Updated: 11/22/2013 10:48 AM
Created: 11/21/2013 6:33 PM WNYT.com
By: Benita Zahn
New York was the fifth state to sign a breast density notification law. Now, the feds are considering doing the same.
The law mandates that if a mammogram finds a woman has dense breast tissue she must be notified of that. Then, she and her doctor can decide if she should undergo another screening with ultrasound.
Debbie Manuyag is married with two children. And she's a nurse. In short, she's busy but well versed in health care. Even so she was surprised when after undergoing a mammogram she got a letter from the radiology center telling her she there was no indication of breast cancer but she had dense breasts.
“I don't actually understand what high dense breasts means,” says Manuyag.
Her doctor recommended she have another type of screening, just to be safe - an ultrasound. Good thing, as a breast cancer was spotted.
“I was scared…knowing I have breast cancer, but then the fact that it was discovered early, I was grateful for that,” she adds.
That's at the heart of the new breast density notification law.
“The goal of this is to find, to help us find small cancer's so that they can be treated effectively and quickly and not impact the patient's overall longevity and lifespan,” said Dr. Beth Whiteside, a radiologist at Albany Medical Center.
As she points out, upwards of 50 percent of women have dense breasts meaning they have a high glandular tissue to fat ratio in their breasts.
“Glandular tissue appears white on the mammogram and so does breast cancer. So if you're trying to find a white breast cancer in a background of white glandular tissue, that can be difficult,” says Dr. Whiteside.
While it's too early for data to show the effectiveness of this second screening tool, Dr. Whiteside's experience is clear - it's helping to find cancers that would otherwise be missed by mammograms.
“Well, we have found small, invasive breast cancers and those are the kind that have the potential to metastasize and go elsewhere in the body,” says Dr. Whiteside.
That's what the ultrasound found in Manuyag - she's now undergoing treatment.
“There are things we can see on mammogram that we don't see on ultrasound and vice versa. So they're tests that compliment each other. They don't replace one another,” says Dr. Whiteside. Despite this, the notification law has detractors.
“Although we know additional tests may help detect breast cancer there's also a downside to it with false positives,” she adds, which can lead to unnecessary testing and worry. That's why Dr. Whiteside says, it's important women discuss their personal risk for breast cancer with their doctor.
“Hopefully this new legislation will open a dialogue between women and their doctors that they haven't had before,” says Dr. Whiteside.
It's not clear why some women have dense breasts and others don't.
Dr. Whiteside says it does not appear that genetics plays a role.
A few things can affect breast density - weight and age, with younger women more likely to have dense breasts.
As for breast density itself being a risk factor for breast cancer, Dr. Whiteside says the jury's out on that.