Margie Singleton did not learn about her breast cancer, despite feeling a palpable “lump” in her breast, until after it had advanced to Stage 2b with involvement of her lymph nodes. At age 44, Margie had already received more than 5 screening mammograms, consistent with recommendations from her doctors. Unfortunately, Margie has “dense breasts,” something she had not heard of before her cancer diagnosis. High breast density prevented screening and 3D mammograms from detecting her breast cancer in its early stages. This delayed diagnosis required her to undergo six rounds of chemotherapy followed by bilateral mastectomy with reconstruction rather than being able to have breast-conserving surgery, or a lumpectomy as 60-70% of women diagnosed with breast cancer choose. She also had 25 days of radiation after surgery and will have to take a chemo pill for another 5-10 years due to the progression of her disease at diagnosis.
Breast density is one of the most common reasons for failure of mammography to detect cancer and presents unique challenges for breast cancer patients and providers. Because dense breast tissue has the potential to mask cancerous tumors in mammography results, many women don’t learn they have breast cancer until their disease has reached an advanced stage. Despite being a well-established independent risk factor for breast cancer(1), 95% of women do not know their breast density.
Since 2009, thirty-six states have passed legislation requiring that patients with dense breasts who have received a mammogram be notified about their breast density and the implications it could have. This is largely due to the efforts of another breast cancer awareness advocate, Dr. Nancy Cappello, and her organization, AreYouDense?, which aims to educate the public about the risks and impact dense breast tissue can have on breast cancer screenings.
Currently, Georgia law does not require that mammography reports include information about breast density. Dune Medical connected Margie and her Army with Dr. Nancy Cappello, and the team has since made it their mission to change this. While density reporting legislation has been brought to Congress eight times in the past, it has yet to have been presented or voted on by Congress.
Dune Medical is acutely aware of the challenges breast density presents for patients and their healthcare providers. Margie, Dr. Capello, and Dune Medical Devices CEO Lori Chmura have met with current Georgia Governor, Nathan Deal, regarding this legislation. He has been very supportive of their efforts, as his wife is a breast cancer survivor herself. This legislation won’t go before Congress until after a new state governor has been elected in early November, but the significance of Deal’s support for this law cannot be overlooked.
Breast density notification is intended to inform women who have undergone screening mammography that they have dense breasts. Armed with this information, in conjunction with their health care provider and in relation to other risk factors, they may want to pursue, further more specific tests, such as ultrasound or MRI.
While we wait for the legislators to come to session in January, please share Margie’s story. Write your congressman/woman, get your mammogram and learn more about your risk for developing breast cancer if you have dense breasts. Remember, awareness is paramount, and knowledge is power! Watch our site for more information in October when we recognize Breast Cancer Awareness month.
You can learn more about dense breast tissue and the possible mammogram screening options at https://www.areyoudense.org/. You can also become a part of Margie’s Army by following her Facebook page where she keeps everyone up-to-date on her journey and events that she organizes for breast cancer awareness – like the golf tournament, Tee’d Off at Breast Cancer, that will be hosted by Margie’s Army on September 22 in Savannah, Georgia.
- The elevated risk of breast cancer in women with dense breasts is attributed to the high cellular content of dense tissue and interaction between cells that line the mammary ducts and surrounding tissue.