Dr. Marianne Petruccelli explains the link between breast density and cancer risk.

  • Marianne Petruccelli —Courtesy

Published: 10/20/2019 6:07:22 PM

Breast cancer is the most common cancer diagnosed in women. One in eight women will be diagnosed with breast cancer during her lifetime. Doctors don’t know exactly what causes breast cancer but they do know the risk factors, which range from family history to lifestyle risks. In observation of Breast Cancer Awareness month, radiologist Marianne Petruccelli, MD of Concord Hospital’s medical staff answers questions about breast density, a risk factor for breast cancer, and new mammography software available to help radiologists assess breast density more objectively.

What does breast density refer to?

Breast density refers to the amount of fibrous and glandular tissue that appears on a woman’s mammogram. On a mammogram fatty tissue appears dark and glandular tissue appears white. A woman with dense breast tissue will have more fibrous and glandular tissue than fatty tissue.

Why is breast density a risk factor for breast cancer?

Breast cancer is four to six times more likely in a woman with extremely dense breasts than it is in a woman with fatty breasts. That’s because cancers tend to form in glandular breast tissue. Mammograms are less sensitive in patients with dense breasts making it more difficult to spot cancerous tumors early. Breast density is a stronger risk factor for breast cancer than family history.

How does a woman find out her breast density?

Breast density can only be determined by having a mammogram. At Concord Imaging Center, digital breast tomosynthesis is the technology used to screen for breast cancer. Digital breast tomosynthesis, also known as 3-D mammography, uses X-rays to create a three-dimensional image of the breast and is better at detecting masses in dense breasts than 2-D mammography. Current guidelines from the American College of Radiology recommend that women start getting annual mammograms at age 40.

What new software is available to help radiologists assess a patient’s risk for breast cancer?

Concord Imaging Center is implementing new software designed to assess a women’s breast density, which can help with early detection of breast cancer. The software is Federal Drug Administration (FDA) cleared to provide both volumetric breast density measurements and a breast density category. It provides a repeatable, consistent, and objective means of scoring breast density and allows identification of women who may benefit from supplemental breast screening.

Are breast imaging centers required by law to include breast density information in reports sent to patients and their physicians?

A federal law, signed February 15, 2019, specifies the FDA must develop standard reporting language and ensure mammography reports and summaries include, at a minimum, how breast density may mask cancer on a mammogram; a qualitative assessment of breast density as performed by the reader; and a reminder to individuals with dense breasts to talk with their provider if they have questions. This will create a national standard for reporting information about breast density to patients.

Dr. Marianne Petruccelli is a board-certified radiologist specializing in breast, orthopaedic and abdominal radiology. She is a member of Concord Hospital’s medical staff and serves Concord Hospital Breast Care Center patients through Concord Imaging Center. Dr. Petruccelli recently presented on breast cancer risks and new mammography software at the October Concord Hospital Trust “What’s Up Doc?” Donor Lecture Series. The monthly series features members of Concord Hospital’s medical staff speaking to Concord Hospital Trust donors about new and innovative medical treatments and services. You can watch Dr. Petruccelli’s presentation on Concord Hospital’s YouTube channel at: youtube.com/concordhospital.

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