Like most women of a certain age, Dr. Nancy Cappello took regular steps to prevent undetected breast cancer. She ate healthy, exercised, checked her breasts regularly, and got mammograms on an annual basis. She was considered low-risk in the way of cancer, so she didn’t excessively worry about the issue.
However, that all changed through a series of events that can only be described as terrifying.
In 2003, Cappello went for a routine mammogram. The result was normal. But in a routine checkup, Cappello’s doctor found something concerning. A ridge in her right breast. As a result, Cappello was sent for both a second mammogram and an ultrasound.
Here’s the thing: the second mammogram was normal. But the ultrasound revealed something life-threatening: a lesion more than two centimeters long that would lead to a diagnosis of stage three breast cancer. Unfortunately, it had spread to 13 lymph nodes. In addition, Cappello learned that she had dense breasts, a common issue that most women aren’t aware of.
Because of both her doctor’s keen wisdom in finding the ridge and the ultrasound, Cappello’s life was saved. However, Cappello underwent a mastectomy in one breast, as well as multiple chemotherapy and radiation treatments. The process was devastating.
The Cappello’s story is not unique. In fact, stories like Cappello’s are popping up around the globe. This is why ultrasounds have become a hot topic in the way of cancer prevention. The reason for this is one you need to know. Ultrasounds can detect cancer in instances where mammograms can’t.
You see, like Cappello, 40 percent of women also have dense breast tissue. And dense breast tissue often acts as a mask that prevents doctors from being able to detect cancer through mammograms.
So why is this?
In general, cancer appears white on a mammogram. And so do dense breasts. As a result, it’s difficult to actually see cancer in order to detect it. This is why mammograms are thought to miss cancer in EVERY OTHER CASE when a woman has dense breasts.
This is where ultrasounds come into play.
Some research has shown that a combination of both a mammogram and ultrasound is the best bet when it comes to detecting cancer in women with dense breast tissue. That said, ultrasound alone isn’t recommended because it may not detect some cancers that a mammogram would detect. In addition, ultrasounds can also give results that are not cancer, leading to unnecessary biopsies.
So just what is an ultrasound?
According to the American Cancer Society (ACS), ultrasound, (which is also called sonography) is a painless and radiation-free test that operates by way of sound waves. First, gel is applied to the outside of the breast. Then, a device called a transducer is used to examine the tissue inside of the breast. This device operates by giving off sound waves and picking up echoes from the sound waves when they hit and bounce off of tissues in the body. These echoes are then turned into the image that doctors see.
The ACS says that ultrasound of the breast is usually used for two reasons: to examine issues found during a breast exam and/or mammogram or as a reference/guide during a needle biopsy. It can also be used to examine the lymph nodes located under the arm. And, of course, it’s used in the case of dense breasts.
That said, ultrasounds pick up fewer tumors than an MRI. However, ultrasound has become a popular option along with mammograms because it doesn’t involve needles, is easily available, and is less expensive than other choices. In any case, the ACS says that what is picked up and how an image is interpreted depends on both the skill and level of experience of the person who is performing the ultrasound.
Another type of ultrasound used is called automated ultrasound. In the case of automated ultrasound, professionals use a larger transducer. This device takes hundreds of pictures which cover just about all of the breast. When problematic areas are found, a second ultrasound is used to zone in on concerning areas.
So just what are your chances of being told you need an ultrasound? This concept has been a news topic for quite some time. Really, this may depend on where you live.
Some states have jumped on board the need for further diagnostic material when it comes to dense breasts. According to Today, Connecticut was the first state to initiate this process. In 2009, the state passed legislation in which women were required to be told if breasts were dense. In addition, legislation requires professionals to recommend ultrasound if breast density is greater than 50 percent.
That said, laws differ by state. This has led Cappello on a unique journey to bring the power of ultrasound to all women with dense breasts. To try to prevent stories like hers, Cappello has become an active advocate of dense breast awareness. Consequently, she founded both Areyoudense.org and Areyoudenseadvocacy.org.
“In the unlikely event that you have cancer, you want it found as early as possible,” says Cappello. “So if you have a tool that is limited, first of all, shouldn’t women know that? They should also have access to adjunct screening.”
According to Cappello, 24 states officially require doctors to readily tell women this information, though eight other states are introducing legislation in 2016. Her goal is for this act to be required of every single state in the nation. And she wants to be sure that procedures associated with dense breasts are covered by every woman’s insurance policy.
“We know that a barrier to any procedure is having the availability to pay for it,” says Cappello. “We want to make sure that when women go for screening they have the availability of having as low a cost as it can be. Mammogram is covered. The challenge is that if you have an added test it may not be covered and the deductible may have to be exhausted before it is covered.”
The first step you can take to protect your own health is to find out if you have dense breasts. Ask your doctor whether or not your breasts are dense after your routine mammogram is performed. And if you do have dense breasts, request an ultrasound. After all, it’s your health on the line. You deserve the best chance possible of detecting breast cancer early. Don’t be afraid to take action.