Understanding Breast Density: What Every Woman Should Know
A mammogram is crucial for detecting breast cancer early. But did you know that another important finding is breast density? Since September, new international guidelines require mammography centers to inform women about their breast density. This information is vital because it can impact your breast cancer screening plan.
Are Dense Breasts Bad?
No, dense breasts are not bad. In fact, they are quite normal. About 40% of women aged 40 and older have dense breasts. Women of all shapes and sizes can have dense breasts, and it’s unrelated to breast firmness. Dense breasts only become relevant in the context of breast cancer screening.
“With these new guidelines, there will be a lot of questions for doctors, and a lot of Googling, which is okay. But we want to make sure people don’t panic,” said Dr. Ethan Cohen of MD Anderson Cancer Center in Houston, United States.
How is Breast Density Determined?
Doctors who review mammograms use a system to classify breast density. There are four categories:
- Least dense: Breasts are almost entirely fatty tissue.
- Most dense: Breasts are mostly glandular and fibrous tissue.
Breasts are considered dense in two 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 explains that 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?
There are two primary reasons:
- Dense breast tissue makes it harder to see cancer on an X-ray mammogram. Dense tissue appears white on a mammogram, just like cancer. “It’s like trying to see a snowball in a blizzard,” explains Dr. Wendie Berg of the University of Pittsburgh School of Medicine and chief scientific adviser to DenseBreast-info.org.
- Women with dense breast tissue have 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 Should I Do?
If you learn you have dense breasts, talk to your doctor about your family history of breast cancer. They can advise whether additional screening with ultrasound or MRI is appropriate. Researchers are actively exploring better ways to detect cancer in women with dense breasts. However, there isn’t enough evidence yet to recommend widespread additional screening. The US Preventive Services Task Force called for more research in this area when updating breast cancer screening recommendations earlier this year.
Do I Still Need a Mammogram?
Yes, women with dense breasts should continue getting regular mammograms, which remain the gold standard for early cancer detection. Mammograms should begin at age 40.
“We don’t want to replace the mammogram. We want to enhance it by adding a specific other test,” said Dr. Georgia Spear of Endeavor Health/NorthShore University Health System in the Chicago area.
“Every woman should have an equal opportunity to have their cancer found early, when it’s easily treated. That’s the bottom line,” emphasized Dr. Berg.
Carla K. Johnson, AP Medical Writer.
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