UK HealthCast: Breast Cancer Screening Guidelines

UK HealthCast is a podcast series featuring interviews with UK HealthCare experts on a variety of health-related topics.

In September, the FDA mandated that critical information about breast density must be included in the lay letters women receive after their mammogram. On this edition of UK HealthCast, Dr. Aurela Clark, a breast radiologist with the UK Markey Cancer Center, explains these changes and how breast density awareness can impact early detection and successful treatment outcomes.

Here are some key takeaways from Dr. Clark’s conversation.

Early detection saves lives

• Importance of early detection: Preclinical detection of breast cancer offers the highest survival rates, with a definite cure when breast cancer is caught early. Screening mammograms remain the most effective tool for detecting small, early-stage cancers, long before symptoms arise.
• Mammography: Mammograms remain the gold standard for catching cancer early, especially with 3D mammography technology, which offers a more detailed view of the breast tissue. UK Markey Cancer Center started using 3D mammography in 2013, becoming one of the earliest centers in Kentucky to do so.
• When to get screened: The U.S. Preventive Services Task Force recently updated their guidelines to recommend that screening mammograms begin at age 40 for all women, instead of age 50. Dr. Clark and other radiology experts recommend annual mammograms starting at 40 for women of average risk. A risk assessment is recommended for all women starting at age of 25, to assess the need for earlier initiation of screening, for the most effective reduction in mortality.
• “Early detection provides a true cure for breast cancer." Dr. Clark emphasizes that screening mammograms save lives, and staying informed about breast density empowers women to take charge of their breast health.

Breast density

• Breast tissue consists of fibroglandular and fatty tissue. Dense breasts contain more fibroglandular tissue, making it harder to detect cancer on mammograms since both dense tissue and tumors appear white.
• About 40% of women have dense breast tissue.
• Younger women, particularly those between 40-50, and some racial groups, like African-American and Asian women, are more likely to have dense breasts.
• Dense breast tissue can reduce mammogram accuracy by 30-40%.
• These educational webpages can help the patients better implications of dense breast tissue (https://densebreast-info.org/for-patients/is-my-mammogram-enough/) and test after screening (https://densebreast-info.org/for-patients/screening-tests-after-a-mammogram/)
• Markey Cancer Center offers breast MRI as a supplemental screening option.

How new guidelines affect screenings

• All women in the United States will receive a letter after their mammogram explaining if they have “dense” or “not dense” breasts, and the implications of having dense breasts. This information allows women to discuss options with their healthcare provider and make more informed decisions about screening.
• For women with dense breasts, mammograms alone may not detect cancer, so additional screenings like ultrasounds or MRIs may be recommended.

The Markey Cancer Center difference

• State-of-the-art technology: Markey Cancer Center offers 3D mammography, the current standard for effective screening.
• Specialized programs: The Kentucky Women’s Cancer Screening Program offers free screenings for underserved women.
• Supportive services: In collaboration with organizations like the American Cancer Society and Kentucky CancerLink, UK Markey Cancer Center provides resources like transportation, gas cards and housing assistance for patients in need.

Click here more information or to schedule a breast cancer screening.