The New Law on Mammography
Hope Gelting had never been told she had dense breasts. It wasn’t until she was diagnosed with advanced stage breast cancer that she learned the dense glandular tissue in her breasts put her at higher risk of developing cancer and made it more difficult to find tumors using standard mammography.
Determined to spare other women of her fate, the South Carolina teacher and mother of two spent the last three years of her life lobbying state legislators to pass a density reporting bill. “Hope’s Law,” named in her memory, makes it mandatory for mammogram reports to include information regarding a women’s breast density. Signed into law by Governor Nikki Haley, the new legislation went into effect in spring 2016. To date, 27 states have density reporting laws. According to the American College of Radiology, about 40 percent of women have dense breasts. Made up of fat and glandular tissue, breasts are considered dense if there is more breast tissue than fat. The only way to determine density is by a visual assessment of a mammogram.
So, why is important to know if you have dense breasts? Studies have shown women with dense breasts are four to five times more likely to develop breast cancer than women with low breast density. To make matters worse, cancer can remain undetected for years in breast tissue.
On a digital image, fat appears dark while fibro-glandular tissue—dense tissue—looks white. Because cancer also appears white, it is virtually invisible on conventional x-ray. The denser the breast, the more it can potentially mask a cancer. One study found 76 percent of missed cancers occurred in dense breasts.
Under the new law, women with dense breasts will receive a mammography report warning them of the risks associated with dense breasts. A copy of the report also will be provided to their physician. Together, they can consider alternative screening methods that make it easier to detect cancer early when it’s most treatable.
Among the options is digital breast tomosynthesis, also known as 3-D mammography. It provides a more complete, layer-by-layer picture of the breast, unmasking cancers that may be lurking in dense tissue.
Researchers have found the advanced screening technology improves breast cancer detection by 40 percent and reduces the number of false positives that lead to unnecessary biopsies.
Recognizing the tremendous benefits of 3-D mammography, Beaufort Memorial began offering the FDA-approved screening in June 2014. This summer, the hospital will put a second tomosynthesis machine into operation at its Women’s Imaging Center. There are others in the area, which offer the 3-D technology.
Tomosynthesis is performed in addition to the normal 2-D screening using the same digital scanner. During the 3-D portion of the exam, the x-ray arm of the imaging machine makes a quick arc over the breast, taking a series of images at a number of angles that a computer forms into a three-dimensional picture. Instead of viewing the breast as a flat image, the radiologist is able to examine the breast tissue one layer at a time. Having a clearer picture of the breast makes it easier to find smaller cancers at earlier stages.
Thanks to Hope’s Law, women with dense breasts now have a fighting chance to prevent this dreaded disease.
Jackie Brown, RN, is a Certified Breast Care Nurse (CBCN) and the Clinical Manager at Beaufort Memorial Hospital’s Women’s Imaging Center. She can be reached at (843) 522-7465.