Are You Dense? Breast Cancer Detection Day

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By Joe Simitian

Everywhere there are campaigns with pink ribbons. People march in pink T-shirts. Baseball players hit with pink bats. These campaigns to save our mothers, sisters and wives from breast cancer have had great success in increasing awareness and in raising funds for a cure.

As a result, most women know they need to get regular mammograms as they get older. Yet surprisingly few of them are aware of a widespread condition that raises the risk of breast cancer and makes it harder to detect.

The condition is dense breast tissue. Although 40 percent of women tested by mammograms have dense breast tissue, a recent survey found that fewer than 10 percent of women are aware of their breast density. To spread the word, and to encourage women to talk to their doctors, the Legislature has declared Aug. 8 “Are You Dense? Day.” Women need this essential knowledge to make informed decisions about their health.

Women with extremely dense breast tissue are five times as likely as women with low breast density to develop breast cancer. Further, dense breast tissue obscures abnormalities such as cancer on mammograms, because dense tissue and tumors both appear white.

A study conducted in 2011 found that 75 percent of cancers are missed by mammography alone in women with dense breast tissue.

The woman who inspired me to take up this issue in the Legislature learned the hard way about the limits of mammography for women with dense breast tissue. Amy Colton, a nurse in my district, was diligent about having regular mammograms, which had come back with reassuring reports. She was floored when she was subsequently diagnosed with advanced breast cancer.

Only in the midst of her treatment -- 16 rounds of chemotherapy, 6 weeks of daily radiation and five surgeries – did she learn from her own research that she had dense breast tissue, which made it difficult to detect the cancer.

She was even more chagrined to find out that radiologists and doctors know their patients’ breast density, because federal standards for mammograms require a breast density rating as part of the report the radiologist sends to the doctor. Yet too few doctors discuss breast density with their patients.

Assuring that women with dense breast tissue are alerted to their condition, as part of the discussion about their mammograms, is the purpose of Senate Bill 1538, legislation that I have introduced with the support of 32 co-authors in the state Senate and 57 in the Assembly.

Senate Bill 1538 is quite simple. It would require that women be informed if they have dense breast tissue; that they be told it can obscure abnormalities on a mammogram; and that they may wish to discuss with their doctor the potential value of additional screening.

Amy Colton, other breast cancer survivors, and all of the legislators sponsoring SB 1538 and supporting “Are You Dense? Day” know that early detection is one of the best ways to spare patients the ordeal of treating advanced cancers.

Early detection saves lives and often reduces the emotional turmoil for patients and loved ones. And it saves money -- for patients, insurance companies and taxpayers who fund MediCal and Medicare.

The message of “Are You Dense? Day” is: get a mammogram, find out your breast density; ask your doctor what breast cancer screening plan is best for you.

All patients should be empowered to be effective advocates for their own health. For women, one of the most important facts to know is “Are you dense?”

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State Sen. Joe Simitian, D- Palo Alto, represents the 11th state Senate District.