Breast Cancer Awareness month includes breast density information and care

SANTA BARBARA, Calif. – During Breast Cancer Awareness month local doctors and clinicians are raising awareness about dense breast tissue.

"Women with dense breast tissue benefit from additional whole breast ultrasound, and people who are high risk benefit from high risk screening breast MRI," said Dr. Winifred Leung.

Leung is a breast radiologist at Sansum Clinic, that is now part of Sutter Health.

Women who are high risk benefit from consultation with genetic counselors.

Doctor describe breast density as the amount of tissue in relation to fat rather than a lump felt during an exam.

"When breast tissue is dense mammographically, it makes it more difficult to detect breast cancer," said Dr. Leung. "Breast tissue looks white on a mammogram and the object of our search is also white, cancers and other masses are also white, so you can understand white on white is an obscuring effect. and ultrasound helps us look beyond that."

But dense tissue doesn't mean patients have an ultrasound instead of a mammogram.

"There's a lot of stuff that we can't see on ultrasound, including microcalcifications, which often are the earliest sign of a breast cancer, as well as overall, the overall landscape, what I call, you know, distortion in the pattern of the breast tissue,"  said Leung.

They credit 3D mammography with making a difference.

"There is no better test than mammography or tomosynthesis is what we actually use, sometimes referred to as 3D mammography. We use it universally now, so, it really is mammography, tomosynthesis is really the gold standard for breast cancer screening."

Thanks to breast density legislation mammogram results will let patients know if they have dense breast tissue.

Dr. Leung said it doesn't mean it is abnormal.

But dense breast tissue patients should talk to their doctor about additional tests, such as a breast ultrasound.

Patients may have mammograms and ultrasound on the same visit.

I'd much rather see them, you know, around the same time rather than, you know, several months apart, for example," said Dr. Leung.

Prior biopsies may also help create a risk calculator

Atypical cells are seen under a microscope may increase the risk of breast cancer.

"We often recommend high-risk screening breast MRI, in addition to mammography, and preferably performed at the same time."

The Ridley-Tree Cancer Center, now part of Sutter Health, has a high-risk breast clinic.

Dr. Katrina Mitchell, who is a breast surgical oncologist with Ridley-Tree Cancer Center said advances have led to excellent outcomes.

"We've had huge advances with systemic therapy, meaning chemotherapy, immunotherapy, targeted therapies with specific gene mutations, endocrine therapy, which is hormone blocking therapy for tumors that are growing using estrogen," said Mitchell, "an explosion of new drugs and new treatment modalities and really precision medicine.

Ridley-Tree Cancer Center Breast Surgeon, Dr. Rosa Choi, says surgical advances can save sensitivity.

"The skin and nipple sparing mastectomies with preservation of sensation to the nipple with what we call a neuroization or re-innervation of the nerve endings behind the nipple," said Dr. Choi, "so that's something that some of the centers do."

Lymph nodes samples taken during surgery can help doctors see if cancer has moved.

"We want to do the best cutting edge job that we can do for our community ," said Dr. Choi , "so that women don’t have to travel far for their breast cancer care. I think that is really important because we all live here."

For more information visit https://www.sansumclinic.org and https://www.ridleytreecc.org