New Legislation Aims to Improve Breast Cancer Screening for Women with Dense Breasts
If you’re a woman over 40, you’ve likely been advised by your doctor to get a mammogram. Mammograms are an essential tool for detecting breast cancer at an early stage and lowering the risk of death from the disease. However, there is a population of women who may not benefit as much from this screening method – those with dense breast tissue.
Approximately 43 percent of women being screened have dense breasts, which can mask or hide breast cancers from detection on a mammogram. Imagine trying to spot a white bunny in a snowy field or finding Waldo in a crowded scene – that’s the challenge faced when trying to detect breast cancer in dense breasts. In some cases, the cancer may be completely hidden from view.
This raises a sobering question: how many cancers are we failing to detect in dense breasts? Recent estimates suggest that screening mammography failed to detect 267,000 cancers in the United States in 2021 alone. These undetected cancers may go on to metastasize before they are detected, making them more difficult to treat.
While mammograms can easily detect many cancers in non-dense breasts and can still identify some cancers in dense breasts, additional screening options are needed for those with dense breast tissue. Thankfully, there are already other imaging exams available, such as contrast-enhanced breast MRI, molecular breast imaging, and contrast-enhanced mammography, which can detect cancers that might be hidden on a traditional mammogram.
Liquid biopsies, which involve testing for cancer DNA in the blood, also show potential for breast cancer screening. Although these methods are still being refined for clinical use, they could revolutionize breast cancer detection, particularly for women with dense breasts.
Recognizing the importance of supplemental screening for this population, national legislation called the Find It Early Act has been proposed. The act mandates coverage for dense breast supplemental screening using ultrasound, breast MRI, and other recommended screening options. If enacted, it would ensure that supplemental screening for dense breasts is covered by private insurance and Medicare/Medicaid. The goal is to lower deaths from metastatic breast cancer and reduce disparities in breast cancer screening outcomes.
Statistics show that approximately 17 million women in the United States with dense breasts undergo screening mammography each year. Offering supplemental screening for dense breasts may come with additional costs, but the payoff could be significant. Detecting more cancers at a curable stage would allow patients to avoid expensive treatments and potentially save thousands of lives each year.
Critics of supplemental breast cancer screenings argue that they may raise false alarms and cause anxiety. However, the risks of not conducting additional screening, especially for women with dense breasts, outweigh these concerns. Overdiagnosis of cancers that would not harm a person during their lifetime is a valid concern, but underdiagnosis resulting in 40,000 breast cancer deaths each year in the United States is a more urgent problem to address.
It is important to note that women with dense breasts who do not have access to supplemental screening often face worse outcomes. This disproportionately affects younger women and women of color, including Black, Asian, and Hispanic women. The Find It Early Act aims to address these disparities by making supplemental screening more widely available to those who need it.
The time to act is now. By supporting the Find It Early Act and advocating for improved breast cancer screening options for women with dense breasts, we can make significant strides in reducing breast cancer deaths and ensuring equal access to life-saving screenings.
Dr. Matt Covington, an assistant professor of radiology at the University of Utah and Huntsman Cancer Institute, is actively working on clinical trials and researching new imaging techniques for cancer detection. He emphasizes the importance of early detection and supports efforts to expand screening options for women with dense breasts.
To learn more about supplemental breast cancer screening and support the Find It Early Act, visit the links provided in this article.