Why Breast Density Issues


I believed I used to be doing every thing proper. I by no means missed my annual mammogram. I did self-exams, ate wholesome, and had no identified danger components for breast most cancers. But, at some point I felt a lump. I wasn’t significantly fearful. I had lately had a “regular” mammogram, which didn’t detect something. Then I used to be despatched for a diagnostic mammogram, which additionally didn’t detect something. However an ultrasound the identical day revealed the heartbreaking information: I had breast most cancers. Why didn’t it present on the mammograms? It was then that I used to be advised that I had extraordinarily dense breasts and the not-so-small, not-so-early-stage most cancers was hidden by the dense tissue. I had by no means earlier than been advised I had dense breasts, by no means been advised that breast density elevated my danger for breast most cancers, by no means been advised that breast density drastically reduces the effectiveness of a mammogram, and, sadly, by no means been advised that further screening instruments have been out there which could have detected my most cancers at an earlier stage.

Mammography is more practical in detecting cancers in some ladies than others. For ladies with dense breasts, most cancers usually grows unseen on mammography and due to this fact, further screening could also be wanted.

Key Details:

  • Dense breast tissue is widespread: 40% of girls age 40 and over have dense breasts.
  • Breast density is decided by way of a lady’s mammogram and described as certainly one of 4 classes relying on the quantity of breast tissue compared to fats within the breast.
  • Most cancers is 4 occasions extra prone to develop in ladies with extraordinarily dense breasts than in ladies with fatty breasts.
  • Although mammograms discover some cancers not seen on different screening exams, in dense breasts, mammograms will miss as much as 40% of the cancers current.
  • In dense breasts, different screening exams, corresponding to ultrasound or particularly breast MRI, along with mammography, considerably enhance detection of early-stage breast cancers.

Why does breast density matter?

Dense breasts enhance each the chance of creating breast most cancers and the chance of that most cancers being missed by mammography.

Dense breast tissue exhibits up as white on a mammogram, whereas fatty tissue is darkish grey. Sadly, cancers additionally show as white on a mammogram. If there’s a number of dense tissue on a mammogram, a most cancers will be “hiding” among the many dense tissue. That is true even when the mammogram was accomplished with 3D/tomosynthesis. On the lookout for a most cancers in a dense breast has been in comparison with on the lookout for a snowball in a blizzard.

In dense breasts, a “regular,” “unfavorable,” or “benign” mammogram doesn’t essentially imply most cancers will not be current. Regardless of how current your final mammogram, a lump or any modifications in your breast ought to be dropped at the eye of your well being care supplier.

Along with hiding most cancers, breast density can be certainly one of many identified danger components for breast most cancers. The larger the density of the breast tissue, the upper the chance for creating breast most cancers.

How is breast density decided?

When you’ve gotten your mammogram, your breast density is rated as certainly one of 4 classes:

  • Class A – Fatty                                                                                                                       
  • Class B – Scattered areas of fibroglandular density
  • Class C – Heterogeneously dense
  • Class D – Extraordinarily dense

Breasts that are Class C – Heterogeneously dense, or Class D – Extraordinarily dense, are thought-about to be “dense” breasts.

How do I do know if I’ve dense breasts?

Usually, this data will probably be supplied to you by your well being care supplier, who could have acquired it from the ability that carried out your mammogram. It might even be included within the letter you obtain after your mammogram is carried out. Many states (38 and the District of Columbia), now have legal guidelines that require some stage of details about breast density be included within the letter ladies obtain after their mammogram. Nevertheless, the legal guidelines differ from state-to-state. To be taught the reporting necessities in your state, please see the legislative map on DenseBreast-info.org.

Early detection issues, so be an knowledgeable self-advocate. All ladies ought to know their breast density and particular person danger components, talk about the advantages and dangers of further screening with their well being care skilled, and pursue further screening if applicable for them, to make sure the earliest stage analysis attainable.


Further sources

Patient Video Series: Let’s Talk About Dense Breasts

In regards to the writer:

JoAnn Pushkin is government director of DenseBreast-info.org. The web site, cited because the “most modern and complete useful resource” on the subject, is the collaborative effort of world-renowned breast imaging consultants and medical reviewers.

Pushkin’s initiative and advocacy served as inspiration for New York State’s Breast Density Inform regulation. On the federal stage, she continues to steer efforts for a single nationwide “density” reporting commonplace by way of each the introduction of the Federal Breast Density and Mammography Reporting Act, in addition to the FDA’s Mammography High quality Requirements Act regulatory modification consideration.