- With Mayo Clinic internist
Sandhya Pruthi, M.D.
read biographyclose windowBiography of
Sandhya Pruthi, M.D.
Sandhya Pruthi, M.D.
Dr. Sandhya Pruthi, certified by the American Board of Family Practice, has been practicing medicine at Mayo Clinic since 1995 with special interests in breast diseases and women's health.
Dr. Pruthi is a consultant in the Department of Medicine, the Division of General Internal Medicine and the Breast Diagnostic Clinic. She is an associate professor of medicine at Mayo Clinic College of Medicine in Rochester, Minn.
The Winnipeg, Manitoba, native is enthusiastic about promoting education and patient-related research and has been active in both areas since joining Mayo Clinic. Dr. Pruthi is the primary investigator at Mayo Clinic of a clinical trial evaluating new agents for the prevention of breast cancer and has research interests in the identification of biomarkers for early detection of breast cancer.
Her other research and clinical interests include managing the health of women who are at increased risk of breast cancer, breast pain and hot flashes, and developing patient education decision-making tools for breast-related concerns.
She is past director of the Breast Diagnostic Clinic and has been a member of the Women's Health Executive Committee. Dr. Pruthi has been newly elected as a secretary of the executive committee for the American Society of Breast Disease. She has assisted with a variety of website content.
"Having an opportunity to share information and empower my patients in the way that will help them to understand and be able to make educated decisions about their own health is very important to me," Dr. Pruthi says.
"The Internet is a tremendous resource and information site for people, and I want them to get up-to-date and accurate information to be able to make informed choices for themselves, their family members and friends."
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Question
Mammogram: Can it find cancer in dense breasts?
I've read that a mammogram is useless when it comes to detecting cancer in women with dense breasts. Is this true?
Answer
from Sandhya Pruthi, M.D.
Dense breasts can make mammograms more difficult to interpret. But this doesn't mean a mammogram is useless for detecting cancer or other breast abnormalities in women with dense breasts.
Breast tissue is composed of fatty (nondense) tissue and connective (dense) tissue. The relative ratio of fatty tissue to connective tissue differs among women. As women age, their breasts tend to become less dense.
Dense breast tissue appears as a solid white area on a mammogram, and fat appears as a dark area. Mammogram X-rays do not penetrate — or "see through" — dense tissues as well as they do through fat. So, in women with dense breasts, mammograms are more difficult to interpret. Tumors also are dense tissue and appear as solid white areas on the mammogram. This can make it more difficult to detect a tumor in dense breasts because it looks a lot like the dense tissue that surrounds it.
Some studies have found that newer digital mammography does a better job detecting cancer in dense breasts than does mammography that uses film. A digital mammogram produces images on a computer screen that can be enhanced and magnified for closer viewing.
Many, but not all, medical centers offer digital mammography. Ask your doctor for a referral to a center that offers this technology if you feel it's best for you.
- Mammograms. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/Detection/screening-mammograms. Accessed Nov. 3, 2011.
- Kerlikowske K, et al. Comparative effectiveness of digital versus film-screen mammography in community practice in the United States. Annals of Internal Medicine. 2011;155:493.
- Pisano ED, et al. Diagnostic accuracy of digital versus film mammography: Exploratory analysis of selective population subgroups in DMIST. Radiology. 2008;246:376.
- MQSA national statistics. Food and Drug Administration. http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/FacilityScorecard/ucm113858.htm. Accessed Nov. 3, 2011.
- The American College of Radiology BI-RADS Atlas and MQSA: Frequently asked questions. American College of Radiology. http://www.acr.org/SecondaryMainMenuCategories/quality_safety/BIRADSAtlas.aspx. Accessed Nov. 3, 2011.
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