Changing the Narrative of Breast Cancer Screening

When most people think about breast cancer screening, mammography immediately comes to mind. While mammograms are beneficial exams and are a great option for preventative screening, the fact is that mammograms can miss approximately 30 to 35 percent of invasive breast cancers. 

No method of breast cancer screening is perfect; even tomosynthesis (3D mammography) misses 20 to 25 percent of invasive breast cancers. However, breast MRI misses less than 5 percent, and the Cris Collinsworth ProScan Fund (CCPF) is working to make sure the women in the Tri-State area know that when it comes to breast cancer screening, there is no one-size-fits-all approach. CCPF is working to educate women about their options through their Pink Ribbon Empowerment Program, or PREP. 

The reason mammograms do not serve the needs of all women equally is due to physiology. What many do not realize is that different women have different screening needs, in particular women with dense breast tissue. For those women, a breast MRI is a more accurate option. CCPF is dedicated to making breast MRIs available and accessible to those who need them through the new Pink Ribbon Breast MRI Program.

Mammograms are still a vital part of screening. For a patient with fatty breast tissue and a level 1 density, a screening mammogram is an excellent test. It is affordable and covered by insurance. However, for a patient with level 4 density, especially if they have a family history of breast cancer, they should consider other types of imaging especially an MRI. Mammography sensitivity in women with dense breast tissue can be as low as 30-45 percent, whereas mammography sensitivity in women with fatty breast tissue is closer to 98 percent. In a very dense breasted woman, even tomography (so called 3D mammography) has its limitations.

The good news is that CCPF provides educational programs to make sure women are equipped to make the best decisions for their health. Through community outreach, CCPF educates women on the importance of breast health and the services available. In addition, through interactive presentations, CCPF empowers women to be proactive about their health. 

For example, during the Power of Prevention lecture at ProScan in October of 2016, Dr. Stephen Pomeranz, the CEO and medical director of ProScan Imaging and president of the Cris Collinsworth ProScan Fund, explained how to find out if you have dense breast tissue. In short, your initial mammogram should tell the story. "After you receive a mammogram, you will receive a letter as a follow-up. In Ohio, it is required for providers to include in the letter if the patient has dense breasts. If it is not listed on your letter, you should ask your physician and if you have dense breasts, you should consider a breast MRI." Your level of breast density can change over the years, which is why it is important to get an annual mammogram and always check your density level on each report.

Unfortunately, MRIs are more costly than mammograms. However, CCPF has developed an enhanced Pink Ribbon Breast MRI program that provides financial assistance for patients who have dense breasts (as determined by their mammogram) and for whom a breast MRI would be more beneficial. Patients who meet the requirements and whose income level is at or below 400 percent of the federal poverty guidelines will be eligible for funding.

The goal of the Pink Ribbon Breast MRI program is to make screening breast MRIs affordable and accessible to more women. According to the American Journal of Roentgenology, dense breasts on a mammogram are the strongest independent risk factor for breast cancer other than age or genetic risk.

"We focus on the steps to being conscientious about your own personal health," says Maggie Fennell, executive director of the Cris Collinsworth ProScan Fund. "We are constantly educating people to be their own advocate and to utilize us as a resource." 

Above all, CCPF wants women to know the steps to take to be proactive about their breast health: 

1. Do your self breast exam.

2. Know yourself. If something seems different, have it checked.

3. Get your baseline screening mammogram between age 35 and 40, and every year after age 40, unless your physician recommends starting earlier due to risk factors or family history. Visit the ProScan Pink Ribbon Centers because you are helping to support all of the programs: Pink Ribbon Bags, Survivor Circle, Cruisin’ for a Cure Vans, Pink Ribbon Empowerment, Mammogram Match and the breast MRI.

4. If you have dense breasts, talk to your physician about a breast MRI to see if it is the right test for you.

Despite tremendous strides in research and screening, more than 40,000 people will die from breast cancer this year in the United States alone. That is why CCPF is doing its part to be a partner with patients in breast cancer diagnosis and early detection, empowering them to be their own advocates. 

"Being proactive includes doing your own monthly self breast exam," says Fennell. "Self breast exams are the best way to know what is normal for you, and will enable you to better recognize when something is different."

The Cris Collinsworth ProScan Fund is located at 5400 Kennedy Avenue, Cincinnati, OH 45213. For more information, call 513.924.5038, email ccpfevents@proscan.com or visit www.ccpf.org.