What Are Dense Breasts? Why Is Cancer Risk Higher in Dense Breasts?

Not only individuals but doctors also need more education about dense breasts , as demonstrated by research published on 7 May 2019 in Journal of Women’s Health . The study included participants of whom 75 percent were female doctors, 77 percent specialists, 42 percent primary care physicians (family physicians and general practitioners), 28 percent radiologists, 17 percent gynecologists and 9 percent other physicians, totaling 155 participants. Almost half, 48 percent, were unaware of dense-breast criteria, while two-thirds, 67 percent, said they needed more education about breast density and additional screening. %62 were unaware of the increased breast cancer risk associated with dense breasts.

What Are Dense Breasts?

Dense breasts, defined as having dense breast tissue, are associated with increased cancer risk. Dense breast tissue and firm breasts are different things. Without a radiologist’s assessment of a mammogram , women cannot know whether they have dense breasts.

Dense Breasts Carry Somewhat Greater Cancer Risk Because:

1. Dense breast tissue is known to increase cancer risk, but the reasons are not yet fully understood. According to the American Cancer Society, not every woman with dense breasts is at high risk. Breast cancer risk depends on many factors besides dense tissue.
2. Cancer can be harder to see on a mammogram in dense breasts. Dense tissue appears white, and breast tumors also appear white, making them difficult to distinguish.

How Do Doctors Determine Whether Breast Tissue Is Dense?

The radiologist assessing the mammogram grades breast density by comparing the proportions of nondense and dense tissue.

Density levels are defined using the BI-RADS reporting system. The levels are:

Almost entirely fatty; the breast consists almost entirely of fat. Among every 10 women, approximately 1 has this result.

Scattered areas of fibroglandular densityindicate scattered dense areas, but most breast tissue is not dense. Among every 10 women, approximately 4 have this result.

Heterogeneously densemeans some areas are not dense, but most breast tissue is dense. Among every 10 women, approximately 4 have this result.

Extremely dense means almost all breast tissue is dense. Among every 10 women, approximately 1 has this result.

Generally, a woman whose breasts are classified as heterogeneously or extremely dense is considered to have dense breasts. Approximately half of women undergoing mammography have dense breasts.

Routine breast cancer screening is recommended for all women aged 45-54 through annual mammography. From age 54, screening should move to every two years, with the option to continue annually for those who wish. Women with dense breasts can also be monitored with mammography, but another imaging method, such as breast ultrasound, may be added according to the breast radiologist’s advice. If other breast cancer risk factors are present, breast MRI may be used. 3-dimensional mammography, tomosynthesis, provides better imaging of dense breasts than conventional mammography.

In conclusion, increased cancer risk in dense breasts, meaning dense breast tissue, is attributed to greater difficulty detecting cancer on mammography. Ask your doctor whether different or additional screening tests might help. If results show dense breasts, remember this is not abnormal and should be considered alongside other risk factors.

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The video below explains how and why breast cancer develops, its types and the latest treatments by stage.