So, given that the typical once-a-year mammogram starting at age 40 or 50 might not be appropriate for you and your dense breasts, what are your options?
First, make sure you’re getting a digital (rather than film) mammogram. Most facilities have switched to digital, as it’s more sensitive; it’s better at picking out potential trouble areas.
Second, ask your doctor about alternate screening methods. An ultrasound can reveal whether or not the questionable area on your mammogram is a cyst; but it can’t go further than that. If it’s not a cyst, but a solid lesion, your doctor may be thinking biopsy.
Before going the biopsy route, ask your doctor about combining another ultrasound with elastography, a type of screening that’s often given concurrent with ultrasound; in fact, many ultrasound machines have elastography capability (it’s a simple software add-on), if the radiologist directs the screening tech to use it.
Problem is, not many choose to access this alternate technology; it wasn’t very accurate when it first came out. Now, though, research has shown it’s much better than the original technology in determining which solid masses might be cancerous, and which are simply breast or scar tissue, or a non-cancerous tumor (fibroadenoma).
How does it work? Simply put, it measures how hard or soft the mass in question is. Cancerous tumors tend to be harder than other breast tissue; elastography determines how “squishable” the tissue is, and compares it to known standards for cancer.
The FDA hasn’t yet approved elastography as a screening tool; but some radiologists are using it in conjunction with ultrasound, where it’s especially helpful in determining whether or not a biopsy is warranted. If neither a mammogram nor ultrasound can either rule out cancer, nor create a really strong case that it’s present, then elastography can help guide the decision: biopsy vs. “watchful waiting.”
If you’re a woman who’s faced multiple biopsies, keep this new tool in mind. Or if you’ve been through the wringer with inconclusive breast cancer screening tests, and your GP is recommending biopsy, but the radiologist says “we’ll just check it again in 6 months” – ask about elastography. This one last test just might give you the information you need to make a very tough decision.
McCarthy, A. (2009, April 29). Arrs 2009: Breast elastography accurately diagnoses malignancies. Retrieved from http://www.medscape.com/viewarticle/702181 Appendix A breast cancer technology overview. (2005). Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK22310/