October is Breast Cancer Awareness Month. Black women are about 40% more likely to die of breast cancer than white women and are more likely to be diagnosed with breast cancer at a younger age, at later stages, and with more aggressive types of breast cancer than white women.
Earlier this month, the United States Food and Drug Administration issued a final rule that requires mammography result summaries to start, including a breast density notification statement. This rule may save lives in the Black community, as Black women tend to have denser breast tissue than white women, which may increase their risk of breast cancer and make it more difficult to spot the initial signs on a mammogram.
Susan G. Komen, the world’s leading breast cancer organization, has offered a statement on the new ruling: “Knowledge is power, and all women can now have informed conversations with their medical providers about the screening plan that’s right for them based on factors influencing their breast cancer risk, including breast density,” Molly Guthrie, Vice President of Policy and Advocacy.
“Knowledge is power, and all women can now have informed conversations with their medical providers about the screening plan that’s right for them based on factors influencing their breast cancer risk, including breast density,” said Molly Guthrie, Vice President of Policy & Advocacy at Susan G. Komen. “This may mean additional tests are recommended to accurately screen for breast cancer.”
Breast density is a measurement on a mammogram of the fibrous and glandular tissue, including the lobules and ducts that make and carry milk, compared to fatty tissue in the breast. Dense breasts are common, affecting about 40-50% of U.S. women ages 40-74. However, breast density is only one factor that can affect a woman’s breast cancer risk. Age, gender, genetics, family health history, and lifestyle factors are essential in a person’s overall risk. Women with very dense breasts are 4-5 times more likely to develop breast cancer, and dense breast tissue can obscure tumors in mammograms. Komen encourages women to talk with their healthcare providers about their breast density and whether additional breast imaging may be suitable for them.
By September 10, 2024, mammography reports must include a breast density assessment. The reports will consist of an overall finding – breasts are dense, or breasts are not dense – and additional detail about the level of density:
- Breasts are almost entirely fatty (not dense)
- Breasts have scattered areas of fibroglandular density (not dense)
- Breasts are heterogeneously dense, which may obscure small masses (dense)
- Breasts are extremely dense, which lowers the sensitivity of mammography (dense)
Because of the Affordable Care Act (ACA), millions have widespread access to annual screening mammography beginning at age 40 without patient cost sharing. However, suppose breast imaging is needed beyond a screening mammogram. In that case, patients are often faced with hundreds to thousands of dollars in out-of-pocket costs, creating a significant financial barrier to needed care.
“We want everyone to know that dense breast tissue alone doesn’t necessitate additional imaging—it’s just one factor in breast cancer risk,” Guthrie added. “For those who do need imaging beyond a mammogram, out-of-pocket costs are often a barrier. That’s why we’ve been advocating for state and federal legislation to eliminate these expenses. We have the technology to detect breast cancer earlier and save lives, financial barriers shouldn’t stand in the way. It’s crucial for people to understand and have affordable access to the breast imaging they need based on their individual risk.”
“The new federal rule on breast density provides women across the U.S. with vital and more consistent information on their breast density. Women with very dense breasts are 4-5 times more likely to get breast cancer than women with fatty breasts, and some studies show that Black women are more likely to have dense breasts. Breast cancer health disparities greatly affect Black women, and having more information can help to empower women to advocate for themselves and have informed conversations with their health care providers. Susan G. Komen encourages women to talk with their health care providers about their breast density, as well as their risk for breast cancer, and consider what breast imaging is right for them,” said Natasha Mmeje, Director of Community Education and Outreach for Susan G. Komem.
Susan G. Komen’s Center for Public Policy has been working with state and federal lawmakers to pass legislation that removes the out-of-pocket expense for imaging beyond a screening mammogram. To date, 26 states have eliminated out-of-pocket costs to patients with state-regulated health insurance plans for diagnostic and/or supplemental imaging. At the federal level, the Access to Breast Cancer Diagnosis Act has been introduced in the U.S. House and Senate but passage is unlikely this Congress. Komen urges legislative action to remove financial and administrative barriers to needed breast imaging, ensuring all people can follow recommended screening guidelines based on their risk.
Additionally, Komen’s ongoing health equity initiative in the Black community, Stand for H.E.R.. This Health Equity revolution is a focused initiative to decrease breast cancer disparities in the Black community by 25%, beginning in the U.S. metropolitan areas where inequities are most significant; read more here.
