What is Your Mammogram Not Telling You?

What is Your Mammogram Not Telling You?

By: St. Vincent Women's Health

May 14, 2018

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What is your mammogram not telling you?

Reviewed by Erica Giblin, MD, Breast Surgeon and Larry Stover, MD, Radiologist

Screening breast MRI is a game-changing technology that improves breast cancer screening in women with average cancer risk and dense breast tissue. This screening test is painless and faster than traditional breast MRI with the same ability to detect breast cancer and improve the detection of small cancers compared to mammography. Mammography detects 5-6 cancers per 1,000 patients, whereas AB-MRI detects 15 cancers per 1,000. The new AB-MRI technology significantly reduces the time it takes to do a breast MRI from 30-45 minutes to less than 10 minutes.

screening breast mri

Screening breast MRI (also referred to as AB-MRI) has been shown to detect more breast cancers than mammography or whole breast ultrasound screening. The screening MRI is now available at St. Vincent Breast Imaging Centers in Carmel, Fishers and Indianapolis, and St. Vincent Anderson, St. Vincent Kokomo, and the St. Vincent Evansville Epworth Breast Center.

(Image Source: Northwest Radiology and St. Vincent Indiana, 2018)

“Dense breast tissue makes it much harder for a mammogram to detect cancer. We needed a better test to help distinguish cancer from dense tissue,” says Erica Giblin, MD, Breast Surgeon at St. Vincent Women’s Health.

So why is breast density so important? When you get a mammogram, the density is documented on your mammogram (a state law). If you don’t know your breast tissue density, ask your healthcare provider. Having dense breast tissue is very common, but it also complicates the interpretation of the mammogram. Radiologists classify breast density into four categories. These range from a breast that is nearly all fat (category 1) to extremely dense tissue with very little fat (category 4). Below is a picture representing this category system. Category I (fatty breast) is on the left and category 4 (extremely dense) is on the right.

Breast tissue density classified into 4 images ranging from little fat to very dense

It’s a myth that firm breasts equal dense tissue. Just because you feel they are firm, that doesn’t make them dense. Nor is breast density related to your cup size. The radiologist who interprets your mammogram will record your breast density on your mammography report. If you have dense breast, ask your St. Vincent healthcare provider about having a breast MRI screening test. This important technology is now available at St. Vincent Imaging Centers in Indianapolis, Carmel, Anderson, Fishers, Kokomo, and Evansville.

Prior to screening breast MRI, women with dense breasts had the option of adding a breast ultrasound to the mammography screening. Having this type of MRI has been shown to detect more cancers in women age 40 years or older and at average risk for cancer than whole breast ultrasound screening.

“Breast cancer detection and diagnosis is improving at many levels. We now have improved imaging examinations that can rule out cancer and detect hard-to-see cancers, while minimizing the impact of radiation exposure from the test.”

Larry Stover, MD, Radiologist, Northwest Radiology at St. Vincent
To get the screening breast MRI, you need:
  • An order from your physician
  • Must be at least 40 years old
  • Identified with having dense breast tissue
  • Asymptomatic
  • Have had a mammogram within the past 12 months

“At St. Vincent, we have a protocol for women with dense breasts. We use the latest cancer detecting technologies, including the screening breast MRI and 3D mammography (tomosynthesis).”

Erica Giblin, MD, Breast Surgeon at St. Vincent Women's Health

The AB-MRI is a simple and quick process. In less than 10 minutes the test is over. Overall, AB-MRI is very fast and painless, and the results are superior to digital mammography. To be a candidate for a screening breast MRI, you must be 40 years of age or older, asymptomatic, have had a mammogram in the last 12 months, identified as having dense breast tissue, and have an order from your doctor. To schedule this test at you can call one number which is 1-833-MRI-4HER (1-833-674-4437). Screening MRI will be offered at Indianapolis, Carmel, Fishers, Anderson, Kokomo, and Evansville.

Take charge of your health, ask questions

Are women with dense breasts at higher risk?

According to the American Cancer Society, women who have dense breast tissue appear to have a slightly higher risk of breast cancer. Tumors are sometimes indistinguishable from dense breast tissue on the mammogram. The screening breast MRI (AB-MRI) increases detection of cancer in dense breast tissue.

If I have been told that I have dense breast tissue, do I still need a mammogram screening test?

Yes, a mammogram is still the primary screening tool for breast cancer detection. Talk to your healthcare provider. Be sure to share your most recent medical history and any family history of cancer. Most breast cancers can be seen on a mammogram. The screening breast MRI supplements breast screening in women (age 40 and older) with average cancer risk and dense breast tissue. If you have a family history of breast cancer, it is important to get tested. Women who are BRAC positive would have the regular breast MRI as part of their surveillance for cancer.

Risk factors that put you at increased risk for breast cancer:

  • Inherited gene mutations (BRAC-1 and BRAC-2)
  • A family history of breast cancer (especially a first-degree relative: mother, sister, or daughter with breast cancer)
  • Being treated for ovarian cancer
  • Radiation oncology treatments at a young age, for example, for the treatment of Hodgkin’s lymphoma

Talk to your primary care doctor about whether this screening breast MRI test is right for you. At St. Vincent, we have breast health navigators and specialists you can talk to. Please call 317-582-4377 for questions. St. Vincent’s Breast Care Services uses cutting-edge technology with patient-centered navigation to deliver the best care to every woman. Click here to learn more about St. Vincent Breast Care Services.

To make screening MRI appointment please calls 1-833-MRI-4HER (1-833-674-4437).

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