By CARLA K. JOHNSON

When a woman has a mammogram, the most important finding is whether there’s any sign of breast cancer.

The second most important finding is whether her breasts are dense.

Since early September, a new U.S. rule requires mammography centers to inform women about their breast density — information that isn’t entirely new for some women because many states already had similar requirements.

Here’s what to know about why breast density is important.

Are dense breasts bad?

No, dense breasts are not bad. In fact, they’re quite normal. About 40% of women ages 40 and older have dense breasts.

Women of all shapes and sizes can have dense breasts. It has nothing to do with breast firmness. And it only matters in the world of breast cancer screening, said Dr. Ethan Cohen of MD Anderson Cancer Center in Houston.

With the new rule, “there are going to be a lot of questions to a lot of doctors and there’s going to be a lot of Googling, which is OK. But we want to make sure that people don’t panic,” Cohen said.

How is breast density determined?

Doctors who review mammograms have a system for classifying breast density.

There are four categories. The least dense category means the breasts are almost all fatty tissue. The most dense category means the breasts are mostly glandular and fibrous tissue.

Breasts are considered dense in two of the four categories: “heterogeneously dense” or “extremely dense.” The other two categories are considered not dense.

Dr. Brian Dontchos of the Seattle-based Fred Hutchinson Cancer Center said the classification can vary depending on the doctor reading the mammogram “because it’s somewhat subjective.”

Why am I being told I have dense breasts?

Two reasons: For one, dense breasts make it more difficult to see cancer on an X-ray image, which is what a mammogram is.

“The dense tissue looks white on a mammogram and cancer also looks white on a mammogram,” said Dr. Wendie Berg of the University of Pittsburgh School of Medicine and chief scientific adviser to DenseBreast-info.org. “It’s like trying to see a snowball in a blizzard.”

Second, women with dense breast tissue are at a slightly higher risk of developing breast cancer because cancers are more likely to arise in glandular and fibrous tissue.

Reassuringly, women with dense breasts are no more likely to die from breast cancer compared to other women.

What am I supposed to do?

If you find out you have dense breasts, talk to your doctor about your family history of breast cancer and whether you should have additional screening with ultrasound or MRI, said Dr. Georgia Spear of Endeavor Health/NorthShore University Health System in the Chicago area.

Related Articles

Walgreens to close 1,200 US stores as chain attempts to steady operations at home

St. Paul mayor says he won’t back $1.5 million supplemental insurance for retirees

What’s new and what to watch for in the upcoming ACA open enrollment period

Listeria recall of chicken hits Target, Walmart, Aldi, Trader Joe’s and others

Medicare open enrollment starts Oct. 15. Here’s what to know

Researchers are studying better ways to detect cancer in women with dense breasts. So far, there’s not enough evidence for a broad recommendation for additional screening. The U.S. Preventive Services Task Force called for more research in this area when it updated its breast cancer screening recommendations earlier this year.

Do I still need a mammogram?

Yes, women with dense breasts should get regular mammograms, which is still the gold standard for finding cancer early. Age 40 is when mammograms should start for women, transgender men and nonbinary people at average risk.

“We don’t want to replace the mammogram,” Spear said. “We want to add to it by adding a specific other test.”

Will insurance cover additional screening?

For now, that depends on your insurance, although a bill has been introduced in Congress to require insurers to cover additional screening for women with dense breasts.

Additional screening can be expensive — from $250 to $1,000 out of pocket, so that’s a barrier for many women.

“Every woman should have equal opportunity to have their cancer found early when it’s easily treated,” Berg said. “That’s the bottom line.”

October is the prime time to get a flu vaccine to protect yourself through the worst of the respiratory season.

However, keep your expectations in check.

This year’s shot may be less effective than last year’s at preventing severe disease. Newly released data from the Southern Hemisphere, where flu season typically runs from April through September, suggests that this year’s flu vaccines offer 34% efficacy against hospitalization, compared to 50% last year.

Overall, though, an evaluation of hospitalizations from places like Brazil, Argentina, Chile, Uruguay, and Paraguay suggests that people who were vaccinated for influenza were at significantly lower risk for hospitalization from a severe respiratory infection than those who did not get a flu shot.

The annual influenza vaccine targets three strains of seasonal flu, and scientists make an educated guess months before the fall season. It takes about six months for pharmaceutical makers to produce the flu vaccine. They try to create a formula that they believe will align perfectly with the circulating strains. In some years, scientists have been more on target than others. The big question is whether the same influenza viruses will predominate during the 2024–25 U.S. flu season as in the Southern Hemisphere.

“We know this is what happened in the Southern Hemisphere during their flu season, but patterns there don’t always predict how the season will unfold in the United States,” said Dr. Bharvarth Shukla, an associate professor of infectious diseases at the University of Miami Miller School of Medicine. “A reduction of 34% in hospitalization is still good, especially for people who are very vulnerable.”

“Also,” Shukla said, “there are a lot of caveats in the study that are important to consider. The age of the primary patient population in Brazil was much younger than ours in Florida.” And some countries like Chile and Ecuador had high levels of flu this season.

In the U.S, the Centers for Disease Control and Prevention recommends that everyone 6 months and older get a flu vaccine yearly. A high-dose inactivated vaccine is approved for people 65 years and older.

Shukla recommends looking at the big picture in making vaccine decisions: Who is involved in your daily life and whether it includes anyone who is immunocompromised or particularly vulnerable. “Take everything into context and talk to your doctor,” he advises.

