Dense breasts on a mammogram? What to know and do

You’re gazing a letter out of your mammography facility. Your breast examination was regular, nice. However then you definately see a word on the underside: you’ve excessive breast density, which may put you at greater danger for breast most cancers sooner or later. Now what?

“The discovering of dense breasts on a mammogram will be anxious and complicated for sufferers,” says Dr. Toni Golen, performing editor in chief of Harvard Ladies’s Well being Watch. It’s data that will concern them, however they don’t know what to do about it.

What’s breast density?

Breasts are composed of:

  • lobules, which produce milk
  • ducts, tubes that carry milk to the nipple
  • fatty tissue, much like fats in different elements of your physique
  • fibrous connective tissue, which supplies the breast its attribute form.

Dense breasts have extra lively tissues — lobules, ducts — and fewer fats. The one option to inform if in case you have excessive breast density is by having a mammogram. Dense breasts don’t really feel or look any completely different from breasts which have a bigger proportion of fatty tissue.

Density is usually gauged by the radiologist who reads the mammograms. It’s labeled on a scale of 1 to 4, with 1 being the least dense and 4 being essentially the most. Ladies who rating a 3 or a 4 are usually mentioned to have excessive density.

Breast density usually modifications over time. Youthful girls usually have greater density than older girls, and density usually declines after menopause. However this isn’t at all times the case. Some older girls nonetheless have dense breast tissue. Taking hormone remedy can also improve breast density.

How a lot does excessive breast density have an effect on most cancers danger?

Estimates range, however a 2011 examine within the Journal of the Nationwide Most cancers Institute discovered that ladies with breasts composed of fifty% or extra dense tissue had been 3 times extra prone to be identified with breast most cancers over a 15-year interval than girls who had lower than 10% dense tissue of their breasts.

What are consultants saying about breast density?

Specialists need girls to know that prime breast density

  • means you’ve extra lively breast tissue, and it’s a danger issue for breast most cancers
  • could make it harder for a radiologist to see a most cancers on a mammogram.

“Proper now, we’ve a danger issue and not using a plan to handle it,” says Dr. Kathryn M. Rexrode, affiliate professor of medication at Harvard Medical Faculty and chief of the Division of Ladies’s Well being at Brigham and Ladies’s Hospital. Whereas medical doctors know that ladies with excessive density are barely extra prone to develop breast most cancers, there is no such thing as a consensus but on how to reply to that danger. Ought to girls with excessive density be screened at a youthful age, extra usually, or utilizing completely different expertise? There’s no official plan.

“We want high-quality analysis information that may inform us if girls with very dense breasts or greater breast density ought to be screened or monitored in another way,” says Dr. Rexrode.

What actions can you’re taking?

If you happen to do obtain this notification:

Discuss to your physician about how your density impacts your total danger of breast most cancers. If in case you have extra danger components for breast most cancers, your physician might advocate modifications to your breast most cancers screening routine.

“These might embrace completely different sorts of imaging, extra frequent imaging, or each,” says Dr. Golen. Docs generally advocate that ladies at excessive danger for breast most cancers be screened utilizing breast ultrasound or magnetic resonance imaging (MRI) along with mammography to assist discover cancers that may’t be seen on a mammogram.

Contemplate completely different screening expertise. Within the June challenge of Harvard Ladies’s Well being Watch, we highlighted a latest examine that confirmed that digital breast tomosynthesis (DBT), generally known as 3D mammography, could be higher at detecting cancers in youthful girls and people with dense breast tissue.

DBT is a comparatively new expertise, accredited by the FDA in 2011. It really works by taking a collection of pictures, which a pc then assembles right into a 3D-like picture of breast slices. Within the examine, which was revealed on-line February 28 by JAMA Oncology, researchers in contrast greater than 50,000 breast screenings carried out with DBT and 129,369 carried out with digital mammography. Their evaluation discovered that DBT recognized 1.7 extra cancers than digital mammography for each 1,000 exams of girls with regular breast tissue. For younger ladies with dense breasts, the benefit of DBT was even better: 2.27 extra cancers had been discovered for each 1,000 girls screened.

The examine authors recommended that ladies in these classes take into account screening utilizing this expertise if it’s accessible.

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