Women with extremely dense breasts and TNBC

BanR

Hi!

How many of us are ladies who were told by the doctor- You got extremely dense breasts.

Dense breasts as per latest studies makes women 4 times more prone to get cancer vs genetic mutations.

Please share your experiences and conversations with your doctors.

Thank you

NinjaMeow

I had extremely dense breasts and zero family history of cancer, breast cancer, genetic factors or TNBC and have wondered if it was a factor

BanR

Hi Ninja..

Unfortunately extremely dense breasts is a big risk factor- 4 times more than BRCAs too.

Lactation increases the density of the breast and thats why many of us have reported TNBC after pregancy/during breast feeding/ soon after breastfeeding years.

Katiha

As far as I know, dense breasts get more dense during pregnancy However, after giving birth and after breast feeding, breasts tend to become less dense.

Katiha

So is it better not to breastfeed then?

moth

The benefits of breastfeeding are great, so no, IMO it's not better to not breastfeed. (conflict disclosure: I'm a lactation consultant)

Breast density is affected by so many factors, incuding genetics & specific variants in genes such as VEGF and IGFR among others.

I think having dense breasts is something to be aware of & to discuss additional screening modalities with your primary provider. I like this handout from Are You Dense? which covers the various screening options. https://www.areyoudense.org/files/9015/1483/6013/A...

Katiha

Hi, Moth!

Thank you for your response. I have already increased risk of breast cancer (my mom was diagnosed with bc twice) and have an extra dense breasts. I do screening every six months, mammogram and then MRI, but if risk goes up so high- is it better to do preventative mastectomy after I have a child ( going trough IVF at the moment)?

Just trying to see the best way to prevent it.

moth

what a very difficult decision Katiha, with both your personal history and the family history. If it were me, I'd breastfeed at least a year and after weaning I'd consider a bmx but I'd want to talk to a couple breast oncologists about this because I think at this point it wouldn't be a true prophylactic mx (as people do before they have cancer) and while it would prevent a regional recurrence, I'm not sure if it would affect the risks of a stage 4 recurrence, which is the one to really worry about. But I don't even know if we have enough data on this. But if a mastectomy doesn't prevent stage 4 recurrence at dx then would it a huge impact on it later? So hard. I'm sorry you're facing all this uncertainty.

Beesie

BanR,

Do you have a source for your comment that "extremely dense breasts is a big risk factor- 4 times more than BRCAs too"? I've read a lot of research on breast density, and I've never seen that. Depending on the BRCA mutation, risk can range from 25% to 95%. For women with dense breasts, the highest risk figure I've ever seen in research, and it was one study only, is "6 times the risk" but this was comparing the risk level of post-menopausal women with the highest breast density to those with the lowest breast density - it was not a comparison against the average woman. The following more recent very large study found approx. 1.5X to 2X the risk for those with extreme breast density (Cat.4 ) compared to those with scattered fibroglandular density (Cat.2). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC55408...

To my understanding, breast cancer risk increases for those who have consistent (i.e. life long) breast density that is greater than the average for one's age. Pregnancy related density, since it is temporary, would not create this risk, and overall pregnancy is considered to be beneficial in reducing risk. It's also important to keep in mind that most women start out with dense breasts when they are young. This is normal. The low breast cancer rates for the "average" young woman (20s and 30s) already factors in this high level of breast density, since the "average" young woman has dense breasts. Where breast density becomes more concerning is that as we get older, our breast density normally goes down - but for some of us, it doesn't. The reduction in breast density as we age is why mammograms, which are not very effective on dense breasts, aren't routinely used for young women, but become part of standard screenings once women are in their 40s or hit 50.

Since I'm always trying to stay up to date on research and breast density is a particular area of interest for me (as someone who's had extremely dense breasts well into menopause), I'd really appreciate seeing the source of your information.