By Rédaction Africa Links 24 with Annalisa Merelli
Published on 2024-01-23 09:30:53
Over 20 millions women over age 40 in the United States receive regular mammograms to screen for breast cancer, and about half of them have dense breast tissue, which makes screening significantly more complicated. Dense breast tissue occurs when there is an increased amount of fibrous and glandular tissue, making it appear white on a mammogram as opposed to fatty tissue. The challenge of having dense breast tissue is that cancers also appear white and can be difficult to detect.
Currently, there is not a clear protocol about how to handle this common issue. 38 states have laws requiring women identified as having dense breast tissue to receive a letter informing them of it, while 2023 FDA guidelines mandated that facilities implement this federal policy by September 2024. However, even once people are informed they have dense breast tissue, the onus is generally on the patient to seek further advice from their referring physician. As such, there is a lack of consensus and guidance on what supplemental screenings are the best.
A mammogram misses cancer in dense breasts in almost half of such cases, but it remains the best initial option. However, people with dense breast tissue may need additional tests, there’s no consensus on the best additional screening tool, and the current available options offer different pros and cons. However, while mammograms have limitations, better strategies are needed and based on the current evidence, some experts believe that additional screenings may do more harm than good.
Some experts are in favor of additional screenings, and noted that insurance coverage will be a significant hurdle. The challenge always is getting reimbursement, Some options for supplemental breast screenings that are being considered include breast ultrasounds, MRI’s, abbreviated MRIs, and contrast-enhanced mammograms.
A mammogram alone for a woman with dense breasts is considered incomplete screening, but no consensus on the best screening methodology has been formed yet. Furthermore, the costs associated with further screenings are also a significant concern for experts. According to Dr. Nancy Lynn Keating, a professor of health care policy and medicine at Harvard Medical School, insurance coverage of follow-up screenings for all women with dense breasts is not currently justified due to a lack of evidence supporting their benefits.
Read the original article on Africa Health News
