Dear Dr. Christina,
I am confused. I thought if you did not have a family history of breast cancer, you had less of a chance of getting breast cancer. I also thought that if I had a mammogram done according to my doctor’s recommendations, I was safe. I even got a letter from my imaging center that says my screening mammogram was okay. I am 45 years old, and I was recently diagnosed with breast cancer. What did I do wrong? Why didn’t they find it on my screening mammogram? I did not even have a breast lump. My doctor told me it was because my breast tissue was dense. Why is this the first time I am hearing about having dense breasts? I would have done something different, if only I had known. ~Sly
I know how frustrated you feel and how confusing all this sounds, but you are right: having a family history of breast cancer can increase any woman’s risk of getting breast cancer. 13% of women diagnosed with breast cancer have a family relative who has or had it too. The younger the relative is who is diagnosed with breast cancer, the higher the chance a family relative can get breast cancer. However, the facts show that most women who get breast cancer do not have any family history. So in other words, not having any relative with breast cancer does not mean you are safe and would not get breast cancer.
The problem is that a lot of women have dense breasts. What does that mean? It just means you have a lot of glandular breast tissue and less fatty tissue that can be seen on a mammogram. Nearly one-half of all women in the US have dense breasts, which means all of those women have an increased risk of developing breast cancer. Younger women usually have dense breasts; older women have more fatty tissue; but every woman is different. Regardless of your age, you may have dense breasts.
Women with dense breasts have an increased risk of breast cancer not being found when radiologists are reviewing your mammogram. It is very important for you to know if you have dense breasts or not from your doctor when they review your findings. If you do, that can increase your risk of breast cancer. A screening mammogram for women with dense breasts makes it difficult for the radiologist to detect breast cancer because dense breast tissue can look like a cancer. Dense tissue appears white, just like a tumor, causing it to mask the breast cancer. It can often lead to why breast cancer was not detected.
I would like to share with you some of my ideas along with others from the Susan Komen for the Cure® organization about what you can do in order for you to be your own best advocate for your care and the early detection of breast cancer.
- Be sure to ask your doctor about your actual mammogram. Don’t just rely on the letter you received from the imaging facility where you got your mammogram done.
- Ask your doctor what your risk is for getting breast cancer. Make sure you ask your family about any family history of breast cancer. Also ask your doctor about your own personal risk (i.e.; medications, etc.)
- Make sure you get your screening mammogram done and ask your doctor when the best time and age is to do it.
- Make sure your doctor gives you a clinical breast exam annually. Don’t just let him or her hand you a mammogram slip.
- Make sure you do your own Self Breast Exam (SBE). Know what your tissue feels like and what is normal for you.
- Make sure you see your doctor if you notice any type of change in your breast such as:
- Lump or knot
- Swelling, warmth or redness
- Changes in size or shape
- Dimpling or puckering of the skin
- Itchy, scaly, sore or rash of the nipple
- Nipple discharge
- New pain in one spot that never goes away
Also remember to please take good care of yourself to help decrease your risk factors by utilizing healthy lifestyles choices:
- Watch your diet and weight
- Make sure you include exercises
- Limit the amount of alcohol you drink
- Be careful with hormone replacement medications
- Decrease your stress
- Beware of insomnia and get a good night’s sleep
Screening mammograms can save your life. Just because you have dense breasts does not make this screening test useless. Prevention is the key. Be sure to be observant and, most of all, ask questions when it comes to your healthcare and needs.
Sly, I know your world at this moment is very confusing, but I want to assure you that you did not do anything wrong. It is critical that you focus your energy now on your care and your progress.
I along with all those who read your letter here will keep you in our thoughts for a successful cure. You have given all of us a great gift and a wake-up call about how we can help ourselves and how to prevent re-occurrence for yourself. You have also revealed vital information to those who had the same beliefs you did.
My thoughts and prayers to you for a cure and healthy recovery,
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