Breast ultrasound for Dense BreastDo I have dense breast tissue?
A screening mammogram must be performed to determine the breast’s density. A mammogram is still the best exam to find early breast cancer because some breast cancers present only as abnormal calcifications and these can only be seen on a mammogram. If your screening mammogram is significantly dense, an ultrasound will be recommended.

What is the benefit of a screening breast ultrasound?
It looks at dense breast tissue in another way. Normal breast tissue appears white on a mammogram but unfortunately so do may cancers. With ultrasound, some cancers are much more visible in patients with dense breast. Screening breast ultrasound will take between 15-30 minutes to perform.

Please read My Best Kept Story by Nancy M. Capello.
On February 3, 2004, I was diagnosed with Stage 3c breast cancer. Less than 48% of women with Stage 3c breast cancer are alive after five years. What I learned since my diagnosis is that 1) I have dense breast tissue and wasn’t aware of its significance in that tumors in women with dense breast tissue are often not detected by mammography alone (tumors appear white on a mammogram and dense tissue is white-thus no contrast to detect the tumor) and 2) the mammography report that is generated by the doctor, which contains more detailed information about a woman’s breasts, is not the same report that a women receives after having a mammogram.

Just two months prior to my diagnosis, I had a mammogram and the “Happy Gram” report that I received gave me a thumbs up. During my annual exam, my doctor felt a “ridge” in my right breast and ordered a mammogram and an ultrasound. The mammogram saw “nothing” but that same day the ultrasound detected a large 2.5 cm tumor. Because cancer was detected at a later stage, I had to endure an aggressive treatment of chemotherapy and radiation. The side effects of the treatment were debilitating. While I lost all my hair, it was minor compared to the other effects. I had mouth sores; my nails fell off; had extreme fatigue and still have neuropathy (numbness and tingling in my feet and hands). This could have been prevented if the cancer was diagnosed at an earlier stage. Since my diagnosis, I am compelled to tell the best kept secret about dense breast tissue and its significance. Please help me reveal this best kept secret about the limitations of mammography alone to detect cancer in women with dense breast tissue.

For more information contact:

Nancy M. Cappello, Ph.D.

Is this procedure covered by my insurance?
Because of Nancy’s compelling testimony in Hartford about dense breast tissue, Public Act 05-69 because a law on October 1, 2005 which requires Connecticut insurance companies to cover ultrasounds, excluding applicable co-pays, co-insurance and deductibles. She was recently honored with a citation by the Connecticut General Assembly in recognition “of her extraordinary commitment to promoting early detection of breast cancer through her successful legislative advocacy and public awareness campaign and for the courage to transform a personal tragedy into a positive force.

How is my breast density reported on the mammogram?
The most commonly used method for assessing and reporting breast density mammography is the BIRADS (American College of Radiology Breast Imaging Reporting and Data System) describing four different categories: (1) entirely fat; (2) scattered fibroglandular densities; (3) heterogeneously dense; and (4) extremely dense.

Ask your doctor which category of breast density you have since your mammography report will contain this information.
Woman with dense breast tissue cannot rely solely on the above BIRADS* scale to determine findings of breast cancer.
Thomas Kolb, M.D. in his research on 11,130 women found that supplementing mammography with ultrasound markedly increased cancer detection in women with dense breasts. The additional ultrasound screening increased the number of women diagnosed with non-palpable invasive cancers by 42%. While mammography detected 98% of cancer in women with fatty breasts, it found only 48% in women with the densest breasts.
(American Medical Association: September 19, 2002)

“I’ve seen over and over cancer cases in which ultrasound has picked up what mammogram has missed in women who were not at risk, and who had dense breasts.” Wendie Berg, M.D., Radiologist and Principal Investigator of a large-scale study to examine the benefits of ultrasound screening.
(Marnell Jameson. Los Angeles Times: June 14, 2004. pg.F.1.)

Who do I call to get this study?
Please discuss this procedure with your physician if you think you need it. We will require an order from your physician. Call Advanced Medical Imaging at 860-489-7314 for questions and to schedule.

ACR - Ultrasound

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