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Dense Fog Can Lead to a Deadly Collision: Preventing a Fatal Flaw in Breast Cancer Screening

Originally Posted Feb 2nd, 2017

Nancy M. Cappello, Ph.D. Founder & Director,
Are You Dense, Inc. &
Are You Dense Advocacy, Inc.
See Bio

As seen in Huffington Post

Even though it was more than 5 decades ago, I vividly remember my 5th grade teacher, with tears in his eyes, relay the news to our 5th grade class that President Kennedy was shot. Many of us recall the exact time and place as we witnessed the devastating attack on our country on 9/11. Catastrophic events remain with us forever and, even decades later, within seconds we can drift back to the exact time and place of these indelible memories.
Meeting Cheri Rauth is one of those haunting occurrences. I was at our Printers - reviewing the final touches of our program booklet for our annual fundraiser - The Are You Dense MusicFest. Multi-tasking as usual, I glanced at my phone and caught sight of a ‘survivor’ story submitted from a woman named Cheri from Nebraska. Embedded in the story was a picture of Cheri with her husband Bill. Her stunning beauty made me pause - it was like viewing a masterpiece painting - and Bill wasn't too shabby either. Wow - I guess Barbie and Ken do exist.

As I read her story, my heart sank. I was incensed that Cheri, like many women with dense breast tissue, was denied equal access to an Early Breast Cancer diagnosis, with a diagnosis of stage 4 breast cancer. "This is so unfair; she had annual mammography screenings for 15 years," I exclaimed to my husband and then continued with my rant and rave about this fatal flaw in breast cancer screening. I responded within minutes to her message and later posted her story on our website.

Residing in our social media neighborhood, this virtual world unites us with total strangers who in a short time become palpable friends, being introduced to their loved ones and witnessing their important life's events. From June 15, 2015, Cheri and I connected by email and also became Facebook friends. Cheri's dream to educate others about the impact of dense breast tissue on missed, delayed and advanced stage cancers was resolute. We had plans to advocate together for a density reporting law in Nebraska. We had a heart-felt connection. Within 17 months, Cheri and her family's dreams were destroyed. As I read the news on Facebook that Cheri passed on - I cried.

Launching and funding two breast-health non profits is an enormous responsibility which has monopolized my life since my advanced-stage breast cancer diagnosis thirteen years ago. "You must love what you do" has been asked of me by a myriad of folks since I experienced Connecticut's first legislative victory in 2005, to prevent missed, delayed and advanced stage breast cancer. The day to day activities of directing two nonprofit organizations are intense. The elation comes in the end zone by giving women with dense breast tissue the opportunity to have invasive cancer detected at an early stage, hence eliminating the grief of a loved one dying prematurely from this disease, as illustrated by Cheri's story.

The majority of my days are spent tethered to my desk, writing and responding to email messages, participating in conference calls, planning and attending meetings, communicating with our two Boards of Directors, planning fundraisers, reviewing budgets, soliciting donors, contributing to my blog, adding content to our websites, posting to social media, all to ensure that the business operates efficiently and that our life-saving message is accomplished. The inspiration to hunker down with a laser like focus to achieve our Mission occurs when I hear from women whose invasive breast cancer was diagnosed by adjunct screening, read research about the Connecticut Experiment, tell my story of patient turned advocate to an audience which appreciates the impact of our breast-health Mission, and educate policy makers at Press Conferences and Public Hearings about the impact of dense breast tissue on Early Detection. A trip to Lincoln, Nebraska to attend a Press Conference and testify at a Public Hearing in support of a density reporting law in memory and honor of Cheri Rauth, aptly named Cheri's law, was one of those rare heart inspiring moments that energize me to continue to relentlessly pursue our Mission to reduce advanced disease and, in turn, reduce mortality from this dream-killer disease. 

I was greeted this Friday morning with extremely dense fog from my Lincoln NE hotel window as I overlooked the historic Capitol building where I would spend the day with Cheri's husband and family, Nebraskan advocates and legislators. Chills overcame my body as Cheri's spirit encompassed me as I stared at the densely formed picture before me. The base of the Capitol was clearly seen like fatty breasts on mammogram, which, as I looked higher towards the dome, was completely masked, engulfed by the fog. As the morning progressed, the fog lifted and like adjunct screening in the dense breasts, the dome was visible. Tragically, Cheri's cancer was masked on mammogram because of her dense breast tissue reducing the visibility to see cancer by mammography alone. The purpose of Cheri's law and the other 28 density reporting laws and several introduced bills in 2017, is to empower women with the same information their doctors have to promote a breast-health dialogue between patient and provider about a personalized screening regimen. 

While I was honored to have a small part in advocating for Cheri's Law, it was a bittersweet day. The dense breast tissue of a mother, wife, grandmother and friend, who never missed her annual screening mammography, led to a delayed diagnosis which metastasized, leading to a deadly collision.
Lincoln NE Capitol Engulfed in Fog
 As the dense fog lifted, the dome was clearly visible.
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Please browse the website further to learn about dense breast tissue, use the available resources, read and share stories and consider making a donation to help expose this BEST-KEPT SECRET about the limitations of mammography alone to detect cancer in women with dense breast tissues.

Are You Dense, Inc. is a 501(c)(3) public charity. IRS Tax ID 26-3643216. All donations are tax-deductible as allowed by law.

  • Are You Dense? Fact #1:

    Breast density is one of the strongest predictors of the failure of mammography screening to detect cancer.

  • Are You Dense? Fact #2:

    Two-thirds of pre-menopausal women and 1/4 of post menopausal women have dense breast tissue. 

  • Are You Dense? Fact #3:

    Adding more sensitive tests to mammography significantly increase detection of invasive cancers that are small and node negative.

  • Are You Dense? Fact #4:

    American College of Radiology describes women with "Dense Breast Tissue" as having a higher than average risk of Breast Cancer.

  • Are You Dense? Fact #5:

    While a mammogram detects 98% of cancers in women with fatty breasts, it finds only 48% in women with the densest breasts.

  • Are You Dense? Fact #6:

    A woman at average risk and a woman at high risk have an EQUAL chance of having their cancer masked by mammogram.

  • Are You Dense? Fact #7:

    Women with dense breasts who had breast cancer have a four times higher risk of recurrence than women with less-dense breasts.

  • Are You Dense? Fact #8:

    A substantial proportion of Breast Cancer can be attributed to high breast density alone.

  • Are You Dense? Fact #9:

    Cancer turns up five times more often in women with extremely dense breasts than those with the most fatty tissue.

  • Are You Dense? Fact #10

    There are too many women who are unaware of their breast density, believe their “Happy Gram” when it reports no significant findings and are at risk of receiving a later stage cancer diagnosis.