Understanding Breast Density and Breast Cancer Risk

Extract

It’s been nearly 40 years since radiologist John Wolfe, M.D., first observed that women with mammographically-dense breasts have a higher risk of developing breast cancer. Since then, dozens of studies have confirmed the association. And yet, physicians have made little progress in understanding how patients might reduce their risk.

That has not stopped politicians and their constituents from taking action, based on the little that is known. At least three states—Connecticut, Texas and Virginia—have passed laws requiring doctors to notify women if their mammograms show high density, which applies to an estimated 30% to 40% of all women. This has many experts concerned.

“At this point, we can’t tell a woman with high density what she can do to reduce her risk,” said Rulla Tamimi, Sc.D., a researcher at Harvard Medical School. “All you do is increase her anxiety.”

That dilemma led California Gov. Jerry Brown to veto a breast density reporting law last year. Critics worried such legislation would lead women to get expensive follow-up tests that might not be scientifically warranted. Still another issue is related to the fact that there is no standardized, automated method for measuring mammographic density. According to Celia Byrne, Ph.D., an epidemiologist at the Uniform Services University of the Health Sciences, “If states are going to mandate it, that’s a problem. What I measure could be different from what someone else measures.”