Doctor tells FDA to change rules; says mammogram won't spot cancer in some
A woman's mammography results should tell her if she has dense breasts, so that she'll know the test may miss a breast cancer diagnosis, a Ridgewood, N.J., radiologist told a federal advisory panel on mammography Friday.
Women with dense breasts are more likely to develop breast cancer, and their cancers may be more aggressive, recent research has found. Those who've already had breast cancer are more likely to have a recurrence if they have dense breasts.
But tumor cells may be impossible to distinguish from normal cells on mammograms of women with dense breasts because both show up as white areas.
"With dense tissue, cancers big and small are often not visible on the mammogram," Dr. Lisa Weinstock, the founder of Women's Digital Imaging in Ridgewood, told the FDA's National Mammography Quality Assurance Advisory Committee at their meeting on Friday in Maryland.
Cancers may be visible with other types of imaging, such as ultrasound.
"Educating patients directly about the risks of dense tissue and the limits of mammography is imperative," she said.
Currently, two reports are produced after a mammogram: one for the referring doctor and one for the patient. The doctor gets information about breast density but the patient doesn't. Weinstock and others advocate that the information also be included in the report to patients.
The committee meets regularly to hear from the public and give advice and recommendations to the federal Food and Drug Administration, which inspects mammography facilities and enforces the law about mammography quality and standards. It was not expected to vote on a recommendation at Friday's meeting.
"Without this information, the patient letter is misleading and may have fatal consequences," said Nancy Capello, a Connecticut woman who founded the advocacy group "Are You Dense?" Capello testified before the committee on Friday.
Capello was diagnosed with Stage 3 breast cancer, which had spread to 13 lymph nodes, in 2004 - after 11 annual mammograms, including one two months earlier, had found nothing. She did not know that she had dense breasts, which reduce the sensitivity of mammograms, she said.
"We have too many women like me, who end up with an advanced stage of cancer," she said, in a phone interview outside the hearing room in Gaithersburg, Md. With better early detection, she believes that fewer women at first diagnosis will learn that their breast cancer has already spread, she said.
A 52-year-old Teaneck, N.J., woman, who asked that her name not be used, also testified.
"I had gone to different radiologists in the past, and nobody told me I had dense breasts," she said.
Weinstock told her she had dense breasts and scheduled ultrasound screenings between her annual mammograms, she said.
It was the ultrasound that found a small invasive lobular cancer diagnosed earlier this year. Even knowing that the tumor was there, it could not be seen on a subsequent mammogram, she said. She underwent surgery and has fully recovered.
The American College of Radiology, in a position statement, said that it recognizes that greater breast density leads to lower sensitivity for mammography. While information on breast density is helpful for physicians, it said, "It is less clear how the typical patient would interpret or understand the same information."
Patients with dense breasts might demand additional alternative forms of screening, such as ultrasounds or MRIs, which would lead to more false positives and unnecessary breast biopsies.
If the alternate forms of screening were not covered by insurance, that might lead to "an unfortunate disparity" between those who could pay for it themselves and those who couldn't. And women without dense breasts might develop a false sense of security, the policy statement said.
The advocacy group, Are You Dense? estimates that 40 percent of women have dense breasts - two-thirds of those before menopause and one-fourth of those after menopause, but no population studies have been done.
Two states - Connecticut and Texas - have enacted laws requiring that reports to patients contain information about breast density, and legislation is pending in New York State. A Connecticut congresswoman also introduced federal legislation last month to require such reports.
(c)2011 The Record (Hackensack, N.J.)
Distributed by MCT Information Services
- Digital mammography superior to film mammography in some cases Jan 29, 2008 | not rated yet | 0
- Gamma imaging provides superior tumor detection for dense breasts Jun 06, 2011 | not rated yet | 0
- Dense breasts, hormone levels are 2 separate, independent risk factors for breast cancer Aug 20, 2007 | not rated yet | 0
- Calif. bill aimed at breast cancer worries docs Sep 15, 2011 | not rated yet | 0
- City-dwelling women at greater risk for breast cancer Nov 26, 2007 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Why is zone 1 in liver more prone to ischemic injury?
May 23, 2013 Hi, Is it because around central vein, there is only deoxygenated blood from the vein where as in the periphery there is hepatic artery. Also why...
How can there be villous adenoma in colon, if there are no villi there
May 22, 2013 As title suggest. Thanks :smile:
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013 Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
- More from Physics Forums - Medical Sciences
More news stories
In recent years, microRNAs (miRNAs) and other non-coding RNAs are small molecules that help control the expression of specific proteins. In recent years they have emerged as disease biomarkers. miRNA profiles have been used ...
Cancer May 24, 2013 | not rated yet | 0
Cancer cells spread and grow by avoiding detection and destruction by the immune system. Stimulation of the immune system can help to eliminate cancer cells; however, there are many factors that cause the immune system to ...
Cancer May 24, 2013 | 5 / 5 (1) | 0
Researchers from London's Kingston University have begun a two-year study which could help prolong the lives of people with colorectal tumours.
Cancer May 24, 2013 | 5 / 5 (1) | 0
Transformative research from Western University has identified new hormones in the body which may suppress breast cancer and stimulate the regression of breast tumors.
Cancer May 24, 2013 | 5 / 5 (2) | 0
(Medical Xpress)—Curtin University researchers have found evidence that targeting specific cells in the body can reverse the effects of cancer on the immune system.
Cancer May 24, 2013 | 5 / 5 (4) | 0
Coenzyme Q10 decreases all cause mortality by half, according to the results of a multicentre randomised double blind trial presented today at Heart Failure 2013 congress. It is the first drug to improve heart failure mortality ...
6 hours ago | 5 / 5 (2) | 4
Heart failure accelerates the aging process and brings on early andropausal syndrome (AS), according to research presented today at the Heart Failure Congress 2013. AS, also referred to as male 'menopause', was four times ...
6 hours ago | not rated yet | 1
Mortality and length of stay are highest in heart failure patients admitted in January, on Friday, and overnight, according to research presented today at the Heart Failure Congress 2013. The analysis of nearly 1 million ...
6 hours ago | not rated yet | 0
(AP)—Department of Justice lawyers have again asked a federal appeals court in New York to delay lifting age restrictions and prescription requirements on an emergency contraceptive popularly known as the morning-after ...
6 hours ago | not rated yet | 0
Two mutations central to the development of infantile myofibromatosis (IM)—a disorder characterized by multiple tumors involving the skin, bone, and soft tissue—may provide new therapeutic targets, according to researchers ...
22 hours ago | 3 / 5 (2) | 0 |
Talking on a hands-free device while behind the wheel can lead to a sharp increase in errors that could imperil other drivers on the road, according to new research from the University of Alberta.
22 hours ago | not rated yet | 0