Singleton had just had her annual mammogram, but she followed up with a doctor who, thank God, ordered an ultrasound and 3D mammogram.
The mammogram missed a 3.6-centimeter tumor. The ultrasound didn’t.
Singleton, a 45-year-old mother from Savannah, had stage 2B breast cancer.
“How can that be?” she asked her doctor.
“Unfortunately, you have dense breasts, and that can hide your breast cancer,” the doctor told her. “It’s like trying to find a golf ball in the middle of a snow blizzard. It’s nearly impossible.”
That was in February. In the weeks and months that followed, Singleton had six rounds of chemotherapy, followed by a double mastectomy and reconstruction, followed by 25 rounds of radiation. Every three weeks, she returns for maintenance treatment to prevent recurrence and will have to take an oral chemo pill for the next 10 years.
Today her cancer is in remission, but let this be a lesson to us all.
Dense breasts hide cancer.
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“What’s really scary is that 50 to 60 percent of the population is walking around with dense breast tissue and don’t know it,” Singleton said. “It’s really scary.”
Yep, that’s scary, but here’s what’s scarier.
We get annual mammograms like doctors recommend, but no one ever tells us whether our breasts are dense or not.
Not only is breast density linked to increased cancer risk, it makes cancer harder to detect because dense tissue has a high proportion of fibroglandular or connective tissue, which shows up white on mammograms. Tumors also appear white, so you can’t see them.
The good news is 36 states have passed laws requiring that breast density be reported to mammography patients. The bad news? Georgia isn’t one of them.
Singleton is hoping that changes soon.
Credit: The Atlanta Journal-Constitution
Credit: The Atlanta Journal-Constitution
State Rep. Sharon Cooper, chairman of the Health and Human Services Committee, is set to introduce a bill, also known as “Margie’s Law,” early next year that would require doctors to report whether women have dense breast tissue, what that means and how they can protect themselves.
The Georgia law would make it mandatory to list a woman’s breast density on a mammogram report and provide information about her dense breast, her risk for getting cancer and the importance of talking to her doctor about additional screening.
We have Nancy Cappello of Connecticut to thank for states where the law already exists. Cappello was not told she had dense breasts until 2004, when doctors found advanced cancer her mammograms missed. She took her story to legislators, and in 2009, the state became the first to require that women be told if they have dense breasts and that insurance companies cover ultrasound scans.
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“Clinicians and medical organizations have turned a blind eye to the decades of science on dense breast tissue,” Cappello said. “I have learned that my experience with dense breast tissue and breast cancer diagnosis are similar to thousands of women, some who have needlessly died prematurely from breast cancer because none of their health care providers told them about their dense breast tissue and the need for more screening.”
Cappello, founder of the AreYouDense? Advocacy group, and Singleton are teaming up with Dune Medical to call attention to the significance of women's breast density and to gain support for dense breast legislation in the state of Georgia.
That partnership would not have happened had Singleton not shared her journey with Lori Chmura, a friend and former colleague, now CEO at Dune Medical, a medical device manufacturer.
Chmura connected Singleton with Cappello, and the three of them agreed to make Georgia the 37th state to ensure that women have information related to their breast density.
They are working now to bring the Georgia Legislature up to speed and get “Margie’s Law” to a vote.
I hope that happens quickly. Less than 24 hours after I interviewed Cappello for this piece, she passed away from complications from treatment. That might not have happened had she known her breasts were dense and received her cancer diagnosis sooner.
“With Nancy’s passing, I am struggling a bit,” Singleton said.
But she and Chmura are not done. Cappello got a law on the books in 36 states. Imagine how easy it’ll be for Singleton and Chmura — propelled by her memory now — to get Margie’s Law passed.
Who in their right mind would refuse them?
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