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The new FDA policies are directed at both patients and doctors. Getty Images

The Food and Drug Administration (FDA) has announced the first policy change in more than 20 years involving mammography services for women.

Agency officials are recommending new steps to modernize breast cancer screening and provide patients with more information when they’re making decisions about breast healthcare.

“It can be difficult for primary care doctors to be as informed as they should be, but we need to educate them to have meaningful discussions with their patients,” Dr. Michele Carpenter, FACS, breast surgeon and cancer specialist with St. Joseph Hospital in California, told Healthline.

According to the Centers for Disease Control and Prevention (CDC), other than for some kinds of skin cancer, breast cancer is the most common cancer in women regardless of race or ethnicity. Almost 85 percent of breast cancers develop in women with no family history of the disease, reports

Breasts with a higher proportion of fibroglandular tissue compared to fatty tissue are considered “dense.” Besides increasing breast cancer risk, this tissue also makes it more difficult to spot tumors during screening.

The FDA now recommends mammogram providers tell patients if they have dense breast tissue and that it indicates a higher cancer risk. These women should also be advised to get additional testing, such as an MRI or ultrasound.

“Since we’ve done this in California for a while, I’m glad they’re making it nationwide,” said Carpenter. “It’s important for women to understand what we can and can’t see, especially in dense tissue.”

The FDA is also proposing to add new categories for mammogram assessment.

These include a category called “known biopsy proven malignancy,” which would help healthcare professionals identify cases where cancer has already been identified in breast screenings.

Additionally, under the proposed regulations, both patients and healthcare providers would receive more detailed information about the mammography facility to improve post-exam communications.

“Breast cancer is one of the most worrisome health concerns facing women. The FDA plays a unique and meaningful role in the delivery of quality mammography to help patients get accurate screening to identify breast health problems early, when they can be effectively addressed,” said FDA Commissioner Dr. Scott Gottlieb in a statement.

Mammography technology has come a long way since the current regulations were published.

The FDA changes take into consideration new advances made in the decades since the current regulations were released.

For example, a recent study finds that using a new process called three-dimensional (3D) mammography with conventional mammography detected more cases of breast cancer than conventional screening alone.

But will insurance cover these new tests?

“Other screening methods aren’t covered by insurance in the same way that mammograms are,” Dr. Cassandra Chow, breast surgeon and medical director of the breast care program at Santa Clara Valley Medical Center in California, told Healthline. “But, if FDA recommendations change, it seems likely that insurance companies would have to cover them.”

According to the American Cancer Society, false-negative results are common. That’s when a mammogram looks normal although there is a breast cancer.

“Conventional screening won’t find about 20 percent of breast cancers, but 3D mammogram was developed to overcome the problem of evaluating dense breast tissue,” said Chow. “There are promising studies showing a decreased false positive rate and significant increase in cancer detection rate with this technology.”

Also, detection rates may soon be improved with new screening methods developed by Menssana Research that use a breathalyzer or urine samples to detect signs of cancer.

A 2018 pilot study used highly advanced software to find that the Menssana breath test detected cancer with an accuracy of about 95 percent.

However, the urine test was a little less precise at roughly 85 percent.

According to the CDC, the biggest factors that affect the risk of breast cancer are impossible to change.

Among them are being a woman and reaching middle age. Because of this, most breast cancer is diagnosed in women age 50 or older.

But those aren’t the only unalterable risk factors, just the most common. Other important ones to consider include:

  • Starting your period before age 12 and starting menopause after age 55 can raise your risk.
  • Your risk is higher if you have a mother, sister, daughter, or multiple family members on either side of the family who had breast cancer.
  • Having had radiation therapy to the chest or breasts before age 30 increases risk of breast cancer later in life.

As mentioned earlier, having dense breast tissue will also raise your risk.

“It’s absolutely a risk in the extremely dense breast,” said Carpenter. “It translates into a high enough risk that most of the time we can make the case for a screening MRI.”

There are several simple lifestyle changes that can significantly improve the odds of avoiding breast cancer.

The National Cancer Institute lists actions you can take that include losing weight if you’re obese, not smoking, and getting sufficient exercise.

Hormone replacement therapy for menopause, if taken for more than five years, and some birth control pills have also been found to increase risk.

But routine screening can ensure your long-term health.

“The prognosis is very good with early detection. Stage zero to one breast cancer has a nearly 100 percent five-year survival rate,” emphasized Chow.

The FDA has announced new guidelines to improve breast cancer screening services for women.

There are unchangeable risk factors for breast cancer that mean some women should be especially vigilant about symptoms of breast cancer.

However, lifestyle changes can reduce the risk of cancer. These include losing weight, not smoking, and getting enough exercise.

With early detection, most breast cancer can be successfully treated.