Reviews of flu season data in the U.S. since 2009 find that vaccine protection ranges from a low of 22% to a high of 60%. For the U.S. population, that means millions fewer illnesses and visits to a healthcare professional. The flu vaccine also lowers the number of people with an illness who need hospital care or who die of influenza.

“These reviews show the vaccine is never a direct match, but there are still benefits of getting one,” said Rachel Guran, director of epidemiology and infection prevention with Memorial Healthcare System. “Even if the vaccine is not 100 percent effective, it still protects you against major serious illness.”

Once you get a flu vaccine, it takes up to two weeks to build immunity. Guran said that because people travel to Florida from all over the world, those who live here are exposed to influenza year-round, raising the risk factors.

“Consider the vaccine your secret weapon,” Guran said. “If you are doing everything else, such as eating well and having healthy behaviors, by getting a flu shot, you are adding that on top. You are even more protected than you would have been, and if you get the flu, you probably will not get as severely sick.”

Experts say while the flu vaccine is your best defense, other steps can provide some protection:

Wash your hands well and often with soap and water for at least 20 seconds.
Avoid touching your face. Keeping your hands away from your eyes, nose and mouth helps keep germs away from those places.
Eat lots of fruits and vegetables.
Clean often-touched surfaces regularly.
Meet outside with others as much as possible during peak respiratory season.
If you are sick, stay home.
Get sunshine daily.

South Florida Sun Sentinel health reporter Cindy Goodman can be reached at cgoodman@sunsentinel.com.

ST. LOUIS — The Wild will play the Blues on Tuesday night without top center Joel Eriksson Ek and captain Jared Spurgeon, both of whom will miss their second consecutive game because of injury.

Neither traveled here for the game. The Wild recalled defenseman Daemon Hunt from Iowa Monday night, and he’ll make his season debut if the Wild are forced to play seven defensemen and 11 forwards. That would be the case if second-line wing Marcus Johansson can’t play because of a lower body injury. He sat out the morning skate.

Eriksson Ek had his nose broken by an elbow in Saturday’s 5-4 shootout loss to Seattle. He was expected to play against the Blues but head coach John Hynes that expectation has shifted to Saturday against the Blue Jackets in Columbus.

“I would assume that based on what I know, he’ll be up and running when we get back,” Hynes said. After a day off Wednesday, the Wild will hold a free outdoor practice in St. Louis Park on Thursday.

Spurgeon’s status is less clear.

Out with a lower body injury, Spurgeon was assessed by doctors and deemed unavailable for Tuesday night’s game. He also stayed in Minnesota. The Wild called the defenseman day to day before Sunday’s 2-1 overtime loss at Winnipeg, and Hynes was asked Tuesday if he still considers that the case.

“Right now I do, yeah,” he said.

Spurgeon, 34, missed all but 16 games last season because of shoulder, hip and back injuries. The latter two required season-ending surgery in February and March, and the Wild believed the longtime captain would be ready to go this season. He went through a full training camp and played in two preseason games.

“We’ll probably know more when we get back,” Hynes said.

The Wild were beset by injuries to several key players, and at several junctures last season and failed to make the playoffs. Their 5-10-2 start had them chasing from the start, and the team never recovered. So far, players say, there’s no concern of that happening again.

The Wild (1-0-2) earned a point in Winnipeg on Sunday without Eriksson Ek and Spurgeon, and it appears they also might be without Johansson, who had two assists in the opener, against the Blues.

“You’ve got to find ways to get points when you’re up against it. … I thought we did a really good job of that (in Winnipeg), which is what I want to see with our team,” Hynes said. “The mindset, the competitiveness, the fight, pushing through fatigue, finding a way to either win the game or get a point out of the game when you’re up against it.”

Related Articles

Wild captain Jared Spurgeon appears unavailable Tuesday in St. Louis

Four early questions for Wild training camp

St. Paul Public Works crews were scheduled to start sweeping approximately 530 miles of residential streets this week.

The sweeping operation is expected to take around six weeks, depending on weather, according to city officials. Sweeping prevents garbage, leaves, dirt and debris from entering the storm sewer system and polluting the lakes, streams and river.

Public Works crews have a short window from when leaves begin to fall and the first snow. If there is time, they will do a second pass.

Residents are asked not to put any materials such as leaves, grass, debris or garbage or recycling bins, in the street. They can take compostable materials to Ramsey County compost sites, use yard waste services, or put out compostable yard waste bags to be picked up with garbage if they are a part of the Citywide Garbage Service.

There will be “No Parking” signs posted 24 hours in advance of the start of the sweeping operations. There are no signs posted if there is a second round of sweeping.

The city of St. Paul encourages residents to adopt a storm drain to keep it free of leaves, debris and ice in coming months. To learn how to do so, go to stpaul.gov/departments/public-works/sewer-utility-division/stormwater/adopt-drain.

Related Articles

St. Paul postal worker shot supervisor five times, critically wounding the Eagan man, charges say

Shooting in St. Paul’s North End is third homicide in 4 days in city

St. Paul Mayor Melvin Carter: Even if child care subsidies are approved, I won’t implement them

St. Paul, Wakan Tipi organization to manage Bruce Vento Nature Sanctuary together

St. Paul mayor says he won’t back $1.5 million supplemental insurance for retirees