To Women with Dense Breasts Please Read

Anonymous

Breast tissue density is a mammographic indicator of the amount of glandular tissue in the breast relative to fatty tissue.  There are two qualitative classification systems to characterize it, the Wolfe grade and the American College of Radiology's BI-RADS.  What I didn't know--and feel ignorant for not knowing--is high breast tissue density is a strong independent risk factor for developing breast cancer.  Epidemiological studies consistently find a 4- to 6-fold increased risk of breast cancer for women with high breast density compared to those with less dense breasts (e.g., here, here, here.) 

Please remember to check your mammogram, please, please, please.

Beesie

Melissa, this is an important reminder. Recently there's been someone posting who noted that she has dense breast tissue and quite a few women responsed saying that having dense breast tissue doesn't increase breast cancer risk, it just makes breast problems more difficult to diagnose. That's not true at all - having extreme breast density does increase breast cancer risk and it is very important that everyone know their breast density.

But... I think it's also important to point out that most young women have dense breasts, and this is normal. So the concern is for women who have breast density that is more severe than it should be for one's age, and particularly, for those who have dense breasts that continue past menopause.

For someone like me, who has extremely dense breasts even after menopause, my breast density is a significant risk factor.

But for a young woman in her 20s or 30s who has normally dense breasts for her age, there is no increased risk.  It can however be more difficult to diagnose breast cancer in a younger woman because of the somewhat higher breast density, so if there is any problem or concern at all, a younger woman should insist on more than just a mammogram - get an ultrasound and possibly an MRI too.

farmerlucy

yes yes yes! I cannot emphasize this enough. If you have dense and busy breasts and a strong family history you CANNOT rely on current methods of screening to detect the cancer. Please see my BIO. Even 2 MRIs could not see it. Thankfully I saw a genetic counselor and decided on the PBM. My outcome could have been so much worse. I sought three opinions before we figured out the discharge issue. Even that was benign, but pushed me into the decision for the PBM. Hooray for discharge!

Beesie

Warning.... the above post appears to be spam. The poster is new and all his or her posts are short, non-specific and include a link to a totally irrelevant website.

aba46

i had my first mammo at the age of 39. I'm 46 now. Every year mammos show up with dense breast tissue. Last year, I underwent a wire loc excisional biospy. Pathology was sent out of state. Came back negitive, but doc (surgeon) says lets have you come back to follow up. we may even redo a mammo to see whats going on.  Ok So just a few weeks ago, I go for a second mammo. This time they found abnormal tumor. radiologist referred me to ultrasound to confirm the abnormality.  Sceduled for sedated biospy in two weeks.  Rather nerve-wracking to question "is this the one that will come back postive??". Is having Dense Breast weaken the probablity of cancerous problems? or does it increase our peace of mind knowing what we may be up againist for the future?  

farmerlucy

My breast were so dense that the doc went through several scalpels/blades at my second biopsy. For me the biggest problem with dense breasts was the difficulty in seeing anything with any screening method.

Shar1

Breast density is a major factor in the failure of mammography to detect breast cancer and many states are now requiring that women be informed of their breast density along with your results.  I recently had an inconclusive mammogram along with a bi-lateral compression test and an ultrasound that were all unable to confirm the absence of cancer because of my density.  I ended up having a BSGI/MBI test which is good for women with dense tissue.  I received an injection of a tracer accumulates in the cancer cells and makes them "light up" on the computer screen.   This test is said to be good for women with dense breasts and was extremely
easy.   Definately know your breast density and push for additional screening if you are not comfortable with the results of your mammogram!

NSJ2

Couple questions I hope you all can help me with.

What are the following please:

BSG

MBI

PBM

Edited: I think Aug242007 may have meant to write "check your mammogram reports" for info on having high density breasts, as opposed to "check your mammograms", yes?

Also, I see the Wolfe article is dated back to 1976. During that time mammograms were analogue technology. Now they are digital and 3D, as are the MRIs. Does that help in these breast density situations I wonder?

farmerlucy

PBM is Prophylactic OR Preventive Bilateral Mastectomy

NSJ2

Thank you, FarmerLucy!

