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Why it's important to know if you have dense breasts

января 31, 2017 | by CTCA

a breast cancer patient being examed
Since dense breast tissue and lumps—both benign and cancerous—appear white on a mammogram, the tests may not distinguish between normal and abnormal tissue and may be less accurate for women with dense breasts.

Twenty-eight states now have laws that require mammography centers to inform women with dense breast tissue that it may increase the risk of cancer and obscure a malignancy on a mammogram, urging them to talk to their doctors about additional imaging options.

About half the women who get mammograms have dense breasts, meaning their breasts have an increased amount of glandular tissue that may develop into cancer. Since dense breast tissue and lumps—both benign and cancerous—appear white on a mammogram, the tests may not distinguish between normal and abnormal tissue and may be less accurate for women with dense breasts.

How common are dense breasts?

Dense breasts are more common in women who:

  • Are younger, especially in their 40s and 50s, since breast tissue tends to lose density with age
  • Are pre-menopausal
  • Take combination hormone therapy to relieve symptoms of menopause

Experts say such women should be informed about their condition so they can take the steps necessary to protect their future health. “Women who have more dense breasts have a slightly increased risk of breast cancer,” says Dr. Dennis Citrin, a Medical Oncologist who treats breast cancer patients at our hospital in Chicago. “It is important to find out if a woman has dense breasts to better understand her breast cancer risk and how sensitive the mammogram will be.”

How do you find out if you have dense breasts? With a mammogram. “It cannot be detected by touch,” says Dr. Citrin. When legally required, mammography providers inform women of their breast density in a letter that is sent with their test results. A follow-up letter indicating the patient has dense breasts will categorize the density by a range of four options:

  • Almost entirely fatty indicates that the breasts are composed almost completely of fat. About 10 percent of women have this result.
  • Scattered areas of fibroglandular density means areas of density have been detected around the breast, but the majority of the breast tissue is not dense. About 40 percent of women have this result.
  • Heterogeneously dense indicates that some areas of non-dense tissue were found, but the majority of the breast tissue is dense. About 40 percent women have this result.
  • Extremely dense indicates that nearly all the breast tissue is dense. About 10 percent of women have this result.

In general, women whose breasts are classified as heterogeneously dense or extremely dense are considered to have dense breasts. If you live in a state that does not have laws on dense breasts, Dr. Citrin recommends that you ask your doctor for the information.

What should you do if you have dense breasts?

What should women with dense breasts do about it? “I tell all my patients the same thing,” says Dr. Citrin. “Make sure you get your annual screening mammograms and check your breasts on a regular basis. Be familiar with your breasts, particularly if you are pre-menopausal. If anything feels different, see your doctor right away. Additionally, if a woman knows she has dense breasts and, therefore, a slightly increased risk of breast cancer, she may want to consider alternative forms of imaging, such as an MRI.”

Some evidence suggests that additional tests may help detect breast cancer in dense breast tissue. Supplemental tests for breast cancer screening may include:

  • Digital breast tomosynthesis: This screening uses X-rays to take multiple images of the breast from several angles. The images are synthesized by a computer to form a 3-D image of the breast.
  • Breast MRI: MRI uses magnets to create images of the breast.
  • Breast ultrasound: Ultrasound uses sound waves to analyze tissue. A diagnostic ultrasound is commonly used to investigate areas of concern discovered on a mammogram.
  • Miraluma breast imaging: This is a non-invasive nuclear medicine test that produces detailed images of malignant lesions in dense, fibrous breast tissue.

Tips to lower breast cancer risk

Dr. Citrin also offers the following tips to maintain a healthy lifestyle and reduce breast cancer risk factors:

  • Eat a diet low in animal fat.
  • Limit alcohol consumption.
  • Get regular exercise.
  • Maintain a healthy weight.
  • Avoid cigarettes and tobacco.
  • Get adequate amounts of vitamin D and calcium.