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Debra Demeulenaere, Mammography Technician at Aspen Valley Hospital’s Breast Center, answers your questions on what every woman needs to know about dense breasts. Deb has been with Aspen Valley Hospital for over 45 years and has performed mammography for three generations of women, some in the same family.
“Just recently, I was having lunch with another Hospital staff member and in the course of our conversation she mentioned that she has always had dense breasts and that her primary care doctor had ordered a mammogram, and she would be booking an appointment,” says Deb. “We decided to put our conversation into a Q&A format for Breast Cancer Awareness Month to educate the women in our community on how to better care for their breast health.”
Q: I’m 40, and I have always had dense breast tissue. Can you tell me what this means?
Dense breasts are not uncommon. In fact, 40 percent of women have dense breasts. Your breasts are a network of milk ducts, milk glands, fatty tissue and supportive tissue that holds everything together. Supportive tissue is dense and shows up as white on mammograms. Fatty tissue is not dense and shows up as transparent, or black on mammograms. There are four categories of breast tissue: fatty tissue, where most of the tissue is composed of non-dense fat; and three categories of dense tissue, including scattered fibroglandular densities, heterogeneously dense and extremely dense tissues. Our fellowship-trained breast radiologists make the determination on which category your breast tissues fall into based on the ratio of dense tissue to non-dense tissue. Your breasts are considered dense if you have a lot of fibrous and glandular tissue and not much fat. Dense breast tissue appears as solid white areas on mammograms, which makes it difficult to see through. Now that you are 40 you should contact your primary provider and schedule your first mammogram. And, as you are in your 40th year, your mammogram is FREE! It is our gift to you, because regular screenings saves lives and having that “baseline” mammogram allows us to have something to gauge any changes, year over year.
Q: Am I more susceptible to tumors or cancers?
Dense breast tissue is linked with an increased risk of developing breast cancer, four to five times greater than that of women with fatty breast tissue. Annual screening mammography is recommended for women starting at age 40. Some women with elevated risk may benefit from screening earlier. With elevated risk and breast density, some women may benefit from supplemental screening with screening breast ultrasound and screening MRI, which can all be done at the Hospital.
Q: How does this affect my breast self-examination?
Dense breasts can be very difficult to self-examine because the lumpy, fibrous and fatty tissue is all mixed together. That said, you should become very familiar with your breast tissue and perform self-examinations regularly. You may notice something sooner rather than later that can be treated.
Q: Can a mammogram reveal everything that is going on in my breasts?
Every imaging test has a bit of gray area, and dense breast tissue is harder to interpret because it appears white on the mammogram. The more dense your breast tissues are, the more difficult to see what is going on, which means that there is an increase that cancer won’t be detected. A combination of mammography and ultrasound creates better imaging – more information for our fellowship-trained breast radiologists to interpret and diagnose. The technologies complement one another because they each detect what the other can’t.
Q: What, if anything, do I need to do differently to take care of my breasts?
A: If you are 40 or over, ask your primary care physician to order a mammogram for you. At the Hospital, our mammograms are read by breast radiologists who, upon reading your mammogram and evaluating your family history, may recommend a breast MRI for further evaluation.
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Q: What kinds of imaging technology and services are available at Aspen Valley Hospital’s Breast Center?
Aspen Valley Hospital invests in the very latest diagnostic imaging equipment to ensure accuracy when a deeper look is needed. Our equipment rivals that found in larger cities, and our patients receive whole-person support services from excellent caregivers. We are a very tight and nurturing team of women who surround our patients with care and compassion. We have put a lot of thought into creating a soothing, spa-like atmosphere in the Breast Center. And our breast screening room is sure to put you at ease. It is filled with an eclectic collection of breast-inspired art, accessories and trinkets that our patients have sent us over the years. Here’s a little more on the services we provide:
3D Mammogram Screening:
We were the first in the Roaring Fork Valley to acquire this technology in 2013, and we have many years of experience producing high-quality imaging for our breast radiologists to read.
