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962875 tn?1314213636

Dense breasts and breast cancer risk

Hi everyone,

This is an informational  post, related to new reseach and legislation being supported and in some cases passed, in regard to breast density:

Women with breasts that appear dense on mammograms are at a higher risk of breast cancer and their tumors are more likely to have certain aggressive characteristics than women with less dense breasts, according to a study published online July 27 in the Journal of the National Cancer Institute.

The researchers found that the risk of breast cancer increased progressively with increasing breast density. The associations were stronger for larger tumors than for smaller tumors; for high-grade than for low-grade tumors; and for estrogen receptor-negative than for estrogen receptor-positive tumors. The link between density and breast cancer also appeared to be stronger for ductal carcinoma in situ (DCIS) than for invasive tumors. There was no association, however, between density and other markers of tumor aggressiveness, such as nodal involvement and HER2 status.

They conclude that breast density is an important risk factor for diverse subtypes of breast cancer. "Given that the magnitude of the association with breast density is strong across all breast cancer subtypes and particularly for ER-negative disease, breast density should be included in risk prediction models across tumor subtypes," they write.

Some states have passed legislation to require that women be informed of their breast density risk. A federal bill is in the draft stage. Digital mammograms are only 60% accurate in detecting timors in these patients, but when annual mammograms are supplemented wirh ultrasound, the accuracy increases to 97%.  

For more information, check out the nonprofit Web site: areyoudense.org.

7 Responses
962875 tn?1314213636
p.s. Sorry about the typos... :-(

739091 tn?1300669627
Awesome post BB!!

I was one of the women who had very dense breasts but was ER/PR positive 90%.

I was told that dense breasts do increase the risk for breast cancer and as evidenced with my invasive lobular carcinoma, it hid it very well.

Hopefully this study they did will get insurance companies to open their tight wallets to allow women with dense breasts to get MRI's for diagnostic purposes. :)
587083 tn?1327123862
As always excellent research bb...
Thank you so much!!
Don't worry about the typos...we all do that,especially me! LOL
962875 tn?1314213636
To clarify the initial information, radiologists use the following categories to rate breast density:

Breast Imaging Lexicon
Mammographic Breast Composition

Mammographic breast composition is described as follows:
1. The breast is almost entirely fat (less than 25% glandular)
2. Scattered fibroglandular densities (25-50%)
3. Heterogeneously dense breast tissue (51-75%)
4. Extremely dense (greater than 75% glandular)

About 4 out of 5 women are rated 2 or 3, and only about 10% a 1 and 10% a 4. (These scores are only estimates, however, based on the radiologists' observations of the images, not by precise measurements.)

Apparently it is the "extremely dense" tissues that carries the additional BC risks reported above.

After menopause, the dense fibroglandular tissue tends to be replaced by fatty tissue, but older women who take hormones may still have dense breasts, because the hormones keep the tissue more like that in pre-menopausal breasts. This is one reason to talk to your doctor about limiting hormone replacement therapy.
Avatar universal
How can you get your Dr. to refer you for either an MRI or entire breast ultrasound?  I have been asking for one or the other for at least the last 3 years, as my report always comes back with "dense" or "Heterogeneously dense".  I go for my annual mammo next week and wonder how you get either done.  thanks
739091 tn?1300669627
The squeeky wheel always get the grease. The better the argument for it the more the likelihood you'll get it.

When I found out I had to have a biopsy (his words to me were immediately or sooner!) I asked the gal doing the ultrasound to please also image me other breast and she said there weren't orders for that. I looked at her and said look, you and I know I've got breast cancer and the biopsy will prove that but I need to know if my other breast is clear. She did to the ultrasound for me.

Sometimes we have to push push push for what we feel we need. My dense breasts hid a 10 cm mass. There was no lump and the mammogram was clean. I fell into the 15 % of cancers that don't image.

Good luck!
Avatar universal
Thanks SO much, bb, for this valuable information. I had heard this before, but I don't think that it was verified with the research at that time. I agree with Sue, that maybe insurance companies need to cover MRI for women with the higher ratings of density. Because of my LCIS, my insurance does cover my MRIs, but I still have a 10% copay which is close to $150 every 6 months. They also refused to cover the CAD services, which I appealed and they denied. I told them my niece's husband is a radiologist and he says CAD review of breast MRIs is the gold standard and no radiologist would review one without it. Besides the fact that my life could be in the balance, I also said finding a cancer early is certainly less costly to them than finding it late. I thought the money issue would sway them, but I was wrong---I still have to pay the $75 charge for it. Fortunately, I have the money for it and it's a small price to pay for my peace of mind, but it's still an extra expense. Women in tighter financial circumstances might not know how to get this service. We just need to keep pushing for the services we need, as Sue said and hoping for the best.
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