The Screening Every Woman with Dense Breasts Needs (But Can't Get)
Why biotech entrepreneur Sheila Mikhail is creating a "ruckus" for supplemental screening
Sheila Mikhail did everything right. Annual mammograms, healthy lifestyle, regular check-ups. She was told repeatedly that 3D mammograms were "perfect" for her heterogeneously dense breasts.
She was also told she was "low risk"—thin, healthy, no family history, doesn't smoke or drink. What could go wrong?
Everything.
In November 2022, Sheila noticed a small indentation on her breast. When she finally convinced doctors to do supplemental screening beyond the "perfect" mammogram that had missed it, they found a 3-centimeter tumor. When she insisted on screening the other breast despite pushback about insurance and "standard of care," they found an even larger tumor there too.
Six centimeters of breast cancer. Completely missed by mammography.
Here's what every woman needs to know:
50% of women have dense breast tissue. In these women, mammograms miss up to 50% of tumors. Would you get on a plane if TSA missed 50% of bombs? Yet women with dense breasts are expected to rely on this screening and "be satisfied with it."
The solution exists: supplemental screening with breast MRI or contrast-enhanced mammography. But only 37 states mandate insurance coverage. In the remaining 13 states, women face pushback, dismissal, and out-of-pocket costs that can run $400 for an abbreviated MRI.
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The economic argument is crystal clear. Early detection dramatically reduces treatment costs—the difference between stage 2 and stage 3 diagnosis is over $100,000 per patient. Earlier detection means less invasive treatment, shorter recovery, and women staying in the workforce instead of facing bankruptcy from advanced cancer care.
What you can do:
Know your breast density. Federal law now requires this information on your mammogram report.
Advocate for appropriate screening. If you have dense breasts, ask specifically about supplemental screening options.
Don't take no for an answer. If your doctor says mammograms are "fine" for dense tissue, they're behind the research.
Support the Find It Early Act. Contact your representatives to mandate insurance coverage for all appropriate screening.
Sheila named her advocacy organization BC Ruckus after that oncologist told her she was "creating a ruckus." Her response? "It's my life."
Sometimes creating a ruckus saves your life. It's time for every woman to make some noise.
Resources for Action:
Educational Resources: mydensitymatters.org, densebreast-info.com
Legislative Action: Contact representatives about Find It Early Act
BC Ruckus: bcruckus.org