{"id":113355,"date":"2024-10-12T16:15:45","date_gmt":"2024-10-12T09:15:45","guid":{"rendered":"https:\/\/hotvideos24.online\/?p=113355"},"modified":"2024-10-12T16:15:45","modified_gmt":"2024-10-12T09:15:45","slug":"why-some-doctors-see-a-downside-to-notifying-women-about-dense-breasts","status":"publish","type":"post","link":"https:\/\/hotvideos24.online\/?p=113355","title":{"rendered":"Why some doctors see a downside to notifying women about dense breasts"},"content":{"rendered":"<p> <script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-3711241968723425\"\r\n     crossorigin=\"anonymous\"><\/script>\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-format=\"fluid\"\r\n     data-ad-layout-key=\"-fb+5w+4e-db+86\"\r\n     data-ad-client=\"ca-pub-3711241968723425\"\r\n     data-ad-slot=\"7910942971\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script><br \/>\n<\/p>\n<div>\n<p class=\"\">Like many women, Shamma Mullen breathes a sigh of relief every time she gets good news about the results of her latest mammogram. Two years ago, however, Mullen\u2019s doctor sent her additional information that alarmed her. <\/p>\n<p class=\"\">She had dense breasts.<\/p>\n<p class=\"\">\u201cI had never seen a letter like that before and had no idea what having dense breasts even meant,\u201d said Mullen, 38, of Andover, Massachusetts. Mullen immediately went online to search for more information, and called her doctor with questions about follow-up tests.<\/p>\n<p class=\"\">Women age 40 and older in every state are now receiving notifications about their breast density along with their standard mammogram report, due to a <a href=\"https:\/\/www.fda.gov\/radiation-emitting-products\/mammography-quality-standards-act-mqsa-and-mqsa-program\/important-information-final-rule-amend-mammography-quality-standards-act-mqsa#:~:text=(21%20CFR%20900.12(c)(,Radiation%2DEmitting%20Products\" target=\"_blank\" rel=\"noopener\">new rule from the Food and Drug Administration<\/a>. Massachusetts and 38 other states have already been <a href=\"https:\/\/densebreast-info.org\/legislative-information\/fda-national-dense-breast-reporting\/#:~:text=Additionally%2C%20the%20mammogram%20report%20sent,%E2%80%9Cdense%20breast%E2%80%9D%20reporting%20requirements.\" target=\"_blank\" rel=\"noopener\">sending notifications<\/a> about breast density, which<a href=\"https:\/\/ketteringhealth.org\/what-having-dense-breasts-means-for-your-health\/\" target=\"_blank\" rel=\"noopener\"> reflects the proportion<\/a> of milk glands and connective tissue to fatty tissue. The FDA requirement standardizes those messages.<\/p>\n<p class=\"\">Dense tissue<a href=\"https:\/\/www.fda.gov\/radiation-emitting-products\/mammography-quality-standards-act-mqsa-and-mqsa-program\/important-information-final-rule-amend-mammography-quality-standards-act-mqsa#:~:text=(21%20CFR%20900.12(c)(,Radiation%2DEmitting%20Products\" target=\"_blank\" rel=\"noopener\"> makes it harder to find<\/a> breast cancer on a mammogram; and that dense breast tissue<a href=\"https:\/\/www.cancer.gov\/types\/breast\/breast-changes\/dense-breasts#:~:text=and%20breast%20cancer?-,What%20are%20dense%20breasts?,amounts%20of%20fatty%20breast%20tissue.\" target=\"_blank\" rel=\"noopener\"> is a risk factor for cancer<\/a>.<\/p>\n<h2 class=\"\">You&#8217;ve got dense breasts. Now what? <\/h2>\n<p class=\"\">Mammogram studies<a href=\"https:\/\/www.cancer.gov\/types\/breast\/breast-changes\/dense-breasts#:~:text=fatty%20breast%20tissue.-,Are%20dense%20breasts%20common?,if%20I%20have%20dense%20breasts?\" target=\"_blank\" rel=\"noopener\"> show that almost half<\/a> of women over age 40 have dense breasts. <\/p>\n<p class=\"\">Going forward, women with dense breasts will be encouraged to talk to their doctors and told that \u201cother imaging tests in addition to a mammogram may help find cancers.\u201d <\/p>\n<p class=\"\">Some health advocates argue that the notifications<a href=\"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2733521\" target=\"_blank\" rel=\"noopener\"> have oversimplified a complex issue.<\/a> They argue that without clear, evidence-based instructions, <a href=\"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2733521\" target=\"_blank\" rel=\"noopener\">women could be left scared, confused and frustrated<\/a>. <\/p>\n<p class=\"\">Judith Garber, a senior policy analyst at the Lown Institute, a nonpartisan health policy think tank, notes that there is no national standard for<a href=\"https:\/\/www.cancer.org\/cancer\/types\/breast-cancer\/screening-tests-and-early-detection\/mammograms\/breast-density-and-your-mammogram-report.html#:~:text=(see%20below).