Here's what my bilateral 3D MRI report states:

Note: A negative breast MRI speaks strongly against invasive cancers down to a detection threshold of 3-5mm. But may not detect some lower grade or insitu carcinomas.

My already clinically diagnosed 6mm DCIS from my earlier biopsy was seen and reported in this 3D MRI. Also in the report they do mention that both my breasts have scattered fibroglandular densities.

farmerlucy

Interesting - I had heard about the 3 -5 mm threshold, but that did not hold true for me. Two MRIs did not see a 1.1 cm IDC. Oh vell. It is all behind me now. I just need to check into that new testing for dense breasts for my DIL and my DD.

Sounds like you had some awesome screening! Good for you!

NSJ2

Hi Lucy

Do you know if the MRI was 3D technology?

I can only hope my screening was good, Lucy. I do have dense breasts and I'm older (57).  I find myself feeling frightened every day. You just don't know, yanno?

I'm truly very sorry they didn't see yours in the 2 MRIs you had. You did everything you were told to do, and then some. As a fellow sister fighting cancer we know how unpredicable this disease is. There are never any definitives.

farmerlucy

That I do not know. I will ask my bs next mo when I go for my checkup. Good luck w the surgery. My second excision was so big they called it a partial mx. I've learned to turn down the versed, so I come out of anesthesia rather quickly. That surgery was breeze for me.

NSJ2

Hi again Lucy

Aside from asking if your MRI was 3D, maybe also ask if your mammos were analogue, digital or 3D.

NSJ2

farmerlucy

The interesting thing about that note " may not detect some lower grade" might partly explain my deal. Although the local pathologist rated the tumor a grade 2, my genetic doc said grade was subjective and old fashioned and that at 3 onco type score it was obviously low grade. Hmmmm interesting.

NSJ2

But my DCIS 6mm lump is lower grade (Grade 1), which was detected in the 3D MRI. I can even see it lit up in the MRI images.

farmerlucy

True that. (I've always wanted to say that!) I never saw any of my MRI images, they'd just call to say yay or nay.  Oh vell. That worry flew out the window about the time the prozac kicked in!!  Just kidding.

NSJ2

Since this started on August 2, 2012 (what seems like a lifetime ago), I have requested a copy of every single image, and their respective reports, that have been taken of my breasts. And every facility has provided them to me.

It helped me in so many ways when I've consulted with different surgeons in having those images and reports readily available for them to see. Most MDs can tap into the databases (the cloud) of the different medical institutions to see them, but some didn't have access.

gwendolynann

I'm 54 yrs old .... I have had Breast Dence all my life.  I"ve found three lumps over the years.  I found one last August 2011, I had a Mamo, Ultra Sound and a Breast Specialist look at it.  She said, "Dencity", no Cancer.  WRONG.  In Decmeber 0f 2011, it started hurting,   Three days before xmas. Boom, Breast Cancer.  Listen to your bodies ladies, if you have even a shadow of adoubt, get a By!   If you have any questions, please contact me.

Good Luck Ladies XXOO 

doggylady

Hi all. Just a little about me... I'm 48 and just went for my first mammogram at the end of last month (I know - I should have started them years ago). I was called back for spot compression and ultrasound of both breasts due to having seen a "mass like density" in each and having "extremely dense breasts". On the ultrasound Wednesday, the radiologist showed me what she called a complex cyst, and I could see specks swirling in it, which she said were "maybe very thick fluid". In the other breast, she showed me several very tiny looking spots and a somewhat larger one, which she said were all cysts, with the somewhat larger one being attached to a dilated duct. She told me she could drain the thing she called a complex cyst if I wanted her to, but that she felt that there was nothing going on that needed anything further than yearly mammograms. I haven't gotten my actual report yet, and it will be another week and a half before I see my PCP. My question is this... do you think I should have told her I wanted the cyst aspirated and sent to pathology, or am I just being over anxious? I declined the aspiration at the time, because I felt like she didn't think it was necessary. Now I'm second-guessing myself. I know everyone is different, but just hearing from some others who have been there might help me know what to do. Thanks in advance for any advice.



Lisa