Dr. Barry Rosen, breast surgical oncologist and Medical Director of the Breast Center and Cancer Prevention Program at Advocate Good Shepherd Hospital in Barrington, Illinois, is passionate about educating the public about breast cancer screening and prevention.

“The first message I think that we have to keep in front of our public audience is that mammograms save lives. But like all screening tests, there are limitations,” he said.  As a medical advisor for My Density Matters, Dr. Rosen is working to spread the word about that limitation.

“The problem with mammography is that it isn’t as sensitive for breast cancer in women who have dense breast tissue,” he explained, noting that there’s a 25% to 50% chance a doctor won’t see cancer on a mammogram in women with dense breast tissue because the dense tissue masks the cancer.

Making matters worse, women with dense breast tissue are at a higher risk for breast cancer.  Dr. Rosen calls it a “perfect storm of bad” and encourages women to work with their doctors to get additional testing when necessary.

“It is increasingly frustrating to see women diagnosed with breast cancer, who, in retrospect could have been diagnosed a year or two earlier, if only they had supplemental imaging beyond mammography because their breast tissue was dense,” he said, pointing women to the My Density Matters website where they can learn about density and additional screening options.

Looking to the future, Dr. Rosen expects breast cancer screening will improve with an increase in the use of abbreviated MRIs and eventually blood tests. “Cancer cells shed the DNA into the bloodstream in very, very small amounts that are now detectable.  For breast cancer, we’re not there yet,” he said.

He also predicts artificial intelligence will improve the consistency of evaluating density. “A radiologist looks up on the screen at the mammograms and literally goes A, B, C, D, and I call this the ping pong effect.  I follow patients who go back and forth between category B, and category C. It’s because of the subjectivity of the interpreting physician,” Dr. Rosen said.

With breast cancer on the rise worldwide, especially in younger women, Dr. Rosen hopes to see more screening at an earlier age particularly for those at an increased risk based on family history.

“The earlier we find that cancer, there’s a lower likelihood that [patients] need chemotherapy. There’s a lower likelihood that they need a mastectomy. So finding cancers early translates into better outcomes. You just have to do the right tests,” he stated.

We are grateful for the support of our entire medical advisory board.