-,Do%20mammogram%20reports%20have%20to%20include%20breast%20density?,the%204%20categories%20described%20above.\" target=\"_blank\" rel=\"noopener\"> following up on dense breast<\/a> reports.<\/p>\n<p class=\"\">That means women will get different advice, depending on their doctor. <\/p>\n<p class=\"\">While some doctors will urge women to undergo extra tests\u00a0 \u2014 such as additional mammograms, ultrasounds or MRIs \u2014\u00a0others will advise women to simply continue getting regular mammograms, said Dr. Mark Pearlman, an emeritus professor at the University of Michigan Medical School, who has written screening guidelines for the American College of Obstetricians and Gynecologists and the National Comprehensive Cancer Network.<\/p>\n<p class=\"\">\u201cYou cannot counsel an entire population of women with dense breasts with one policy that\u2019s going to be appropriate for everybody,\u201d Pearlman said.<\/p>\n<p class=\"\">Whether a woman can get additional imaging<a href=\"https:\/\/densebreast-info.org\/providers-faqs\/will-insurance-cover-supplemental-screening-beyond-mammography\/#:~:text=In%20the%20U.S.%2C%20the%20answer,in%20most%20cases%20is%20zero).\" target=\"_blank\" rel=\"noopener\"> may depend on insurance,<\/a> which doesn\u2019t always cover them, said Robert Smith, an epidemiologist and senior vice president of cancer screening at the American Cancer Society.<\/p>\n<p class=\"\">Smith said it\u2019s important for women to know if they have dense breast tissue. <\/p>\n<p class=\"\">Radiologists<a href=\"https:\/\/www.mayoclinic.org\/tests-procedures\/mammogram\/in-depth\/dense-breast-tissue\/art-20123968#:~:text=The%20four%20levels-,Breast%20density%20%E2%80%94%20The%20four%20levels,extremely%20dense.\" target=\"_blank\" rel=\"noopener\"> sort breast tissue<\/a> into four groups:\u00a0<\/p>\n<ul class=\"break-above body-ul body-list-el\">\n<li>Extremely dense\u00a0<\/li>\n<li>Mostly dense\u00a0<\/li>\n<li>Mostly fatty<\/li>\n<li>Almost entirely fatty.\u00a0<\/li>\n<\/ul>\n<p class=\"\">Because breast cancers can hide behind dense tissue, \u201cthese cancers can be growing and getting larger and more advanced until they finally peek out of the corner of that density and you can see them\u201d on a mammogram, Smith said. \u201cWhen the diagnosis takes place, it\u2019s not an early one.\u201d<\/p>\n<p class=\"\">Smith added, \u201cif the breast is completely dense, the conventional technologies just simply aren\u2019t very accurate and supplemental imaging is needed.\u201d<\/p>\n<p class=\"\">Dr. Hilary Marston, the FDA\u2019s chief medical officer, said the notifications will empower women.<\/p>\n<p class=\"\">\u201cWe really wanted to make sure that women had the information that they needed in plain language to make good decisions for their own health,\u201d Marston said. \u201cThe most important thing is to make sure that people have the information in a high-quality way that\u2019s communicated clearly.\u201d<\/p>\n<h2 class=\"\">Benefits and risks of additional screening <\/h2>\n<p class=\"\">Part of the confusion is that experts disagree whether women with dense breasts need extra imaging.<\/p>\n<p class=\"\">Although the<a href=\"https:\/\/www.acr.org\/Advocacy-and-Economics\/ACR-Position-Statements\/Reporting-Breast-Density\" target=\"_blank\" rel=\"noopener\"> American College of Radiology<\/a> and<a href=\"https:\/\/jnccn.org\/view\/journals\/jnccn\/21\/9\/article-p900.xml#F1\" target=\"_blank\" rel=\"noopener\"> National Comprehensive Cancer Network<\/a> recommend that women and their doctors consider supplemental screening, two other influential groups \u2014 the<a href=\"https:\/\/www.acog.org\/clinical\/clinical-guidance\/committee-opinion\/articles\/2015\/03\/management-of-women-with-dense-breasts-diagnosed-by-mammography#:~:text=Current%20published%20evidence%20does%20not,In%20%E2%80%9CCommittee%20Opinion%20No.\" target=\"_blank\" rel=\"noopener\"> American College of Obstetricians &amp; Gynecologists<\/a> and the<a href=\"https:\/\/www.uspreventiveservicestaskforce.org\/uspstf\/recommendation\/breast-cancer-screening\" target=\"_blank\" rel=\"noopener\"> U.S. Preventive Services Task Force<\/a> \u2014 say there\u2019s not enough evidence of benefit to recommend additional tests.