In August 2015, I received my mammogram results. I was relieved to read “dense breasts” and not “suspicious findings.” Tossing the results aside, I went on with my day and life. Little did I know that five months later, during a routine self-exam, I would discover a suspicious, fingerling potato-sized welt under my right breast. What I wasn’t told regarding my mammography results was that dense breasts increase the risk of breast cancer diagnosis twofold. Five months had gone by while the cancer grew unabated to stage 2B.
Why was I kept in the dark about the significance of dense breasts? Why weren’t preventive healthcare measures offered to ensure early detection and avoid a devastating diagnosis? Unfortunately, this lack of awareness isn’t uncommon.
The degree of density was never disclosed to me nor that dense breasts could obscure breast cancer. The degree serves as a weather forecast, offering insights into the condition of our breasts. Picture a plane representing a potential tumor in the sky. On a sunny day, the plane stands out distinctly, just like a detectable tumor. On a partly cloudy day, most of the plane or tumor is visible, though not as clear. However, on a cloudy day, you sense the presence of an object, but it remains vague and suspicious. Similarly, highly dense breast tissue is akin to a mostly cloudy or overcast day, where nothing is discernible except for the density itself.
Women with dense breasts are at an increased risk for a breast cancer diagnosis and are more likely to have a false negative mammogram; something could be lurking, but the radiologist reading a mammogram can’t always tell. In those cases, you should ask your doctor for an additional screening study with more sophisticated imaging — an MRI and/or an ultrasound.
In spite of being a healthcare executive for over a decade, I, like most Black women, did not have additional screenings, which could have meant an earlier diagnosis and curative treatment instead of what turned out to be an aggressive HER2+ breast cancer that ultimately metastasized to my brain.
That is my story. That is unacceptable. Black women refuse to be invisible in the conversation about our own health, and it’s beyond time for us to be provided with better, more appropriate care.
While the overall U.S. breast cancer mortality rate has decreased by 46 percent since the 1990s, the decline for Black women is a dismal 26 percent. Women with dense breasts experience higher rates of interval cancers that emerge within a year of a normal mammogram. In 2019, 38 states mandated patient notification of breast density. But unfortunately, my state was not among them. This raises a pertinent question: why are Black women less likely to be referred for supplemental breast screening despite the lack of racial variation in breast density?
According to a 2020 study, “Minority women with dense breasts are less likely to be ordered supplemental breast imaging. Further research should investigate physician and patient behaviors to determine barriers in supplemental imaging. Understanding these differences may help reduce disparities in breast cancer care and mortality.”
Throughout my journey, I’ve found strength through community support. We are working together to educate Black women on what to do if their mammogram results say dense breasts: