Breast density

Breast density makes detection of cancer harder in 2D mammography

By Emma Palova

Grand Rapids, MI- Being a woman, a mother, a grandmother, a sister and a daughter is a joy. However, the number one risk factor for developing breast cancer is just that; the simple fact of being a woman. Being a woman with a dense breast tissue increases the risk further.

Although dense breast tissue is not an independent risk factor, it can make it harder to find cancer through a traditional two-dimensional (2D) mammography, according to Kent County Medical Society (KCMS) & Kent County Osteopathic Association (KCOA) bulletin.

As of June 1, 2015 breast imaging centers in Michigan are required by law to notify women if they have dense breast tissue.

Breast surgeon Dr. Jamie Caughran

Breast surgeon Dr. Jamie Caughran

“Your mammogram shows that your breast tissue is dense,” will read on the report from the imaging center.

Approximately 50 percent of women undergoing screening mammography have dense breast tissue. Breasts are considered dense if they contain a majority of fibro glandular tissue. Fibro glandular tissue and breast masses appear similar on 2D mammograms, making it difficult to detect a small breast cancer.

Karen Jarrell attested to that in her comment on the WOTV4women “Are you dense?” recent series.

“I had a mammogram in March 2014 that was clean. In December I was diagnosed with stage 2 breast cancer. Only when diagnosed did I learn I had dense breasts despite having a mammogram routinely.”

If a woman with dense breast tissue is at high risk, as determined by the Gail Risk Score, further screening may be appropriate. A good starting point is a breast cancer risk assessment, according to the KCMS/KCOA bulletin.

“Women need to know the risks in addition to having dense breast tissue,” said Dr. Jamie Caughran, medical director at the Mercy Health Comprehensive Breast Center in Grand Rapids.

Top risks include age, gene mutations, breast cancer is higher among women who have first degree relative with breast cancer (mother, sister or daughter), and personal history of breast cancer three to four fold increases the risk of a new cancer.

The additional screening options include 3D mammography or Digital Breast Tomosynthesis, now available in Kent County. The cutting edge technology produces a conventional 2D mammogram while also acquiring images of individual layers of breast tissue which can be viewed as an aggregate. This diminishes the masking effect of dense breast tissue, compared to the 2D image.

Levels of density

Levels of density

The 3D technology allows the radiologist to more accurately distinguish normal fibro glandular tissue from an underlying mass.

“3D mammography helps in the setting of dense breasts,” said Caughran. “It reduces the chances of screening patients having to come back for additional views and improves our cancer detection for masses in dense breasts.”

Insurance coverage varies. Priority Health and Medicare are covering diagnostic as well as screening. 3D is often performed as part of a diagnostic evaluation for a mass or known imaging finding.

Tomosynthesis (3D) is appropriate for patients with prior mammograms read as heterogeneously dense or extremely dense breasts, patients who are at high risk for developing breast cancer, and for patients who have strong desire to pursue 3D screening but do not fulfill either of these criteria.

The out-of-pocket cost is $150.

In high risk patients, MRI can be performed in addition to the 3D, as well as ultrasound as a side test.

Caughran said she is not in favor of additional 3D on top of a 2D because of double radiation.

“Do one exposure instead,” she said. “Come up with a plan. Know your density and risk level. The lack of coverage shouldn’t be an issue. We have grants and programs to cover.”

Caughran recommends for all women once a year mammogram, monthly self-exams and yearly exams at your doctor.

For more information go to

Sources: Kent County Medical Society & Kent County Osteopathic Association (KCMS/KCOA}


Cutlines: Dr. Jamie Caughran, breast surgeon and medical director at the Mercy Health Comprehensive Breast Center, Grand Rapids


Graf of levels of density:

  1. The breasts are almost entirely fatty.
  2. There are scattered areas of fibro glandular density.
  3. The breasts are heterogeneously dense, which may obscure small masses.
  4. The breasts are extremely dense, which lowers the sensitivity of mammography.

Copyright (c) 2016. All rights reserved, Emma Blogs, LLC


Enabling the future


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Full show: Are You Dense? Detecting breast cancer to save your life.

Watch for a story on this in the Ionia Sentinel-Standard.

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GRAND RAPIDS, Mich.  (WOTV)-  Are you dense? It’s a question WOTV 4 Women and WOOD TV8 have been asking all month long. That’s because a new law took effect on June 1, 2015 in the state of Michigan requiring that women are notified of their breast density with their mammogram results.

