Do You Have Dense Breasts? Figuring out Your Standing Might Make a Distinction in Your Breast Most cancers Screening
An annual mammogram is an important tool for the early detection of breast cancer. When you get your mammogram results, you may also get a report letting you know that you have dense breast tissue. It is important to look out for this status, as women with dense breast tissue are more likely to be diagnosed with breast cancer.
“Women with thick breasts are at increased risk of breast cancer and the reasons are not clear,” said Dr. William Cance, a surgical oncologist and senior medical and research fellow for the American Cancer Society. “Separately, dense breasts make mammograms less sensitive to detecting cancer.”
Women’s breasts have three types of tissue – fibrous, glandular, and fatty – and women with dense breasts have more fibrous tissue than fatty tissue. Breast density is not related to the size or shape of the breast, nor does it indicate any negative health status. however, dense breast tissue is common. In fact, 40% to 50% of women ages 40 to 74 in the United States have dense breasts. Only about 10% of women have extremely dense breasts – which means that almost all of the breast tissue is dense.
Dense breast tissue is also more common in younger women – breast density may decrease as the woman ages, but some women have the same breast composition throughout their lives. Women with lower body mass and women who are going through menopause hormone therapy are also more likely to have dense breast tissue.
A personal story leads to advocacy
Joseph Cappello spent nearly two decades in the legal profession trying to figure out the importance of knowing the status of breast density. His wife, Dr. Nancy Cappello, had been diligently taking mammograms and supposedly had normal mammograms for 11 years before a doctor felt a lump in her breast during an annual check-up in 2004.
That doctor sent her for another mammogram that again found nothing, and an ultrasound that found a lesion that was later diagnosed as stage 3C breast cancer and metastasized to 13 lymph nodes. That was the first time Nancy, then 51, learned she had dense breast tissue and discovered how it delayed the detection and treatment of her cancer. Adipose tissue appears dark in a mammography measurement, whereas dense tissue does not.
“When a woman with dense breast tissue is given a mammogram, the mammogram shows that the tissue is white,” said Joseph. “The problem is that a tumor also appears white and there is no contrast. If you don’t find that you have dense breast tissue, you could be hiding a tumor and not even know it.”
Nancy asked her doctors why she was not told about her dense breast tissue status, and learned that this was not the standard. Outraged by her experience, she and her husband started Are You Dense? To educate women about dense breast tissue and the importance of understanding the relationship between dense breast tissue and cancer screening. The organization has also set up an advocacy group to help pass laws in each state that require professionals to inform women of their breast density status.
Before Nancy died in 2018, 36 states had passed a law requiring medical professionals to give women their breast density status. In early 2019, national legislation was signed under which women must be informed about their dense breast status. This means that all American women now have the right to be informed about their breast tissue density.
“We came a long way from 2004 when we thought we were just telling our family and friends about breast density that no one has ever heard of,” said Joseph. “And then we passed a law [our home state of] Connecticut, and it just started from there. I just hope we can continue to do justice to Nancy’s work because she has done so much for millions of women. “
What to do when you have thick breasts
Breast dense status is only the first step. Women should then speak to their doctors about the possible need for additional testing.
“There are additional screenings with MRI, ultrasound, and 3D mammography (breast tomosynthesis) that can help better visualize the breast tissue,” said Cance. “However, its absolute value is not yet known and is being assessed in ongoing studies.”
Some of these tests can expose women to low levels of radiation or identify problem areas that are not cancer but may require even more tests or biopsies. Some can be expensive and not fully insured. For this reason, it is best to discuss the pros and cons of additional screening if you have dense breast tissue, and based on your own health profile and family history, decide whether to proceed. Women with dense breast tissue should continue to have regular mammograms.
For Joseph Cappello, who wrote Are You Dense? Going on, he is convinced that additional screenings could have extended his wife’s life. After surviving from breast cancer, Nancy was diagnosed with bone marrow cancer in August 2018 and died three months later. Joseph said the blood cancer was caused by the extensive treatment she received in 2004 for her advanced breast cancer.
“If Nancy had a simple ultrasound, if the doctor said, ‘You have dense breast tissue, you need an ultrasound,’ they would have caught this thing at stage 1 and maybe she could have had a lumpectomy or something instead of a mastectomy and heavier Doses of chemotherapy and radiation, “he said.
American Cancer Society
Susan G. Komen