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DR. THOMAS KOLB ON ABC NEWS VIDEO ON DENSE BREASTS

WHAT ARE DENSE BREASTS?

Dense breasts refers to the amount of glandular tissue vs fat. The less fat (and the more glandular)  makes the breast more dense. On a mammogram, which is a black and white and shades of grey, dense breasts appear "white" and fatty breasts appear more "dark.". This is important because cancers  on a mammogram are also white and so it is more difficult to find cancers in women with dense breasts. In fact the more dense a breast, the more likely a mammogram will fail to detect a small cancer. In women with densest breasts a screening mammograms will miss 60% of breast cancer. Fortunately, on ultrasound cancers are dark. So it is easier to find a cancer on ultrasound in a woman who has dense breasts. In fact screening breast ultrasound will find 40% more cancers in women with dense breasts than mammograms will. On the other hand fatty (non-dense breasts) are predominantly black on a mammogram. Therefore cancers are more easily seen in women with fatty and screening ultrasound is not necessary. 

WHAT IS THE DIFFERENCE BETWEEN A "SCREENING" AND A "DIAGNOSTIC" BREAST ULTRASOUND?

A screening breast ultrasound is done in an asymptomatic  patient who has a normal breast physical examination and a normal mammogram. It is meant to screen for breast cancer. A diagnostic (or targeted) breast ultrasound is done to evaluate a palable mass or an abnormality seen on a mammogram. 

WHO HAS DENSE BREASTS?

Two thirds (66%) of premenopausal women and 25% of post-menopausal women have breasts dense enough that a mammogram will miss their breast cancer

 

http://abcnews.go.com/Health/dense-breasts-breast-cancer-doctor-telling/story?id=14673580

WHY IS IT IMPORTANT TO KNOW YOUR BREAST DENSITY?

As described, in women with dense breast, mammograms will miss a large percent of small potentially curable cancers. It has also been shown that dense breasts, increases the risk for breast cancer. Therefore women with dense breasts even if there s no family history of breast cancer should consider having a screening breast ultrasound at the time of their mammogram.