Mammogram that proves better for women with dense breasts barely used in the United States

A large study shows that one particular mammogram can find more cancers for women with dense breast tissue.

According to a recent story by Roni Caryn Rabin in The New York Times, the study, which compared various types of scans, "has found that mammography enhanced with iodine-based dye can detect three times as many invasive cancers in dense breast tissue as ultrasound."

Women with dense breast tissue are at an elevated risk for breast cancer. Because insurers often decline to pay for scans such as the contrast-enhanced mammograms, many women stick with basic mammograms that often miss tumors buried in dense breasts.

Dr. Fiona J. Gilbert

Rabin quotes Dr. Fiona J. Gilbert, lead author of the study that was published in The Lancet and a professor of radiology at the University of Cambridge's  School of Clinical Medicine, as saying that "contrast-enhanced mammography needs to become standard of care for women with dense breasts" — if they're at high risk of developing breast cancer.

She explained that "when you have lots of white normal breast tissue, it's hard to see the white cancers, but when you do the contrast, the cancers take up the iodine, and all you're seeing is this cancer lighting up."

The Times piece also quotes JoAnn Pushkin, executive director of the educational group DenseBreast-info, to the effect that the study showed contrast-enhanced mammograms could save lives. She said that researchers not only found more tumors but detected them when they were small and had not yet spread to the lymph nodes.

"These," she said, "were tragedies averted. If they had not been found, they would have grown undetected until they were horror stories."

Contrast-enhanced mammography has yet to be approved by the Food and Drug Administration for breast cancer screening, so it is barely used in the United States. It is, however, utilized in limited cases as a diagnostic tool after suspicious findings appear on a regular mammogram.

More information about screenings can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at male caregivers. My other books are MysteryDates — How to keep the sizzle in your relationship; The Roving I, a compilation of 70 of my newspaper columns; and Grampy and His Fairyzona Playmates, a whimsical fantasy intended for 6- to 10-year-olds that I co-authored with my then 8-year-old granddaughter.

Researchers identify possible new risk for breast cancer for aging women with dense tissue

"While breast density declines with age, a slower rate of decline in one breast often precedes a cancer diagnosis in that breast."

That conclusion is reported in a story published a while back by Roni Caryn Rabin in The New York Times that I just unearthed.

Rabin writes that a study published in JAMA Oncology says, "Scientists has long known that dense breast tissue is linked to an increased risk of breast cancer in women" but these new findings apparently indicate another risk.

Sue (Joy) Jiang, PhD

Shu (Joy) Jiang, the study's lead author, a PhD and an associate professor of public health sciences at Washington University in St. Louis, says that "right now, everybody only looks at density at one point in time" but, since women have mammograms at regular intervals and the density of each breast is measured each time, "this information is actually already available but [is] not being utilized."

Jiang hopes the findings can be put "into clinical use as soon as possible — it will make a huge difference."

Scientists at Washington University in St. Louis, over a 10-year period, analyzed breast density changes in 10,000 women.

Dense breast cancer tissue, it's long been established, makes tumors harder to detect in imaging scans.

More information about density issues can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Neither bras nor caffeine cause breast cancer

Article details risk factors for breast cancer while outlining preventive measures and dispelling myths

Are the causes of breast cancer known?

No, according to a feature story by Dr. Lizellen La Follette in the Marin Independent Journal that I've kept around quite a while because it's a good summary.

Both the article and its headline note, however, that although the roots of breast cancer aren't clear, the risk factors are.

Dr. Lizellen La Follette

La Follette details those factors: gender (being a woman); age ("two out of three with invasive cancer are diagnosed after age 55"); family, personal health, menstrual and reproductive histories; dense breast tissue; radiation to the chest; genetic changes; poor diet and alcohol consumption; obesity; lack of physical activity; smoking; and exposure to DES, a medication to prevent miscarriage that was heavily prescribed from the '40s through the '60s. 

Also, looking for dimpling or puckering of the breast, inversion of the nipple, redness or scaliness of the breast skin or nipple/areola area, or discharge of secretions from the nipple.

La Follette also dispels some myths about the disease — including the biggie, that it's contagious. It's not.

Other myths include that the disease can be caused "by wearing underwire bras, implants, deodorants, antiperspirants, mammograms, caffeine, plastic food serving items, microwaves or cellphones."

The article also suggests what women can do as prevention: having monthly breast cancer exams, checking for changes in breast tissue (such as in size), and feeling a palpable lump.

As for the risks, La Follette writes that a woman's "risk of breast cancer nearly doubles if she has a first-degree relative (mother, sister, daughter) who has been diagnosed" with it — "and her risk increases if a relative was diagnosed before the age of 50."

Furthermore, she notes, "studies show about 5 to 10 percent of breast cancers can be linked to one mutations inherited from one's mother or father."

Regarding smoking, the columnist contends that smoking is a danger "particularly when it's long-term, heavy and among those who started before their first pregnancy." Meanwhile, the risk "is about 1.5 times higher in overweight women, and two times higher in obese women than in lean women." 

In addition, La Follette maintains that "numerous studies confirm on average alcohol consumption increases the risk of breast cancer in women by about 7 to 10 percent for each drink consumed," and she writes that "women who have two to three alcoholic drinks a day have a 20 percent higher risk…compared with non-drinkers."

Finally, she postures that "early menstruation (before age 12), mate menopause (after 55), having first child at older age or never having given birth can be risk factors."

La Follette also takes a moment to mention males, citing statistics that while the average man's lifetime risk is about 1 in 1,000, African-American men "are hit harder by breast cancer than their white counterparts and after diagnosis are three times more likely to die" from it than white men.

To learn more about other causes of the disease, get a copy of  "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

For 1st time, mammogram doesn't scare survivor

Breast cancer anxieties of 'Rollercoaster' author's wife vanish — after only 23 years 

Cancer-free Fox and Weingarten

My wife, Nancy Fox, wasn't at all afraid.

For the first time in 23 years.

She'd previously been nervous each time she'd gone for a mammogram, fearful the test would show her breast cancer had returned.

This go-'round, just last week, no anxiety — probably because she'd been cleared by her gynecologist two days before.

The follow-up letter from her primary physician confirmed the good news:

"No signs of breast cancer."

The letter also reprinted a statement required by California law that her dense breast tissue "can make it harder to evaluate the results of your mammogram and may also be associated with an increase risk of breast cancer."

But even that didn't scare her.

Her current emotional stability and mine clearly are far from the emotions I detailed more than two decades ago about having to let go "of my anger at doctors for not having instant answers, at pharmaceutical companies for manufacturing life-extending but not necessarily life-saving drugs, at myself for not having a magic wand."

Yes, I'd initially been petrified "breast cancer would be my wife's killer," but I also was thrilled to note more than two decades later that "she's flourishing today, as am I."

Specifics on how I, Woody Weingarten, and my wife managed the ups and downs of the diagnosis, treatments and aftermath can be found in "Rollercoaster: How a man can survive his partner's breast cancer," my VitalityPress book aimed at male caregivers.