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Five Things Friday – Breast Density

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Woman checking her breast

So, You Have Dense Breasts. Now What?

Thirty-six states, including California, have passed laws requiring health facilities to notify women when they have dense breasts.  Breast density is the degree to which a woman’s breasts are made up of lobules, ducts, glands and connective tissue versus fatty tissue. And density matters — it’s a risk factor for breast cancer and it makes cancer harder to detect.

Here are five things you should know about having dense breasts and what your options are:

1. Dense breasts are common in many women.

Being told you have dense breast tissue should not cause undue anxiety. About 43 percent of U.S. women between the ages of 40 and 74 have dense or extremely dense breast tissue.

Mammogram

Your breasts are considered dense if you have a lot of fibrous or glandular tissue but not much fatty tissue. Breast density is a term that describes the relative amount of these different types of breast tissue and can only be determined by a mammogram.

When a radiologist looks at your mammogram, they determine your breast density. There are four categories of breast density. They go from almost all fatty tissue to extremely dense and very little fatty tissue. The radiologist decides which of the four categories best describes your level of breast density.

2. What causes dense breast tissue?

Dense breast tissue is not something you can control and it often changes over time. It’s not clear why some women have a lot of dense breast tissue and others do not. According to the Mayo Clinic, you may be more likely to have dense breasts if you:

  1.  Are younger. Your breast tissue tends to become less dense as you age, though some women may have dense breast tissue at any age.
  2.  Have a lower body mass index. Women with less body fat are more likely to have denser breast tissue compared with women who are obese.
  3.  Take hormone therapy for menopause. Women who take combination hormone therapy to relieve signs and symptoms of menopause are more likely to have dense breasts.

3. Does this increase my risk of breast cancer?

Having dense breast tissue may increase your risk of getting breast cancer. It’s not certain why this is. But, to really gauge your breast cancer risk, density can’t be considered in isolation — 

it needs to be discussed in the context of other risk factors, such as your family history, age, weight, physical activity, and many other factors. Breast density is just one part of a woman’s overall breast cancer risk profile.

4. If I have dense breasts, do I still need a mammogram?

Yes. Most breast cancers can be seen on a mammogram even in women who have dense breast tissue. However, on mammograms, dense breast tissue looks white, and breast masses or tumors also look white. So, the dense tissue can hide tumors. Fatty tissue looks almost black, and something white, such as a tumor, can be easily seen. So, mammograms can be less accurate in women with dense breasts.

5. Should I get additional testing done?

If your mammogram report says that you have dense breast tissue, talk with your doctor about what this means for you. At this time, experts do not agree what other tests, if any, should be done in addition to mammograms in women with dense breasts. The U.S. Preventive Services Task Force  says there’s not enough information to know whether offering women with dense breasts additional screening will help them, so many women are being given potentially concerning news without any way to address it.

 So, after talking with your doctor, you may choose to have other tests. These could include:

  • Breast MRI.
  • 3-D mammogram.
  • Breast ultrasound.
  • Molecular breast imaging (MBI).

Dense breast notification laws have added another layer of complexity to the long-running and often emotional debate over how best to screen women for breast cancer. Critics say the laws cause women unnecessary anxiety and can lead to higher costs and treatment that doesn’t save lives or otherwise benefit patients.

The intention is to make women aware of whether they have dense breast tissue so they can decide, in consultation with their health care provider, whether to pursue additional screening. This is a very personal decision. We at Albie Aware are happy to provide you with additional resources so you can make the best decision for you.

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