Posts Tagged ‘breast’

Size doesn’t matter but density does

June 25, 2010

An article published recently in the Los Angeles Times, Breast Density Linked to Cancer Risk, reports that density of the breast tissue is a bigger indicator of breast cancer risk than family history.  And, this might be one of the best kept secrets.

The link between breast tissue density and breast cancer has been known since the 1970’s, but it has only been recently that researchers and cancer specialists have accepted the relationship as important. While the scientific community  admits is could help identify women of high risk, it isn’t yet a widely known nor measured clinically significantly marker. Part of the challenge is creating a universally accepted measurement of breast density.  While radiologists have traditionally measured the density of the breast, it was not to determine the cancer risk but as an indicator of how difficult the mammogram is to read.  So, even though the density has been recorded, it was not recognized as a useful reporting tool for screening until recently.

Last year, a law passed in Connecticut requires that breast density must be included in mammogram reports.  This allows a woman to track her density over time and take precautionary steps if she has dense breasts, such as more frequent clinical exams or MRI’s to supplement or replace mammograms.  Studies show that women’s breast density can change over time and so does the risk of breast cancer, so tracking an increase or decrease in density can change the precautions  and actions a woman chooses. For example, a woman with very dense breasts may choose to forgo taking hormone replace therapy during menopause as they may contribute to breast cancer risk as well.

There are several challenges to using the density of breast tissue to determine cancer risk.  The first is developing a workable rating system.  The system used by radiologists, while helpful, is subjective and very basic.  It a 4 level system, with 1 being predominately fat and 4 being very dense.  Finding an easily quantifiable and measurable tool that is universal will take some time to develop and ensure the usefulness of accuracy in assessment.  Secondly, educating women to the importance of knowing their breast density and utilizing that information to help decrease the risk is a long-term undertaking.

We can be pro-active.  Ask your doctor to request your density be included in the report at your next mammogram.


The Cancer Bitch–no, not me!

March 18, 2010

Continuing on the post-cancer-treatment journey, I came across a book titled “The Adventures of Cancer Bitch” by S. L. Wisenberg and I thought “you have to read it!”  I was concerned that it would be radical and angry and then, it wasn’t.  It was just life–angry and sad and funny and confused and all those things that make up day to day life.  While there are many things in the book I can relate to, there are many that don’t speak to me.  I am not a breast cancer survivor, and breast cancer ranks very high in the cancer heirarchy for funding and visibility and media.  But, I too, was diagnosed in the early stages, which is, in itself, another heirarchy.  We seem to have the need to be different from each and to quantify that difference.  So, breast cancer is more visible and researched and “media-ed” about than, say, uterine cancer, or ovarian cancer, or cervical cancer, or prostate cancer, or the hundreds of cancers that are possible.  And, so, we hear things like “well, thank god it wasn’t breast cancer and all they did was take out your uterus.”  ALL THEY DID?

And, then there is the staging.  What stage of cancer do you/did you have? is a common question.  And, of course, in our need to quantify, it matters.  Stage I is not as serious as stage IV and doesn’t carry as much risk of death and recurrence.  And yet, Stage I is treated as if it can re-occur, so it is still scary and threatening and CANCER!  From that point, I understand Cancer Bitch.

If you have read her book or her blog, I would love to hear your thoughts.