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Breast Cancer Awareness: Are You Dense?

Shauna Farnell | Vail Valley Medical Center

No woman really enjoys being called “dense” but when it comes to screening for breast cancer this term has completely different implications.

Speaking the language of mammography if a patient is deemed “dense” or “extremely dense” it means her breasts are comprised of a large amount of dense tissue rather than fatty tissue a common characteristic of younger pre-menopausal women or those on hormone therapy. The aging process typically causes breast tissue to become less dense. The problem is that when doctors review a mammogram dense tissue looks very similar to cancerous tissue making cancer in dense-breasted women difficult to detect. Don't know if you are dense? Breast density is determined from a mammogram.

What should you do if you have dense breasts? Susan G. Komen for the Cure has the following recommendations:

  • Know your risk – talk to your doctors about family history and personal risk.
  • Get screened annually starting at 40 and have clinical breast exams.
  • Know what is normal for you and notice if anything changes with your breasts.
  • Make healthy choices to reduce your risk: maintain a healthy weight limit alcohol exercise regularly.

Having dense breasts in Eagle County just became a little less concerning. A few months ago Sonnenalp Breast Center became the first facility in Colorado to use quantitative breast assessment software in conjunction with 3D mammography allowing for a much clearer distinction between healthy dense tissue and cancer.

“We've been doing 3D mammography in Edwards since May and I would say about 30 percent of the people I might have brought back previously I did not bring back because I could get a better look at their breast with this technology” says Sonnenalp Breast Center radiologist Dr. Janice Ugale. “We know that we can pick up smaller cancers compared to the 2D mammogram. The breast density assessment software enables us to be very uniform and precise with the women we call dense.”

When a suspicious abnormality shows up on a mammogram using the 2D technique the patient is called back for diagnostic imaging. There is considerable stress and even a sense of doom that comes with a call back following a mammogram. If this step can be eliminated for some patients due to the clarity of the 3D software it is beneficial to everyone involved. Patients are spared not only anxiety but the time and expense of additional visits and the medical staff is spared the unpleasantness of trying to explain the need for more screening.

With the 3D software radiologists can see tissue more clearly particularly in women with dense breasts. In some cases what may have previously looked like an area of concern is really nothing but healthy dense tissue. They are also better able to detect small treatable cancers.

“The 3D software takes images of one-millimeter slices of the breast and it gives the radiologist the ability to look at the slices like pages in a book” explains Sonnenalp Breast Center mammography technologist Colleen Berga. “It's giving the radiologist the best image and the most information. Prior to this we just had a static image. You could enhance the contrast but you couldn't get to the deep layers to evaluate the tissue.”

Many other medical facilities don't yet have the 3D mammography software because it's expensive. The Sonnenalp Breast Center at Shaw Regional Cancer Center acquired the new technology thanks to the generous support of The Sonnenalp Foundation the Vail Breast Cancer Awareness Group and Pad the Bra of Cordillera.

“But It's not just the equipment that gives the Sonnenalp Breast Center its excellent reputation” Berga says. “A lot of the praise needs to go to our great staff. We have people who really care and spend time to educate the patient and family.”

Shaw Regional Cancer Center and the Sonnenalp Breast Center are services of Vail Valley Medical Center a nonprofit since 1965.

Mammogram Facts for Breast Cancer Awareness Month

  • All women 40+ should have a mammogram annually and potentially younger if there is a family history.
  • All breasts come in various densities from fatty to extremely dense. Dense breasts can make cancer detection more difficult because dense tissue can look very similar to cancer in mammography.
  • Essentially an X-ray of the breast a 2D mammogram has been “the gold standard” for breast cancer screening with approximately an 85-percent detection rate. 3D mammogram software producers claim an increase in detection by up to 40% from 2D and a drastic decrease in call backs. It is better able to detect smaller treatable cancers and more clearly differentiate healthy dense tissue from cancerous tissue.
  • Although it is uncomfortable compression of the breast is still necessary for a mammogram because spreading the tissue out is crucial to attain the clearest images.
  • Mammograms – especially using a 3D machine – are the best way to detect breast cancer at its earliest possible stage.

For more information or to schedule your mammogram at the Sonnenalp Breast Center call (970) 569-7690.