This special brings together a series of stories and reports from WOTV 4 Women and WOOD TV8  to give viewers a broad understanding of breast density. We’ve been talking to doctors, radiologists and breast cancer survivors to equip West Michigan women with all of the information they need to understand.

This topic is far-reaching; almost half of all women are estimated to have some form of breast density, which makes it harder to spot breast cancer on an annual mammogram.  Dense breast tissue and cancer both appear white on a mammogram making additional screenings necessary…

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New study suggests heart disease research should focus on women

This is very important.

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(WOTV) — A new study suggests much more work needs to be done when it comes to young people and heart disease deaths, and the focus needs to be put on women.

New research shows deaths from heart disease have declined dramatically over the last few decades in people over 65, but that’s not true for people under 55, especially women.

“The next step would be trying to understand why this younger population is not showing the improvement the older patients do,” said Dr. Alexander Gorodnitskiy, cardiologist at Lenox Health in Alabama. “It is because of the traditional risk factors and they’re citing increases in obesity and diabetes, in this population.”

Researchers at Emory University also point out that diabetes and obesity may pose a greater heart disease risk for younger women.

Heart disease is still the number one killer of both men and women in the U.S…

View original post 110 more words

Eyeology with Dr. Verdier

New eyes one year later.


New eyes one year later

By Emma Palova

EW Emma’s Writings

Grand Rapids, MI- It’s been exactly a year since I’ve had surgeries to remove cataracts from both eyes. The process took close to two months at the Verdier Eye Center in Grand Rapids.

In May, I went almost completely blind to a point where I could no longer drive or write because I couldn’t see the computer screen or the windshield. And that’s exactly what a cataract is- a dirty windshield or lights on the car. Some cataracts take years to develop, mine only took two years from the first consultation. They don’t necessarily just strike older people, which is also one of common misconceptions.

Verdier Eye Center Dr. David Verdier, a recognized eye surgeon

I couldn’t see the TV screen, so I couldn’t do my yoga practice. I cried hard. I was afraid I wouldn’t be able to see my son…

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Lunch from farmers markets

From farmers fields to table

By Emma Palova

EW Emma’s Writings

Belding, MI -I picked up both my lunch and dinner at the local farmers’ markets. They are your local source for the freshest produce close by. At Paulson’s Pumpkin Patch you can see the owners picking the fresh vegetables from the road stand.

At this time of the year, the markets offer summer squash, zucchini, red beets, romaine purple lettuce, dill cauliflower, cucumbers, black raspberries and red potatoes.

The local markets are cheap, you are supporting the local economy and at the same time doing something good for yourself and the family.

Fresh produce from the farm.

Fresh produce from the farm.


Fresh produce from Paulson’s Pumpkin patch in Belding, Michigan.

I made salad with cucumbers, cantaloupe, black raspberries, red peppers, olives and tuna for lunch.


All locally grown except for tuna and olives.

Lettuce lunch cups with tuna and cucumbers.

Lettuce lunch cups with tuna and cucumbers.

From this same batch of fresh produce for $8.25, we will have a dinner tonight. It will consist of fried cauliflower from the farm picked this morning with red potatoes from another stand and cucumber salad with yogurt.

Fried cauliflower for dinner.

Fried cauliflower for dinner.


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BlogHer conference connects

I feel privileged that I could have been a part of the #BlogHer15 conference via fellow blogger @cherylstober.
Watch for more news for a well balanced life, as the BlogHer slogan goes: A life well said. Welcome to new horizons.


BlogHer conference in NYC July 17 & 18

By Emma Palova

EW Emma’s Writings

I am sharing this through my new blogger friend Cheryl Stober, a syndicated blogger on the  BlogHer platform. She has been blogging for eight years, at a time when I was chasing after stories and yawning at  township meetings for print media.

“You gotta cover that,” said the editor also yawning, “It’s our bread and butter you know.”

Among hundreds of posts, Stober caught my attention with her nice piece about getting ready for the conference. I was bummed that I couldn’t go so I literally devoured the article and commented and I got a comment back. And there you go we were friends.

My new BlogHer buddy Cheryl Stober My new BlogHer buddy Cheryl Stober

“I hope to meet you at the conference next year,” she wrote. “Follow me on @cherylstober.”

Her article included getting new business cards and clothes for…

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