ROCHESTER, N.Y. — The FDA’s new requirements for mammograms went into effect this week. Next time you go in for an exam, you’ll be leaving with some new information about breast density.

A mammogram is an X-ray exam of your breast that’s looking for breast cancer. Doctors scan those images, looking for unusual lumps or masses. Dr. Jennifer Harvey, chair of imaging sciences at the University of Rochester Medical Center, explains that the problem is that everyone’s breasts are different, so the density of breasts can vary. Denser breasts can make mammogram results less reliable.

“A lot of times it’s like, ‘Oh good, it says negative, that’s great, I can go on with my life.’ And we do rely a lot on healthcare providers to say, ‘Wait, wait, wait, you’re dense, let’s get you back in for more screening,'” Harvey said.

Harvey says the more dense your breast is, the more white tissue shows up on your X-ray. That blocks the X-ray. So if you have dense breasts, doctors have a harder time spotting that cancer.

The new FDA rules require that every doctor explains breast density to patients when they go in and get their results. The patient experience during the actual screening itself will not change.

Dr. Lori Medeiros, Rochester Regional’s Executive Medical Director of Breast Surgery, said a mammogram, which is an X-ray, is considered the best tool for finding cancer but it’s not perfect.

“It’s important to understand that density spans a whole spectrum of change and sometimes dense isn’t really all that different from a non-dense breast,” Medeiros said. “Sometimes it’s something that we really need to do additional things with. The first step is really talking to your doctor.”

One of its shortcomings is breast density, as cancerous masses show up white on the mammogram, just like dense breast tissue. New York already had a state rule to discuss breast density with patients. Dr. Medeiros herself was part of the original push ten years ago to mandate the conversation.

However, in states where this conversation wasn’t mandated or in more rural communities, it may have been overlooked. The new FDA rule provides language guidance and requires doctors to explain how density could affect mammogram results and what the next steps could be.

These steps may include an ultrasound or even an MRI if the risk of cancer is high and breast density makes the mammogram result uncertain. Medeiros says that major centers like Rochester Regional are well aware of these risks but the new regulations ensure that all patients receive this important information.

Women over 40 should be getting a mammogram once a year and looking at their results to understand their breast density and any potential risks.

If you don’t have insurance, you can still get a mammogram. Rochester Regional Health offers screenings to anyone without insurance through New York State’s Cancer Services Program. Elizabeth Wende Breast Care also utilizes the state program.

The University of Rochester uses its mobile mammogram unit to offer free screenings throughout the year. The next is this Saturday from 10 a.m. to 3 p.m. at the Romulus Fire Department.

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