Michele Winn didn’t know having dense breasts increased her risk of breast cancer, despite having first been diagnosed with the disease eight years ago.
“They found something back when I was 50, and they immediately took me in for an ultrasound,” she said. “They just saw a shadow, but they couldn’t, they had to make sure with the ultrasound, and that’s when that all got set into motion, and it was definitely there.”
Winn was surprised to learn this year that she once again had breast cancer — this time on her other breast. She said she has been diligent about getting her mammogram every year.
“I could tell by the look on her face there was something, but she couldn’t say. And then they brought somebody in and said they had to do a biopsy.
“They did tell me they were dense, but again, I heard everybody’s dense so I didn’t really take too much stock in it, but it’s real,” Winn said.
The Risks of Dense Breasts
The breasts are made up of fatty tissue and dense tissue, which includes the milk glands, milk ducts and supportive tissue. A person with dense breasts has more dense tissue than fatty tissue.
“We can’t change our breast density,” said Dr. Jennifer Gass, the director of the Breast Health Center for Care New England who is also a professor of surgery at Brown University.
Gass said the only way to know if a woman has dense breasts is through a mammographic finding.
About half of women 40 and older have dense breasts, which can make mammograms harder to read.
“The fatty tissue is helpful in the breast because on (an) X-ray mammogram, the fatty tissue is very translucent,” Gass said. “And so when the mammogram is translucent, then the density pops out like a light bulb. But when the mammogram is dense, the brilliance of that light bulb is masked by all of that density.”
According to the Susan G. Komen Breast Cancer Foundation, women with very dense breasts are four to five times more likely to get breast cancer than those with fatty breasts. It’s a sobering statistic for Charles Kelley. His wife, Ann, died of breast cancer in 2019.
How Ann Kelley’s Cancer Diagnosis Helped Others
“It was quite a shock to her and all of us when she found a lump in her breast. She said, ‘Well, it can’t be anything serious because I’ve just got a clean bill of health from a mammogram,’” Kelley said.
Ann Kelley’s doctor recommended she get an ultrasound, which found a tumor in her breast. When the mother of two asked why the tumor didn’t show up on a mammogram, the doctor said it was because she had dense breasts.
“She being a very logical CPA and business person said, ‘Well, why hasn’t someone told me this years ago that I should have had some alternative procedures?’” Charles Kelley said. “And so we talked about it, and that set her off on not only fighting her own fight with cancer, but also fighting to make the public and particularly women aware that they needed to be an advocate for themselves.”
Breast Density Notification
Ann Kelley helped write and pass a law in Rhode Island that requires health care facilities that perform mammograms to notify patients if they have dense breasts. It took effect in 2014.
“Patients receive a letter about their mammogram result,” Gass said. “And on that mammogram result letter was an additional paragraph about your breast density, and that if you were dense that you should be asking your provider for additional imaging such as ultrasound or MRI.”
A Rhode Island law took effect this year that requires insurance companies to cover additional screening needed for patients with dense breasts.
“Before this legislation, my office spent some time working to ensure there would be coverage. So there was unnecessary work effort to ensure that the patient could get the test that she needed,” Gass said. “So now hopefully with this legislation, it will be more streamlined and really the woman should be able to advocate for herself.”
Advocating For Your Health
Winn said she has learned how important it is to advocate for your health. Her cancer was found early and she said her prognosis looks good, but she added that she did not know she could have benefited from additional screening over the years because she has dense breasts.
“That’s why this time when I went in and they said there was something there, I was angry. I was like, ‘Why haven’t I been getting an ultrasound all this time if my doctor recommends it now?’” Winn said. “There were two schools of thought with whether or not an ultrasound was necessary with every mammogram. Again, they might find something with every ultrasound and go in unnecessarily. But in this case, I’m glad they did.”
Doctors say ultrasounds and MRIs can lead to false alarms and involve unnecessary biopsies. It’s a concern Kelley heard when his late wife was working to pass the legislation but he believes it is worth it.
“I grew up around strong women. My wife was a strong woman,” Kelley said. “They want to know what’s going on with their body and their health, and it’s a lot more anxiety-prone to be dealing with surgery and radiation and chemotherapy than just finding out that you maybe should get a little biopsy.”
Kelley has no doubt that Ann has saved lives and continues to make an impact.
“Many people have said to me, ‘I never knew that I needed these additional procedures.’” he said. “And a couple of people have actually said, ‘We found a tumor early, stage one,’ and if they hadn’t found it, it could have developed and metastasized and been a real problem for that person. So there’s nothing more rewarding or heartening or a greater tribute to Ann’s efforts than those women.”
