Scott Webb (Host): Individuals who have dense breast tissue are at higher risk for developing breast cancer, and that's why regular exams and mammograms are essential. And joining me today to tell us more about dense breasts and the fairly new Ohio legislation that can help offset some of the costs for regular screenings is Dr. Patrick Slattery. He's fellowship-trained in breast imaging and he's a radiologist with Summa Health.

Host: This is Healthy Vitals, a podcast from Summa Health. I'm Scott Webb. Doctor, thanks so much for your time today. We're going to discuss an important topic today, breast density and what that means and how it's diagnosed and so forth. So, let's just start there. What does that mean? What is breast density?

Dr. Patrick Slattery: Yeah. So, breast density discusses how much of your breast is made up of fibroglandular tissue or fibrous tissue versus fatty tissue, which are the three main categories that kind of are the tissue that make up the breast.

Host: Yeah. So, there's different types obviously. Maybe we can, you know, go into a little more detail there, just in understanding why is this even something that we're discussing, why is this an important topic. So, maybe just go into a little more detail about the different types.

Dr. Patrick Slattery: There's mostly fatty breast density, which is exactly as it sounds. It's breast tissue that's mostly made up of fatty tissue. Scattered fibroglandular breast tissue is another kind of low breast tissue density, which is made up of fibroglandular tissue and fatty tissue, but mostly fatty tissue. And then, there's heterogeneously dense breast tissue, which is made up of more fibroglandular tissue than it is fatty breast tissue. And then, extremely dense breast tissue is where the breasts are mostly made up of fibroglandular tissue. And this is an important topic because women who have dense breast tissue, which is the categories of heterogeneously dense or extremely dense, it decreases the ability to detect breast cancer on yearly screening mammograms.

Host: I see. Okay. So, more dense breasts, that can create some issues or complications in diagnosing other things. So then, how do you diagnose or discover dense breasts?

Dr. Patrick Slattery: So, the only way we currently have to discover breast tissue density is through imaging. The best modality for figuring that out is through screening mammograms. But it can also be seen on MRI or breast ultrasound.

Host: All right. So, a couple of ways, but basically gold standards in terms of discovering or diagnosing, if you will. What are some of the common misconceptions about breast density? You talked about, you know, dense breasts that make it more difficult to diagnose cancer and things like that. So, what are some of the misconceptions anyway about it?

Dr. Patrick Slattery: And so, I think the most common misconception out there is that you can tell the density of your breast based on, you know, physical exam or the way that your breasts feel. But as we discussed a little bit ago, the only way to know for sure if you have dense breast tissue is through imaging, most commonly seen on mammograms, but you cannot diagnose dense breast tissue on physical exam.

Host: Right. So, some imaging would be necessary, whether that's screening mammogram, or as you say, MRIs, that kind of thing. We'll talk about misconceptions anyway. If a person does not have dense breasts, does that mean that they don't need to be screened as often? Can they sort of be screened less often because they don't have dense breasts?

Dr. Patrick Slattery: This is a very common misconception. And unfortunately, the answer is no. I know that some women don't like getting yearly screening mammograms, but early detection is our best treatment or prevention for breast cancer and the gold standard for early detection is yearly screening mammograms. And so, even if you don't have dense breast tissue, it's still important to get your yearly screening mammogram in order to detect any changes in your breast tissue.

Host: Yeah. And you discussed that a person having dense breasts then maybe presents some complications anyway in terms of diagnosis for something like breast cancer. Does that mean that they're at higher risk or greater risk for developing breast cancer because of the dense breasts?

Dr. Patrick Slattery: Yes, that is correct. So, it's kind of a double edged sword in the sense that dense breast tissue makes it harder to detect breast cancer on mammogram, and it also increases patient's risk of developing breast cancer at some point in time in their life.

Host: Yes, you can see that really the importance of regular screenings, early diagnosis. And I know in the last year, Ohio passed legislation to expand the coverage for screenings, which is awesome. Maybe you could tell us a little bit more about that and what patients should really know.

Dr. Patrick Slattery: Yeah. So, a really great bill that was passed and it requires insurance companies to cover additional screening beyond just yearly mammograms for patients who are at high risk or have dense breast tissue and patients who are at high risk have like a family history of breast cancer or other risk factors that increase their risk of developing breast cancer in their lifetime.

Host: Yeah. And you mentioned their family history and genetics, which of course none of us can outrun, but good if we know our family history and genetics, especially if that means, you know, earlier screenings for different types of things like breast cancer. Is there anything else individuals can do? Are there behavior and lifestyle things that people can address or be mindful of that can reduce their risk of developing breast cancer?

Dr. Patrick Slattery: Breast cancer along with other forms of cancer, the best way to reduce risk is by leading a healthy lifestyle, partaking in a healthy diet and regular exercise, as you said, that we're unable to change our genetics or our family histories, but the things that we can control are kind of our lifestyle and making healthy choices, maintaining a good weight and regular exercise are all very important aspects of that.

Host: Yeah, for sure. As you're saying, your message here is, you know, to sort of live as healthy as you can, be as healthy as you can, make good choices, be screened, all that good stuff. It's been really educational today, doctor. As we wrap up here, just final thoughts, takeaways, things that you really want listeners to know if they suspect that maybe they have dense breasts and really haven't been screened or screened as often as they should have been and so forth, what would you like them to know?

Dr. Patrick Slattery: Yeah. So, kind of going back to the law that we discussed earlier in Ohio about additional screening that's covered by insurance companies. And that is screening breast ultrasound and breast MRI for patients who are high risk or have dense breast tissue. Here at Summa, we offer, , breast MRI as our additional screening option for patients who have dense breast tissue or are at high risk for breast cancer. And so, genetics and family history and personal history all kind of come into play with regards to personal risk of breast cancer. And so, I think it's just really important for women to talk to their doctors about their personal risk of developing breast cancer, and if they do qualify for additional screening, what types, what is covered by insurance and what options they do have.

Host: Yeah, that's perfect. As always, we want folks to reach out to their providers, understand their risk factors. And as you were saying about this new legislation that was passed, take advantage of that if they can. Doctor, thanks so much for your time today. You stay well.

Dr. Patrick Slattery: All right. Thanks. You too.

Host: And for more information on today's topic, go to summahealth.org/breastdensity. And if you found this podcast to be helpful and informative, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is Healthy Vitals, a podcast from Summa Health. I'm Scott Webb. Stay well, and we'll talk again next time.