Q&A: How does dense breast tissue weigh in on cancer risk
This is a question and answer session with Dr. Ruthane Reginella, a diagnostic radiology specialist with Butler Health System.
She has been instrumental in bringing state-of-the-art testing, including Breast MRI, 3D mammography and ABUS, and support services such as the nurse navigator program to benefit women in the region.
<b>What are dense breasts?</b>Breasts are composed of glandular tissue and fat. Dense breasts are breasts that have greater than 50% glandular tissue.There are four categories of breast density: fatty, scattered, heterogeneously dense and extremely dense. The heterogeneously (51% to 75% glandular) and extremely dense (greater than 75% glandular) are the categories that constitute dense breasts.Forty to 50% of women have dense breasts, so it's very common.<b>Why are dense breasts important?</b>Having dense breasts can cause the mammogram to be more difficult to interpret.The reason for this is that glandular tissue appears as white on a mammogram and so do cancers. The more white tissue or glandular tissue, the more likely this white tissue will mask or hide a small cancer.In fact, the number one reason breast cancers are missed at mammography is dense breasts.Moreover, increased breast density is a significant risk factor for developing breast cancer. There is a 4 to 6 times increased risk of breast cancer in extremely dense breasts, and 70% of all breast cancers occur in dense breasts.<b>What can be done to increase brest cancer detection?</b>The American College of Radiology recommends annual mammograms for women 40 years and older. Mammography is the gold standard for screening for breast cancer.However, for some women with dense breasts, mammography is not enough. They need an additional screening method. One of these additional screenings is with ultrasound.As stated earlier, cancers appear to be white on mammograms. However, on ultrasound, cancers appear as black areas in a background of white glandular tissue. Therefore, they can be easier to see on ultrasound.Breast ultrasound can detect about three more cancers per 1,000 screened women than what screening mammography alone can.Ultrasound should not replace mammography because mammography can reveal changes in breast tissue that ultrasound will not. Mammography and breast ultrasound should be performed together in dense breasts.<b>What is ABUS?</b>ABUS is Automated Breast Ultrasound. Instead of a hand-held ultrasound, this is equipment with a mechanical arm that scans the breasts.There is a small degree of compression by a plate-like device that rests on the top of the breast while laying on your back. The scanning mechanism is inside this device. Total scan time is about 20 minutes.Benefits of the ABUS include consistent, reproducible exams and decreased operator error. As images are obtained, they are recorded for the radiologist's review. These images are also processed into a 3-D format for review.<b>Where may I get an ABUS scan?</b>Butler Health System is proud to offer ABUS at its Women's Imaging Center at 129 Oneida Valley Road, Butler. We are the only facility in a 50 mile radius offering this new, advanced imaging. You may make an appointment by calling 724-284-4000.You will need to have a doctor's order for this exam. Most insurances will cover this test. A new law in Pennsylvania, signed by Gov. Tom Wolf in July 2020, requires insurance companies in Pennsylvania to cover additional breast cancer screening in women with dense breasts.Check your insurance to make sure you are covered.
<b>Position:</b>Diagnostic radiology specialist with Butler Health System<b>Education & training:</b>- Medical school — Pennsylvania State University College of Medicine, Hershey- Diagnostic Radiology Residency — Penn State College of Medicine- Women's Imaging Fellowship — UPMC Magee-Womens Hospital, Pittsburgh- Board Certified — American Board of Radiology- Specialties — Women's imaging, ultrasound
