- With Mayo Clinic internist
Sandhya Pruthi, M.D.
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Sandhya Pruthi, M.D.
Sandhya Pruthi, M.D.
Dr. Sandhya Pruthi, certified by the American Board of Family Practice, has been practicing medicine at Mayo Clinic since 1995 with special interests in breast diseases and women's health.
She is a consultant in the Department of Internal Medicine, Division of General Internal Medicine, and the Breast Diagnostic Clinic. She is an assistant professor of medicine at Mayo Clinic College of Medicine in Rochester, Minn.
The Winnipeg, Manitoba, native stresses education and patient-related research and has been active in both areas since joining Mayo Clinic. She is the primary investigator at Mayo Clinic of several clinical trials evaluating new agents for the prevention of breast cancer and identification of biomarkers for early detection of breast cancer. Her other research and clinical interests include managing the health of women who are at increased risk of breast cancer, breast pain and hot flashes, and developing patient education decision-making tools for breast-related concerns. She is director of the Breast Diagnostic Clinic and is a member of the Women's Health Executive Committee. Dr. Pruthi has been newly elected as a member to the board of directors for the American Society of Breast Disease. She has assisted with a variety of articles for MayoClinic.com.
"Having an opportunity to share information with my patients in the way that will help them to understand and be able to make educated decisions about their own health is very important to me," she says.
"The Web has become a major information site for people, and I want them to get the best and accurate information to be able to make informed choices for themselves, their family members and friends."
Cancer (3)
- Mammogram: Can it find cancer in dense breasts?
- Breast implants: Do they interfere with mammograms?
- Conflicting mammogram results: What should I do?
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Question
Mammogram: Can it find cancer in dense breasts?
I've read that a mammogram is useless when it comes to detecting cancer in women with dense breasts. Is this true?
Answer
from Sandhya Pruthi, M.D.
Dense breasts can make traditional mammograms more difficult to interpret. But this doesn't mean a traditional mammogram is useless for detecting cancer or other breast abnormalities in women with dense breasts.
Breast tissue is composed of fatty (nondense) tissue and connective (dense) tissue. The relative ratio of fatty tissue to connective tissue differs among women. As women age, their breasts tend to become less dense.
Dense breast tissue appears as a solid white area on a mammogram film, and fat appears as a dark area. Mammogram X-rays do not penetrate — or "see through" — dense tissues as well as they do through fat. So, in women with dense breasts, mammograms are more difficult to interpret. Tumors also are dense tissue and appear as solid white areas on the mammogram. This can make it more difficult to detect a tumor in dense breasts because it looks a lot like the dense tissue that surrounds it. It's not clear why some women have denser breast tissue than do others.
Some studies have found that newer digital mammography does a better job detecting cancer in dense breasts than does traditional mammography. A digital mammogram produces images on a computer screen that can be enhanced and magnified for closer viewing. However, digital mammograms aren't as widely available as are traditional mammograms. Also, some insurance companies won't pay for the more expensive digital mammograms.
Make an appointment with your doctor if you notice any worrisome breast signs or symptoms, such as a lump or nipple discharge, even if a recent mammogram was normal. Your doctor may recommend other imaging tests, such as a breast ultrasound, to further investigate a breast abnormality.
Next questionBreast implants: Do they interfere with mammograms?
- Pisano ED, et al. Diagnostic performance of digital versus film mammography for breast-cancer screening. The New England Journal of Medicine. 2005;353:1773.
- Mammograms. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/Detection/screening-mammograms. Accessed Sept. 14, 2009.
- Mammography. RadiologyInfo. http://www.radiologyinfo.org/en/info.cfm?PG=mammo. Accessed Sept. 17, 2009.
- Berg WA. Tailored supplemental screening for breast cancer: What now and what next? American Journal of Roentgenology. 2009;192:390.
- Mammography. Susan G. Komen Foundation. http://ww5.komen.org/BreastCancer/Mammography.html. Accessed Sept. 17, 2009.
- Pisano ED, et al. Diagnostic accuracy of digital versus film mammography: Exploratory analysis of selected population subgroups in DMIST. Radiology. 2008;246:376.
- Venkataraman S. Breast imaging: Mammography and ultrasonography. http://www.uptodate.com/home/index.html. Accessed Sept. 17, 2009.
- Pruthi S (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 24, 2009.
