this the reason women go for screening ?); I hunted for information about my dense breast tissue . Popular women ’ s publications and cancer and physician organization ’ s websites were void on the subject of this dense condition that prevented my cancer from being detected early , conveying less than a 50 % chance of being alive after 5 years . Searching the medical journals , I uncovered a myriad of studies that first shocked me and later compelled me to bring this critical breast health information to women , since the medical and cancer community had failed to do so and had no plans to routinely tell women about their breast tissue composition .
Why is Density Important to EARLY detection ?
Decades of studies have concluded , without a doubt , that the size of a breast tumor , upon discovery is the fundamental determinant of mortality . Women with dense breast tissue are 17 times more likely to have interval cancers ( missed on mammogram and detected by palpation before her next mammogram ) than women with fatty breasts . Once a cancer is palpable , all promises of EARLY detection have vanished . The assessment of potential benefit and harm of a specific test can be made only if the information given to the patient is complete , accurate and true . Evidence based medicine with more than 150 studies have established that a mammogram alone , in dense breasts , is not a sufficient screening tool for breast cancer .
Armed with knowledge and the decades of science about the risks and screening challenges of dense breast tissue , I began working with the Connecticut Legislature , and in 2005 , we passed the first bill in the nation to require insurance companies to cover whole breast ultrasound as an added screening to mammography for women with dense breast tissue . I started receiving invitations to speak and developed a brochure and fittingly named it , “ Are You Dense ?” We officially started the corporation , Are You Dense , Inc . in 2008 , concurrently filed an application to the IRS as a 501 ( c )( 3 ) public charity and launched the Are You Dense ? website to educate the public about the risks and screening challenges of dense breast tissue .
These scientific facts that I uncovered in 2004 were researched in the literature for more than a decade ( I call it the best-kept secret ):
• 40 % of women have dense breast tissue .
• Mammography misses every other cancer in dense breasts .
• Dense breast tissue is a well-established predictor of breast cancer risk .
• Adding ultrasound or MRI to mammography for women with dense breast tissue will significantly increase detection of cancer that is occult ( not seen ) on mammography . These cancers are invasive , small and at an early stage . We estimate , based on scientific studies and
Connecticut data , that each year 45,000 U . S . women receive their ‘ Happy Gram ’ report of their mammogram which states normal yet have hidden invasive cancer that will continue to lurk in their dense tissue and , once palpable , will be at an advanced stage . There is no requirement that doctors speak to women about their dense breast tissue even though it predicts the accuracy of a mammogram at any age .
Presently , there are 9 additional states in addition to Connecticut with notification legislation ( Texas , Virginia , New York , Hawaii , Maryland , California , Tennessee , Alabama and Nevada ) and in the 2013 legislative session , we are working with legislators and advocates from 9 states with density notification bill introductions . Federal breast density notification legislation , introduced by Representative Rosa DeLauro of CT in 2011 , is scheduled to be reintroduced soon in the U . S . House of Representatives with plans to introduce a companion bill in the Senate later this spring .
What is all the fuss about additional screening tests to mammography ?
Ultrasound and MRI , the current tests most likely ordered as a supplement to the mammogram for women with dense breast tissue , are more likely to have false positives ( findings that look suspicious but once biopsied are not cancer ). Many of the critics of mammography in general and the
Summer 2013 THE PINK PAPER
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