Dense-breast Ultrasound Diagnostic Imaging:
One of our breast radiologists may want us to call back a patient for a breast ultrasound. As I mentioned before, this technology detects what cannot be seen in a mammogram.
Ultrasound-guided and Stereotactic Biopsy:
We added this service because our patients were having to go to Denver to get their biopsies. We wanted to offer our locals the comfort of getting this often emotional procedure close to home so they did not have to drive or fly back to the Roaring Fork Valley.
Coordinated Care via our Breast Navigator:
Heather Milne, RN, works to connect all of the dots between practitioners so that your experience is smooth. And she is there to answer your questions so you can be involved in your treatment.
Breast Surgery and Reconstructive Surgery:
At Aspen Valley Hospital, you will find an extraordinary combination of expert care from physicians with advanced training in breast cancer surgeries. Through a partnership with Surgical Specialists of Colorado (SSOC), the Hospital has access to two breast care surgeons onsite, complemented by a state-of-the-art surgical suite to match their expertise.
Oncology Care:
For our patients who require outpatient medical oncology, they can receive treatment here at the Hospital in the Marian and Ralph Melville Oncology and Infusion Center which is led by respected Medical Oncologist Dr. Stephen Mayer and our Family Nurse Practitioner Nancee Dodge, FNP-C, AOCNP who will guide your cancer treatment with care and compassion.
Chemotherapy & Infusions:
Personalized, quality care here in the upper Roaring Fork Valley means you can receive the treatment you need, close to home.
Nutrition Counseling:
With cancer, nutrition can be impacted. Our registered dietitian provides an individual assessment to all breast cancer patients to help determine the best diet to aid recovery, manage side effects and help maintain a healthy weight. She helps you overcome treatment complications including bowel complications, diarrhea, loss of hunger and medication side effects.
Oncology Rehabilitation:
Our oncology rehab team works collaboratively with our physical therapists to help you regain range of motion and your desired fitness level. Treatment includes exercise in a dedicated cancer rehab gym, massage therapy and skin care. It is offered at both Aspen Valley Hospital and at the After-Hours Medical Care clinic in Basalt.
Lymphedema Care:
Mastectomy or radiation treatment can sometimes create lymphedema, a buildup of fluid often in the arm and hand, and sometimes in the breast, underarm, chest, trunk or back. With early management, lymphedema can be controlled. Our lymphedema expert helps lessen symptoms with lymphatic massage, compression and exercises.
Genetic Counseling:
Knowing if your cancer is genetically driven helps determine your oncology treatment plan. Aspen Valley Hospital offers genetic counseling via telemedicine with licensed, expert genetic counselors in Denver, coordinated by our breast navigator.
Psychosocial Support:
Our clinical social worker provides ongoing support for breast cancer patients and loved ones before, during and after treatment. Services include counseling, case management, advocacy and connection to community resources with help setting up meal delivery, financial assistance, home care (e.g. nursing help with drains) and more.
Q: What is a Breast Navigator?
Whether you are here for your annual visit or for more complex care, our Breast Navigator, Heather Milne, RN, will be with you from your very first mammogram to your final recovery, coordinating your care and providing you with the knowledge to empower your decision making.
Q: My daughter just turned 20 and she has dense breasts as well. Should she get a mammogram?
When there is a history of breast cancer, the daughter is eligible to come in for her first mammogram 10 years before it was detected in the mother. That way, our breast radiologists may be able get a head start on detecting any abnormalities.
Q: You have mentioned that you work with breast radiologists, what does this mean?
Our leading-edge imaging technologies are complimented by an elite group of fellowship-trained breast radiologists with advanced expertise in interpreting images of the breast. Less than 10% of radiologists are fellowship-trained in breast radiology, and we are the only breast imaging center in the Roaring Fork Valley to offer this.
Aspen Valley Hospital offers women in their 40th year a free mammogram. Contact your primary care physician to order a mammogram for you so you can receive this complimentary gift.
If you have questions about the Breast Center at Aspen Valley Hospital, call us at 970.544.1420. We are here to help.
