently passed legislation requiring mammography providers to notify women about breast density. Nearly 40 percent of women have dense breast tissue, but it wasn't always clear how one's breast density might impact the interpretation of their mammogram. In Missouri, a new law goes into effect January 1, 2015 requiring healthcare facilities that perform mammography procedures to provide the following information about breast density in letters and reports sent to patients and their physicians:

"If your mammogram demonstrates that you have dense breast tissue, which could hide abnormalities, and you have other risk factors for breast cancer that have been identified, you might benefit from supplemental screening tests that may be suggested by your ordering physician. Dense breast tissue, in and of itself, is a relatively common condition. Therefore, this information is not provided to cause undue concern, but rather to raise your awareness and to promote discussion with your physician regarding the presence of other risk factors, in addition to dense breast tissue."

Annual mammograms are still the most effective method to screen for breast cancer, and some early types of breast cancer can only be seen on a mammogram. Other screening exams that may be recommended, such as whole breast ultrasound or breast MRI, would be in addition to and not instead of a routine screening mammogram. Breast density can only be determined by a mammogram and has nothing to do with breast size, age or firmness.

As a result of the new law, many mammography facilities in Missouri will also begin providing patients with information regarding their individual breast density based on a four-level density classification system created by the American College of Radiology. For women whose breast density is in the upper two levels, "heterogeneously dense" or "extremely dense," it may be more difficult to see a cancer on a mammogram. If dense breast tissue is a woman's only risk factor, the increase in overall breast cancer risk is very low. Breast density is only one of several risk factors that should be taken into account in determining whether additional screening exams should be considered.

Becky Tackett, RN, MSN, is a certified nurse navigator and breast care coordinator with St. Luke's Hospital. For more information, contact your mammography provider or visit the Breast Health Services page.

This article was published in the St. Louis Post-Dispatch on October 2, 2014.