Dr. Randy Miles

Meet Dr. Randy Miles, Medical Advisor to My Density Matters October 10, 2024

Dr. Randy Miles, Chief of Breast Imaging at Denver Health, works to improve patient care at all levels, from reducing wait times for appointments to setting policy for new screening tools to educating women about breast density.

“It’s important that women know their breast density. One, it may decrease the radiology sensitivity and make it harder for radiologists to identify cancer. Two, it does increase your risk for breast cancer,” he said.

While this breast radiologist is on the front lines of breast cancer screening, Miles knows many women have the first chance to talk about their breast health with their primary care physician.  He recognizes it’s a challenging but opportune situation.

“Many times when you’re in these primary care appointments, you’re covering so many topics related to your health that breast health can often be overlooked. It’s important to understand how to bring up this topic of breast health and breast density, and make sure that you’re getting the right information so that you can get the best care based on your preferences,” he said.

So what are the doctor’s orders?

Learn about your own breast density and ask for a breast cancer risk assessment at the age of 25.

“This is important because if you are at high risk for breast cancer, particularly if you have a greater than 20% lifetime risk, you actually start breast MRI screening at age 25 based on certain guidelines,” he explained. “It’s not only breast density, it’s not only risk, it’s all these things combined to make sure that you’re getting the appropriate screening.”

The next step is talking to your doctor to fully understand the various types of screening, including contrast enhanced mammography which, Miles said, is becoming more widely available.

“Contrast enhanced mammography is really going to help us detect breast cancer in dense breast tissue. If there is cancer that’s hiding, we’ll see it pretty much light up and stand out from the background,” he said.

While there are no current standard recommendations for who should undergo contrast enhanced mammography, Miles is working with his colleagues nationwide to establish  parameters through the American College of Radiology.

At the same time, he’s very aware of the challenges women face just getting to an appointment and working to reduce wait times.

“I’m talking to other leaders in their roles and probing: what are you doing to try to improve the experience for your patients?” he said.

Miles’ attention to the details and the big picture of breast health began early in his career

“I decided to actually take a year off in medical school after discovering this love for radiology because I really wanted to connect my interests and my medical interests and interpreting images to public health goals,” he said.

He went on to earn a master’s degree in public health and dug into the breast cancer mortality disparities in certain populations.

“African American women are about 41% more likely to die from breast cancer. We know that Hispanic women are more likely to be diagnosed with an advanced stage of disease,” he said.  “I was hooked in terms of really trying to attack this issue of gaps in care for women dealing with breast cancer and being a part of the solution.”

We are grateful that Dr. Miles is working alongside us to address the challenges in all areas of detecting breast cancer.

Meet other members of the My Density Matters Medical Advisory Board.