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Having Dense Breasts May Require Additional Screening




Please keep in mind that women with dense breast tissue without a family history of breast and other cancers, are not necessarily at an increased risk for breast cancer.


This October during breast cancer awareness month, I would like to bring more awareness to dense breasts. If you received a mammography report after getting a mammogram and learned you have dense breasts, you may want to take additional steps to safeguard yourself from breast cancer. Having dense breasts can make it more difficult to see breast tumors during a mammography screening.


Women like me with dense breasts have an increased risk for breast cancer because tumors may not be found with a regular mammography screening. At least 50% of women in the U.S. are diagnosed with dense breasts Yale (2023). Unfortunately, you cannot tell by looking at your breasts to determine if your breasts are dense. The only way to determine if you have dense breast tissue is with a mammogram Yale (2023). Dense breasts are made up of more fatty tissues in comparison to less dense breast tissue.


There are several classifications of breast density which range from fatty breast tissue to extreme density. Doctors classify breast density based on the Breast Imaging Reporting and Data System, or BI-RADS, which divides breast density into four categories Melnikow et al. (2016). Having extreme breast density means it is more difficult for a mammography or digital mammography to detect breast cancer tumors.


You can still be proactive with safe-guarding your health if you have dense breasts and a family history of breast cancer. First and foremost, talk with your doctor about your concerns. Second, ask your doctor for a referral to have a whole-breast ultrasound screening. Make sure your referring physician provides dense breasts as the reason for the supplementary screening. This way, your insurance may cover most or all the costs of your ultrasound screening. An ultrasound screening uses sound waves to produce images of your breast tissue. Finally, some patients have a magnetic resonance imaging (MRI) with contrast dye to detect breast tumors Yale (2023). Talk with your doctor about the benefits and risks of additional breast screenings, to determine which test is best for you.


Please be advised that some doctors may not recommend patients with dense breasts to get supplementary screening tests due to the risk of false-positive test results. Researchers at the National Cancer Institute (NCI), found that for the vast majority of women undergoing mammography, including those with dense breasts and a low 5-year breast cancer risk, the chance of developing breast cancer within 12 months of a normal mammogram was low NCI (2015). Certainly, no one wants to receive a false-positive test and undergo more invasive testing like a breast biopsy. However, follow your instincts and make a decision based on your own unique family history and personal risk factors.


Be well!


Sources:


Melnikow J, Fenton JJ, Whitlock EP, et al. (2016). Supplemental Screening for Breast Cancer in Women With Dense Breasts: A Systematic Review for the U.S. Preventive Service Task Force [Internet]. Rockville (MD): Agency for Healthcare Research and Quality. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK343791/



National Cancer Institute (NCI). 2015. Many Women with Dense Breasts May Not Need Additional Screening. Retrieved from: https://www.cancer.gov/news-events/cancer-currents-blog/2015/dense-breasts-screening


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