Using Your Platform to Empower When to Screen for Cancer Early
- Actress Viola Davis, 59, emphasizes the importance of regular mammogram screenings, particularly for Black women, who face a higher risk of aggressive breast cancer. She undergoes screenings every six months.
- Mammograms are a standard procedure for detecting breast cancer, allowing doctors to examine breast tissue for early signs of the disease.
- While most medical experts recommend annual mammograms for women aged 45 to 54, the U.S. Preventive Services Task Force (USPSTF) now advises starting biennial screenings at age 40.
- Research from UCLA Health, published in the Journal of the American College of Surgeons, indicates that Black women with cancer in one breast are less likely than white women to choose preventative mastectomy.
- A Centers for Disease Control and Prevention (CDC) study found that 64% to 85% of women aged 50 to 74 receive annual mammograms, but those with lower incomes may struggle with access to care and are more likely to miss screenings.
“I have had several friends who have already succumbed to breast cancer—or they had the BRCA gene, and they have elected for surgery to get the double mastectomy and their ovaries removed. It is very close to my heart,” Davis shared with Las Vegas Black Image magazine.
Davis’ message carries profound significance, particularly within the Black community, where studies show Black women are more likely to be diagnosed with aggressive breast cancers. Her advocacy is a call to action for early detection and proactive health care.
Expert Resources on Breast Cancer Screening
- Earlier Mammograms for Black Women May Reduce Breast Cancer Mortality Disparity Rates By 57%; How to Screen for this Disease
- I Have Dense Breasts. Do I Need a 3D Mammogram?
- Millions of Women With Dense Breasts — A New Congressional Law — What You Need to Know
- When You’re Getting a Mammogram, Ask About Dense Breasts
Black Women and Mammograms & Preventative Mastectomies
The Centers for Disease Control and Prevention (CDC) analyzed data from the 2022 Behavioral Risk Factor Surveillance System to assess mammography rates among women aged 40 to 74 over the previous two years. The findings underscore the critical role of socioeconomic status and healthcare access in determining whether women receive regular screenings.
Women with reliable health insurance and quality medical care were significantly more likely to undergo mammograms, ensuring early detection and better health outcomes. In contrast, those facing systemic barriers—such as financial hardship, limited healthcare access, and social isolation—had lower screening rates, increasing their risk of undiagnosed breast cancer.
The study identified several adverse social determinants of health linked to decreased mammogram use, including unemployment or underemployment, reliance on food assistance programs, lack of transportation, inadequate health insurance, low income, loneliness, and overall dissatisfaction with life. Addressing these disparities is crucial to ensuring all women—regardless of socioeconomic status—have access to vital preventative healthcare.
The report also pointed out that low-income Black women were more likely to die from breast cancer.
WATCH: Mammograms are still the best tool for detecting breast cancer.
New research published in the peer-reviewed Journal of the American College of Surgeons highlights a significant racial disparity in preventative mastectomies—procedures that can dramatically lower the risk of breast cancer for high-risk women.
“Black women with cancer in one breast are less likely than white women to undergo contralateral prophylactic mastectomies (CPM), a procedure to remove the unaffected breast,” researchers from the University of California, Los Angeles (UCLA) explained to UCLA Health.
The study, which spanned from 2004 to 2020, analyzed data from more than 597,000 women, including nearly 71,000 Black women. Findings revealed that, overall, Black women were 35% less likely to opt for preventative mastectomies compared to white women. Even at predominantly Black-serving hospitals, the likelihood of Black women receiving this procedure was 17% lower.
“Our findings that Black-serving hospitals are less likely to perform CPM suggest these racial disparities are encoded structurally. We need to examine the systems-level factors affecting the care of Black women and address the deeper causes of structural racism to ultimately lead to equitable outcomes for all patients,” said Amulya Vadlakonda, the study’s lead author at the David Geffen School of Medicine.
These findings underscore the need to address healthcare inequities and ensure Black women receive the same access to preventative care that can be life-saving. Let me know if you’d like additional refinements!
The study draws added attention to racial disparities in healthcare and the need to Close the Gap regarding access to cancer care.
SurvivorNet is committed to highlighting the racial and socioeconomic disparities that hinder access to quality healthcare. It is crucial to unite in addressing the systemic barriers that prevent minority communities from receiving cancer care, participating in preventive health measures, and enrolling in clinical trials. Through awareness and action, we can work toward a more equitable healthcare system for all.
When to Screen for Breast Cancer
The medical community has a broad consensus that women have annual mammograms between the ages of 45 and 54. However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) is saying that women should now start getting mammograms every other year at the age of 40, suggesting that this lowered the age for breast cancer screening could save 19% more lives.
