How Breast Density Affects Your Breast Cancer Risk

What Does Dense Breast Tissue Mean?

Human breasts feature a mix of fat, fibrous connective tissue, and milk glands. The precise composition varies from one individual to another. While it is often inherited, it may also be affected by age, diet, body mass index (BMI), and menopause. Dense breasts contain more fibrous and glandular tissue than fat. High density is fairly common, found in almost half of women who receive mammograms.

Understanding your breast density is important, as it can affect breast cancer screening. Dense breast tissue may make it harder to see cancer on a routine mammogram. This can lead to diagnoses being made at a later stage. In addition, research has revealed a possible link between dense breast tissue and a higher risk of developing breast cancer. Being proactive is essential to make sure cancer in dense breasts is identified early, ensuring the best chances of successful treatment.

How Do I Know If I Have Dense Breasts?

Breast density is not related to breast size or firmness and cannot be detected with an external physical exam. Instead, density is determined during a mammogram screening. The radiologist will evaluate the mammogram images, looking for white patches indicating fibrous or glandular tissue zones. They will then describe the overall density in one of four categories:

• Category A: Your breasts are almost all fatty tissue.
• Category B: Your breasts are mostly fatty tissue, with scattered areas of dense tissue.
• Category C: Your breasts are described as heterogeneously dense, with large amounts of evenly distributed dense tissue.
• Category D: Your breasts have very high amounts of dense tissue.

Mammogram results include the breast density category, in addition to whether the breasts are dense or not dense. Category C and Category D breasts are considered dense.

How Does Breast Density Affect Cancer Screening?

Mammograms use X-rays to take images of the insides of breasts. The mammogram machine emits a small dosage of X-rays into the breast, passing through soft tissue but reflecting off denser structures. The mammogram machine uses the reflected rays to generate an image. Radiologists evaluate the image for areas of abnormal tissue, which reflect more X-rays than normal breast tissue and show up white on the mammogram image.

Dense breasts can lead to confusing mammogram results since fibrous and glandular breast tissue also reflect more X-rays and appear white on mammogram images. When most of the image is white due to dense tissue, it is difficult to identify abnormal areas.

Mammograms can still detect most breast cancers in women with dense breasts. However, to ensure accurate results, additional screening may be recommended. An ultrasound or MRI (magnetic resonance imaging) scan may allow for more accurate evaluation. Your physician may also recommend a three-dimensional mammogram. This involves taking multiple X-ray images at different angles, which can be digitally assembled to create a clear three-dimensional image.

What Should I Know About Dense Breasts and Cancer Risk?

Along with the challenges it presents in screening, dense breast tissue may also be linked to a higher breast cancer risk. The reason for this link is still unclear. If you have Category C or D breasts, speak with your healthcare provider about a cancer risk evaluation. They will consider your breast density alongside other known risk factors, including your:

• Height and weight
• Personal or family history of breast cancer
• Use of hormonal medications
• Racial and ethnic heritage
• Current age
• Age at your first menstrual period
• Age when you first gave birth
• Age at menopause
• Age at any previous cancer diagnosis
• Results of previous breast biopsies

Anybody may develop breast cancer. These factors, however, may increase your chances. Higher-risk individuals may pursue earlier or more frequent screenings to ensure that cancer is detected as soon as it develops. The earlier breast cancer is identified, the more treatments will be available to you, and the better your prognosis will be.

Find Expert Cancer treatment at RCCA

Understanding the relationship between breast density and cancer risk helps individuals make informed decisions about screening. Find out more by reaching out to Regional Cancer Care Associates. RCCA specialists provide care to more than 30,000 new patients and 265,000 established patients each year. RCCA physicians offer patients innovative therapies, including immunotherapies and targeted therapy, cutting-edge diagnostics as well as access to approximately 300 clinical trials in community-based centers close to home.

Frequently Asked Questions About Breast Density and Cancer Risk

Do dense breasts cause breast cancer?

Dense breasts do not directly cause breast cancer. However, high amounts of dense breast tissue have been connected to a higher risk of cancer. The cause for this connection is not yet known.

Do dense breasts affect mammogram screenings?

Yes, because dense breasts contain large amounts of tissue that appears white on mammograms. This makes it difficult to identify areas of abnormal tissue, which also appear white. As a result, additional screening may be needed to decipher between the two.

What cancer screening options are available for dense breasts?

Standard mammograms can detect breast cancer in dense breasts. For more accurate results, however, patients and providers may consider the following:

• Breast ultrasound
• Magnetic resonance imaging (MRI)
• 3D ultrasounds

How often should I get screened for breast cancer?

Patients at average risk for breast cancer should be screened every year or every two years after age 40. People at higher-than-average risk may begin routine screening earlier or get screened more frequently. Speak with your healthcare provider about screening recommendations for you.