But one significant risk factor that women can’t control? Breast density.
Breast density, a term that some women who have had mammograms may be familiar with, refers to the percentage of different tissues that make up a woman’s breasts—fat tissue, glandular tissue and connective tissue. While some women’s breasts are comprised primarily of fat tissue, nearly 40 percent of women have breasts with mostly glandular and connective tissue, a characteristic commonly referred to as dense breasts that can make breast cancer more difficult to detect.
“Dense breast tissue appears white on a mammogram, and so do tumors and other abnormalities, which makes it easier for tumors to hide. Although mammograms can still be effective for women with dense breasts, detecting calcifications for example, this camouflaging does make it more difficult to detect some cancers,” explains John Stassi, MD, radiologist with The Barbara Brodsky Comprehensive Breast Center at Bryn Mawr Hospital, part of Main Line Health.
Not only do dense breasts make breast cancer more difficult to detect, they also make it a more likely occurrence. Studies have linked breast density with a higher risk for breast cancer.
Previously, women were not made aware of their breast density but thanks to new regulations in nearly half of the states across the country, including the 2013 Pennsylvania Breast Density Notification Act, physicians are now required to alert women when a mammography exam shows dense breasts.
“For women, this news can be concerning. However, by telling our patients whether or not they have dense breasts and then educating women about how to manage that risk, we will hopefully be able to reduce the number of undetected or hidden cancers in our patients with dense breasts,” says Dr. Stassi.
Even if they learn they have dense breasts, Dr. Stassi encourages women to continue to schedule their annual mammogram. Some of the earliest signs of cancer, such as calcifications, are still easily detected even in dense tissue. The use of 3D mammography throughout Main Line Health has already improved breast cancer detection in our patients with dense breast tissue.” says Dr. Stassi. Learn more about 3D mammography at Main Line Health.
If you learn that you have dense breasts, talk with your primary physician or gynecologist, or a breast center nurse navigator about your lifetime breast cancer risk. A risk assessment will take into account your family history and many other factors and if it indicates that you are at a higher lifetime risk for breast cancer, they can help you determine what supplemental screenings are best for you. If additional testing is necessary, your physician may recommend breast MRI, or breast ultrasound, all of which have been shown to increase cancer detection in dense breasts.
“The earlier we can begin education and awareness, the better. We are making efforts to educate women and their physicians not only about the significance of having dense breasts, but how to manage the associated risk,” says Dr. Stassi.