The American Cancer Society recommends getting a mammogram every other year for women 55 and older. However, women in this age group who want added reassurance can still get annual mammograms.
WATCH: When you’re getting a mammogram, ask about dense breasts.
Women with a strong family history of breast cancer, a genetic mutation known to increase the risk of breast cancer, such as a BRCA gene mutation, or a medical history, including chest radiation therapy before the age of 30, are considered at higher risk for breast cancer.
Experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk for developing breast cancer, you should begin screening earlier.
Screening Options for Women with Dense Breasts
Women with dense breasts should get additional screening to supplement their mammograms. Dense breasts mean more fibroglandular tissue and less fatty breast tissue exists.
The dense tissue has a “masking effect on how well we can perceive cancer and find cancer on mammograms,” Dr. Cindy Ly, Chief of Breast Imaging and Vice Chair of Clinical Research and Faculty Affairs at the Stony Brook Renaissance School of Medicine, told SurvivorNet.
Glandular tissue within dense breasts appears white on mammograms, which can help mask potential cancer. The “frosted glass” effect from the glandular tissue can thus mask cancerous areas, especially developing ones. Undetected, these cancers can progress, growing large and advanced. They will then likely require more intensive treatments to cure or can become incurable altogether.
WATCH: What is 3D Mammography?
“Digital mammography, it turns out, significantly improves the quality of the mammogram…It’s 3D or tomosynthesis mammography,” Dr. Connie Lehman, a diagnostic radiologist who specializes in breast cancer at Massachusetts General Hospital in Boston, explains.
“This allows us to find more cancers and to significantly reduce our false-positive rate. With digital mammography 3D tomosynthesis, we’re taking thin slices through that breast tissue, like slices of a loaf of bread. We can look at each slice independently rather than trying to see through the entire thickness of the entire loaf of bread. So those thin slices help us find things that were hidden in all the multiple layers,” Dr. Lehman adds.
Additional testing can be considered for dense breasts, depending on a woman’s personal history, preferences, and physician’s guidance. These tests include:
- 3-D Mammogram (Breast Tomosynthesis): This technology acquires breast imaging from multiple angles and digitally combines them into a 3D representation of the breast tissue. This allows physicians to see breast tissue architecture better, even in dense breasts. 3D mammograms are fast becoming the standard way of performing mammography.
- Breast Magnetic Resonance Imaging (MRI): An MRI machine uses magnets to create highly detailed, intricate images of the breast. These are mostly reserved for women with an extremely high breast cancer risk. Dense breasts alone may not be a valid reason to obtain a breast MRI. However, dense breasts in women with genetic mutations, like BRCA1 and BRCA2, or a strong family history of breast cancer could justify obtaining breast MRIs.
- Molecular Breast Imaging (MBI): MBI is a newer imaging technique that uses a radioactive tracer to detect breast cancer. It is beneficial for women with dense breasts. However, MBI is not as widely available as other screening methods.
The Food and Drug Administration (FDA) now requires facilities offering mammograms to notify patients about their breast tissue density and recommend they speak with a doctor to determine if further screening is necessary. There will be “uniform guidance” on what language to use and what details to share with the patient to make the communication clear and understandable.
Understanding Your Mammogram Report
A radiologist reading mammograms categorizes breasts into four different categories using the Breast Imaging Reporting and Data System (BI-RADS), a classification system developed by the American College of Radiology (ACR). These include:
- Fatty breast tissue: These breasts are mainly fat with very little dense tissue. Found in less than 10% of women, fatty breasts appear dark on mammograms.
Scattered fibroglandular breast tissue: These breasts contain a mix of fatty and dense tissue (composed of glands and fibrous tissue). On a mammogram, they have dark areas (fatty tissue) intermixed with light areas (dense tissue). Around 40% of women have breasts that fall in this category. - Heterogeneously dense breast tissue: This type of breast tissue has many areas of dense tissue and some areas of fat. Found in 40% of women, these breasts look mostly light, with some dark areas on a mammogram.
- Extremely dense breast tissue: Such breasts are almost entirely composed of dense glandular and fibrous connective tissues with very little fat. They are found in 10% of women and appear light on mammograms.
Your breasts are usually called dense on a mammogram report if they fall within the heterogeneously dense breast tissue or the extremely dense breast tissue categories.
How Can I Manage Mammogram Anxiety?
It’s common to feel anxious while awaiting mammogram results. This feeling is often called mammogram anxiety.
If you are awaiting test results and your nerves are running rampant, try doing something that relaxes you, such as exercising or listening to your favorite music. Breathing exercises and meditation can also help you relax.
SurvivorNet has more resources to help you manage your mental health while awaiting test results.
Learn more about SurvivorNet's rigorous medical review process.