<\/p>\n<p class=\"\">And while additional tests can detect more cancers than mammograms alone,<a href=\"https:\/\/www.cochranelibrary.com\/cdsr\/doi\/10.1002\/14651858.CD009632.pub3\/full#CD009632-abs-0002\" target=\"_blank\" rel=\"noopener\"> there\u2019s no evidence<\/a> that extra testing<a href=\"https:\/\/www.uspreventiveservicestaskforce.org\/uspstf\/faqs\/final-faq-document\/breast-cancer-screening#:~:text=These%20women%20deserve%20to%20know,with%20breast%20ultrasound%20or%20MRI.\" target=\"_blank\" rel=\"noopener\"> saves lives<\/a>, said Dr. Nancy Keating, professor of health care policy at Harvard Medical School.<\/p>\n<p class=\"\">\u201cWe don\u2019t know that outcomes<a href=\"https:\/\/academic.oup.com\/jnci\/article-abstract\/116\/2\/249\/7331237?redirectedFrom=fulltext\" target=\"_blank\" rel=\"noopener\"> are going to be any better<\/a>\u201d by adding more tests, Keating said. \u201cWe don\u2019t know that additional imaging has benefits that outweigh the harms.\u201d<\/p>\n<p class=\"\">Additional imaging \u2014 such as ultrasounds and MRIs \u2014<a href=\"https:\/\/lowninstitute.org\/new-fda-guidelines-on-breast-density-notifications-and-implications-for-overuse\/\" target=\"_blank\" rel=\"noopener\"> carry risks<\/a>, Garber said. Both tests<a href=\"https:\/\/www.cochranelibrary.com\/cdsr\/doi\/10.1002\/14651858.CD009632.pub3\/full#:~:text=False%E2%80%90positive%20and%20false%E2%80%90negative,biopsy%20than%20with%20mammography%20alone.\" target=\"_blank\" rel=\"noopener\"> can lead to \u201cfalse alarms,\u201d<\/a> in which benign tissue is flagged as suspicious. <\/p>\n<p class=\"\">False alarms can lead to invasive biopsies that can be painful and cause bleeding, as well as stressful and<a href=\"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2791002#google_vignette\" target=\"_blank\" rel=\"noopener\"> unnecessary follow-up tests<\/a>, some of which<a href=\"https:\/\/academic.oup.com\/jbi\/article\/2\/3\/188\/5824531\" target=\"_blank\" rel=\"noopener\"> involve additional radiation exposure<\/a> or dyes that<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK482487\/#:~:text=Gastrointestinal:%20Abdominal%20discomfort%2C%20teeth%20pain,%2C%20Feb%2026%2C%202016).\" target=\"_blank\" rel=\"noopener\"> can cause side effects<\/a> and<a href=\"https:\/\/www.mayoclinic.org\/tests-procedures\/breast-mri\/about\/pac-20384809#:~:text=False%2Dpositive%20results.,How%20you%20prepare\" target=\"_blank\" rel=\"noopener\"> allergic reactions.<\/a><\/p>\n<p class=\"\">In some cases, additional screenings can lead women to be diagnosed and treated for cancers that would never have bothered them, problems known as overdiagnosis and overtreatment. <\/p>\n<p class=\"\">A study published in 2022 estimated that 15% of mammogram-detected breast cancers in women age 50 to 74<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC9359467\/\" target=\"_blank\" rel=\"noopener\"> were overdiagnosed.<\/a> Ruth Etzioni, a biostatistician at the Fred Hutchinson Cancer Center and a co-author of the study, notes that not all cancers are the same. While some aggressive tumors grow quickly and need immediate treatment, others grow too slowly to harm women in their lifetime. Older women who are diagnosed with a slow-growing breast tumor can die of another cause before the cancer would have caused problems.<\/p>\n<p class=\"\">Some research also<a href=\"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2733521\" target=\"_blank\" rel=\"noopener\"> casts doubt on the reliability<\/a> of the system used to label breasts as dense or not dense. A review article in Annals of Internal Medicine found that 13% to 19% of women<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5100826\/\" target=\"_blank\" rel=\"noopener\"> were reclassified into a different breast density category<\/a> \u2014 from dense to nondense or vice versa \u2014 on their subsequent screening mammogram.<\/p>\n<p class=\"\">Crissy Matos said she underwent her first mammogram at 40, but received her first dense breast notification this year at 42. Matos, who lives in Stroudsburg, Pennsylvania, said she wonders why her breasts didn\u2019t look dense on her first mammogram, given that breasts tend to be denser in younger women. <\/p>\n<p class=\"\">Doctors recommended a second mammogram, this time using a newer technology known as digital breast tomosynthesis, often called 3-D mammography. An ultrasound showed that the suspicious area on her mammogram was nothing to worry about, Matos said.\u00a0<\/p>\n<p class=\"\">The high cost of advanced imaging puts it out of reach for many patients. Women from rural areas or<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4742376\/#:~:text=Results,%25%20CI%200.25%2D0.63).\" target=\"_blank\" rel=\"noopener\"> marginalized communities<\/a><a href=\"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2776561\" target=\"_blank\" rel=\"noopener\"> often lack access<\/a> to the latest technology.<\/p>\n<p class=\"\">Garber, the analyst from Lown Institute, said that some of the FDA\u2019s language is misleading. Although it\u2019s true that women with dense breasts<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC9530665\/\" target=\"_blank\" rel=\"noopener\"> are 1.5 to 2 times more likely<\/a> than other women to<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3561467\/\" target=\"_blank\" rel=\"noopener\"> develop breast cancer<\/a>, they\u2019re<a href=\"https:\/\/www.cancer.gov\/types\/breast\/breast-changes\/dense-breasts#:~:text=and%20breast%20cancer?-,What%20are%20dense%20breasts?,amounts%20of%20fatty%20breast%20tissue.\" target=\"_blank\" rel=\"noopener\"> no more likely to die<\/a> from it.<\/p>\n<p class=\"\">The FDA\u2019s \u201cnotification language is sort of pushing people toward doing more tests, when, in fact, the tests aren\u2019t actually recommended\u201d universally, Garber said. \u201cSo the FDA is saying \u2018you have this breast density, you should be aware that you have an additional risk factor.\u2019 But then there\u2019s not really anything that people should do about it. It\u2019s a really terrible place to be as a patient.\u201d<\/p>\n<p class=\"\">The FDA\u2019s Marston said she hopes women and their doctors will use the density notifications to have informed conversations. \u201cWe certainly don\u2019t want to hide the information from women,\u201d Marston said.<\/p>\n<p class=\"\">Given the uncertainty about the benefits of additional screening, Pearlman said \u201cthe safest and probably most accurate\u201d way to advise women with dense breasts is to say, \u201cWe don\u2019t know for sure what the best practice is at this point.\u201d<\/p>\n<p class=\"endmark\">Mullen said she was relieved when follow-up tests \u2014 which were covered by insurance \u2014 found nothing suspicious. But breast cancer \u201cis always on the top of my mind because of my family history,\u201d Mullen said. Now that she knows her breasts are dense, \u201cI think I would be nervous if I didn\u2019t do an ultrasound.\u201d<\/p>\n<\/div>\n<p><script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-3711241968723425\"\r\n     crossorigin=\"anonymous\"><\/script>\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-format=\"fluid\"\r\n     data-ad-layout-key=\"-fb+5w+4e-db+86\"\r\n     data-ad-client=\"ca-pub-3711241968723425\"\r\n     data-ad-slot=\"7910942971\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script><br \/>\n<br \/><div data-type=\"_mgwidget\" data-widget-id=\"1660802\">\r\n<\/div>\r\n<script>(function(w,q){w[q]=w[q]||[];w[q].push([\"_mgc.load\"])})(window,\"_mgq\");\r\n<\/script>\r\n<br \/>\n<br \/><a href=\"https:\/\/www.nbcnews.com\/health\/cancer\/doctors-see-downside-notifying-women-dense-breasts-rcna174342\">Source link <\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Like many women, Shamma Mullen breathes a sigh of relief every time she gets good news about the results of her latest mammogram. Two years ago, however, Mullen\u2019s doctor sent &hellip; <a href=\"https:\/\/hotvideos24.online\/?p=113355\" class=\"more-link\">Read More<\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[],"class_list":["post-113355","post","type-post","status-publish","format-standard","hentry","category-health","entry"],"_links":{"self":[{"href":"https:\/\/hotvideos24.online\/index.php?rest_route=\/wp\/v2\/posts\/113355","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hotvideos24.online\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hotvideos24.online\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hotvideos24.online\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/hotvideos24.online\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=113355"}],"version-history":[{"count":0,"href":"https:\/\/hotvideos24.online\/index.php?rest_route=\/wp\/v2\/posts\/113355\/revisions"}],"wp:attachment":[{"href":"https:\/\/hotvideos24.online\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=113355"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hotvideos24.online\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=113355"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hotvideos24.online\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=113355"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}