If it was something that couldn’t be seen, I would find it easier to understand and to accept. It is however, Clearly Visible.
The problem arises when a woman goes for her screening mammogram. Her radiologist can see if the woman has extremely Dense Breasts. Sometimes so Dense in fact, that it is impossible to see if there are any suspicious leisions or Cancer in a woman’s breasts.
Breast Density is clearly visible on a woman’s Mammogram. The more Density there is, the easier it is to see. We know that, so there’s no issue there, Breast Density is not, in itself the problem.
Breast Density shows as white on a Mammogram, Cancer also shows white on a Mammogram. White on White does NOT contrast. It’s commonly referred to as a Masking Effect.
Now you would think that because of the uncertainty, the possibility of masking and because the Mammogram image clearly shows the woman’s Breasts are Very Dense, the logical thing would be to take more images. We know that Ultrasound is way more reliable for women with Dense breasts, right? So it’s logical to expect that this woman would be recalled by the radiologist for an Ultrasound, wrong.
It is not a requirement or standard protocol that women with Dense Breasts are even paid the courtesy of being routinely notified. Standard Operating Procedure does not even warrant an acknowledgement on this.
Of course the absurdity of that is really compounded by this. The only way to determine Breast Density is by having a Mammogram.
The very tool that is used to screen for Breast Cancer, is also the tool used to determine Breast Density – the Mammogram. The person who reads the Mammogram is a radiologist. The radiologist however is not mandated to inform the woman about her Breast Density and no report is issued following the woman’s screening Mammogram.
This woman has no idea her Breasts are Very Dense. Her Mammogram shows the extent of the Density. The two radiologists who read the Mammogram note that it’s Clear. They do not have to inform the woman about her Dense Breasts, so they don’t.
Less than 6 months later the Woman notices something is not right and after a Breast Ultrasound is diagnosed with a 7cm node positive Breast Cancer. A slow growing Breast Cancer that had been masked for a considerable period of time, probably years.
That woman is me. I should have been told that I had Very Dense Breasts. Radiologists had been reading my Mammograms for years. They knew for years that I had Dense Breasts.
All women should be routinely notified about their Breast Density. Not only does it mask Breast Cancer, Breast Density is an independent risk factor for Breast Cancer. I never missed a Mammogram. I had several screening Mammograms. I never heard of Breast Density until after my late Diagnosis.
I subsequently had 4 months of Chemotherapy, a Mastectomy, Axiliary node clearance and 30 Radiotherapy sessions. I have developed Lymphedema and a very painful condition called AWS, axiliary web syndrome. I live with the consequences of a delayed Breast Cancer Diagnosis.
Had I known about my Breast Density, I would still have been diagnosed with Breast Cancer, yes, but I would have known to have Ultrasound or MRI and I would have been diagnosed months, perhaps years earlier. That would have made such a difference to my treatment, my quality of life, my prognosis.
Please help to ensure that this process is placed under critical review. If your screening mammogram determines that you have Dense Breasts, you need to know. Currently women are not routinely notified about their personal Breast Density and this has to change. It’s in our #BreastInterests