Most women are aware that a family history of breast cancer increases their risk of the disease. But few understand that extremely dense breasts can pose a greater risk.
A study published Monday in the JAMA Network Open Journal found. That most of the nearly 1,900 women who participated saw breast density as. A less consequential risk factor than family history.
But women with very dense breasts, characterized by minimal fatty tissue. Have four times the risk of breast cancer than women with the least dense breasts, according to the study. About 10% of women who have a mammogram have this level of breast density. In comparison, having a mother, sister or daughte. With breast cancer doubles the risk of the disease.
According to the study, women whose breast tissue is dense enough but not extreme—about 40% of those who. Have mammograms—have a 20% higher risk of breast cancer than those with average breast density.
That’s slightly lower than the risk of consuming a glass of wine each night. According to Dr. Phoebe Freer, chief of breast imaging. At the University of Utah’s Department of Radiology. And Imaging Sciences, who was not involved in the survey.
“Everyone has a different amount of fibroglandular tissue. And a different pattern,” Freire says, referring to dense breast tissue. “It’s almost like a patient’s fingerprint.”
The only way to know if you have dense breasts is with a mammogram. Which doctors usually recommend every year or two for women in their 40s or 50s.
The Food and Drug Administration proposed a rule in 2019. That would require mammography facilities. To inform patients of their breast density and its significance. In October, the FDA said it was optimistic the final rule would be published in early 2023.
38 states already require providers to tell women about breast density after. A mammogram, but not all require providers to tell if a woman herself has dense breasts.
Because dense breasts are common, doctors may inadvertently underestimate the risk. Said researcher Christine Gunn of the Dartmouth Institute for Health Policy. And Clinical Practice, who led the JAMA study.
“There are many conversations with primary care doctors where they say, ‘This is normal.’ For some women, that translates to, ‘Oh, I don’t have to worry about that,'” Gunn said.
In separate interviews as part of Gunn’s survey, six of the 61 women said dense breasts contributed to breast cancer risk.
Two factors are associated with a higher risk of breast cancer in dense breasts.
First, breast formation can be affected by human cancer. The reasons for this are unclear, but scientists suspect that fibroglandular tissue. Which is unique to the breast, is more likely to develop cancer. As opposed to fatty tissue, which is found throughout the body.
Second, because women with very dense breasts have almost all fibroglandular tissue. It is difficult to detect cancerous masses or calcium deposits on mammograms.
According to Dr. Melissa Durand, an associate professor in the Yale School of Medicine’s Department of Radiolog. And Biomedical Imaging, examining a patient.; With dense breasts. For cancer is like searching for a white spot on a white wall.
Durand explained that both fibroglandular tissue and cancer appear white on a mammogram. While fatty tissue appears black.
“On a full-fat breast — lots and lots of black on the mammogram — we can be as accurate as 98%,” he said. “But our sensitivity can be really low—in some studies, even as low as 30%—if you have a very, very dense breast.”
Radiologists say the ideal type of mammogram for women with particularly dense breasts. Is a digital breast tomosynthesis, which is often better at detecting cancer than standard mammograms.
From there, doctors may recommend an ultrasound or MRI. Women with dense breasts should probably have complementary screenings every year, radiologists say.
Ultrasounds are safe and relatively inexpensive, but Freer says they can miss cancer or show false positives. Which can be confusing for patients. MRI is the most sensitive option, but for insurance companies to cover the cost. Patients usually have to show additional risk factors, such as genetic mutations or a family history of breast cancer.
“The more often you get screened, the more likely you are to be called back for additional imaging,” Freer said. “It creates some anxiety and it certainly takes time. Most patients are willing to go through that risk to get life-saving benefits.”
Women cannot change their breast density, but it can change with age.
“Typically, younger women will have thicker breasts,” Durand said. “As we age, like other parts