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New Advancements in Breast Cancer Screening Enhance Early Detection

While breast cancer mortality has declined overall in the last 30 years, according to the American Cancer Society, the incidence of breast cancer in women under 50 has increased. Disparities still exist among Asian American and Pacific Islanders of all ages. These setbacks have led to new advancements, regulations, and screening techniques to improve early detection and treatment.

IN THIS BLOG:

 

1. What recent change has been made to the Mammography Quality Standards Act regarding screenings?

The new regulations require all facilities to notify women of their breast density after a mammography appointment.

2. How does breast density affect cancer detection?

Higher breast density increases the risk of breast cancer and makes it harder to find cancer because denser tissue may be hiding some of the cancerous parts.

3. At what age does the U.S. Preventive Services Taskforce recommend women begin regular mammograms?

The task force recommends starting regular mammograms at age 40, with women aged 40–47 screened every other year.

4. Why is it essential for women to know their breast density?

Knowing their breast density is important as it can impact early detection of breast cancer and help women seek appropriate follow-up care.

5. Where can individuals go to learn more about breast cancer and other screening methods?

For breast cancer resources and support, visit the American Cancer Society website.

Mammography Quality Standards Act Requires Breast Density Notification for All Women

In a 2024 AFMC TV episode, Dr. Stacy Smith-Foley, medical director for the breast cancer center at CARTI, spoke about the latest changes to the Mammography Quality Standards Act (MQSA) issued by the Food and Drug Administration (FDA), which now requires all facilities to notify women of their breast density after a mammography appointment.

“The MQSA was originally enacted in the 80s to ensure women standardized quality imaging,” Dr. Smith-Foley said. The Act also standardized the interpretation of imaging results, providing clearer communication among providers, referred physicians, and patients.

New FDA rules and regulations replace grassroots, state-by-state efforts on breast density with a uniform federal guideline. “One of the biggest issues with the state-by-state decision [whether or not to notify patients of their breast density] was that the patient notifications, requirements, and verbiage were all different,” Dr. Smith-Foley said. Unclear expectations created more follow-up appointments and missed diagnoses, which are vital for breast cancer treatment and recovery.

Density, in this context, refers to the internal composition of a breast, specifically, the ratio of fatty tissue to glandular tissue. Higher breast density increases the risk of breast cancer, irrespective of family history.

“Increased breast density also makes it harder to find cancer if it is there because of the denser tissue that may be hiding some of the cancerous parts,” she said.

Because it has such a positive impact on early detection and decreased cancer risk, it is important for women to know their breast density. However, breast density cannot be determined by a self-exam or even by a physician or nurse practitioner. Only the radiologist who views the mammography image can accurately calculate the percentage of fatty and glandular tissue.

The MQSA change also requires all patients who receive a mammograph to receive a letter notifying them of their breast density. “This is a great step for patients,” Dr. Smith-Foley said. “The processes and procedures are now standardized across the nation. Women will have more similar experiences.”

Being notified about their own breast density will allow women to know and not wonder. This new requirement will allow for clarity, transparency, and clear communication for patients.

This change is also great for providers, as it will open more doors to discussions about breast cancer, mammograms, and breast density. “Referring providers must know that breast density is not a terrible thing,” Dr. Smith-Foley said. “It’s just like eye color. It’s the composition of the breast in this snapshot, and it can change with weight gain or loss, menopause, breastfeeding, pregnancy, and a list of other factors.”

For more information about mammograms, breast cancer screenings, or breast density, visit CARTI.com.

Lowered Mammogram Age Recommendation Could Also Save Lives

Due to the rise in breast cancer incidence in women in their 40s, the U.S. Preventive Services Taskforce recommends starting regular mammograms for breast cancer at age 40, with women aged 40–47 getting screened every other year.

The task force had previously said women could choose to begin breast cancer screenings as young as 40, but women 50–74 were strongly encouraged to get screened every other year.

The new requirement aligns with the recommendations of other medical groups, including the American College of Radiology and the American Cancer Society, though both of these organizations recommend annual screenings starting at age 40.

Changing the age recommendation will help further reduce breast cancer death rates, which have continued to decline as treatment has improved. Nevertheless, breast cancer remains the second most common cause of cancer death for women nationally.

Other Imaging Options are Still Being Tested but Look Promising

As mentioned previously, mammograms do not always detect carcinomas, especially in women with higher breast density. Additionally, the imaging and screening process may be lengthy, uncomfortable, or even scary to some.

To combat these fears and increase the detection rate in women with higher breast density, researchers are evaluating the impact that a breast computed tomography (CT) scan may have on early detection. Research on breast CT as a screening tool is still in its early stages, however.

Some researchers are evaluating whether breast CT scans would be a better screening tool than traditional mammography. It is also important to note that CT scans are not routinely used to evaluate the breast, and CT scans would generally not be needed if you have early-stage breast cancer. Radiologists may recommend a breast CT scan to look at the chest or abdomen to determine if the cancer has spread to other parts of the body.

For breast cancer research, resources, and other support, visit the American Cancer Society website.

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