breast density

What Women Should Know About Breast Density and Cancer

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Urban cities in India like New Delhi, Mumbai, Ahmedabad, Kolkata, and Trivandrum have seen a rise in the cases of breast cancer over the last decade. Lifestyle factors like weight gain, lack of exercise, excessive alcohol consumption, hormone replacement therapies, stress, and erratic work timings have largely contributed to this. 

However, other non-modifiable factors like genetics, age, gender, and dense breast tissues have also contributed to this increasing number.

But what does it mean to have dense breast tissues? Why does it increase your risk of breast cancer? Can you do anything about it? Here’s everything you need to know about breast density and its implication for breast cancer in women.

What Does it Mean to Have Dense Breasts?

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Breast tissues are made up of milk glands and ducts, supportive tissues (dense breast tissue) and fatty tissue (non-dense breast tissue). Dense breast tissues appear as a solid white area on a mammogram, obscuring any hidden lumps. This makes it difficult for doctors to identify any potential breast cancer threats. 4 out of 5 women who screen for breast cancer are unaware that dense breasts can increase their risk of breast cancer. 

“Women with dense breasts are 5 times more likely to develop breast cancer than women with less dense breasts.”


It is imperative for all radiologists to inform and educate their patients about breast density and what it may mean for their health.

What Causes Dense Breasts?

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Breast density is usually dependent on your natural body composition. It is also affected by age and hormones. If you are undergoing hormone replacement therapy, it can increase your breast density as well. More often than not, one cannot do much to alter their breast density. 

Why Does Breast Density Matter?

Dense breasts can obscure the detection of any lumps or malformations in your breasts in a mammogram. This increases the chance of any potential breast cancer threat to go undetected.

What Are the Screening Options for Women With Dense Breasts?

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Breast density cannot be diagnosed by touch. 

“A woman’s breast may feel soft but appear dense on the mammogram,” –  Renee Pinsky, M.D., associate professor, University of Michigan.

3D Mammography, also known as Tomosynthesis, is by far the best way to screen for breast cancer in women with dense breasts. During a 3D Mammography, the breasts are observed in visual slices, helping remove some of the obscure, masking effects of dense breast tissue. 3D Mammography machines can help radiologists to get deeper insights and make early detection easier and more accurate.

Breast density is categorised into four levels :

  1. Almost entirely fatty
  2. Scattered fibroglandular densities
  3. Heterogeneously dense
  4. Extremely dense

Women who have dense breasts or think they might have dense breasts should discuss with their doctor on other screening methods like an ultrasound, which can pick up other cancers that may not be detected in a mammogram. But it is to be noted that Ultrasound may also have a higher false positive rate. 

Some other screening methods for breast density include Breast MRI, and Molecular Breast Imaging (MBI). Consult your doctor on what screening method is best for you.

Furthermore, it is important to understand and discuss breast cancer risk factors with your doctor to remain compliant with the growing need for breast cancer screening.

Takeaway

The concept of breast density is an important factor in determining breast cancer risks. Here are some key factors you should keep in mind:

  1. Breast density cannot be diagnosed by touch, you need to consult your doctor for specific screening methods.
  2. Dense breasts can make it difficult to detect any signs of breast cancer in a mammogram.
  3. Breast density may change with age and conditions like pregnancy, lactation, and menopause.
  4. Dense breasts require additional screenings like Ultrasound and Breast MRI.

It is important we talk more about breast density and address this issue head-on. So #ScreenItOut and have the best chance of early cancer detection.

Aspirin could reduce breast density by almost 40%

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Almost half of women eligible for mammography screening have dense breast tissue, and density has been linked to increased cancer risk. But what if a simple intervention could reduce a woman’s risk — even before she gets to screening?

The humble aspirin tablet could be a worthy agent for reducing breast density and, by extension, the risk of breast cancer, according to research presented recently at the San Antonio Breast Cancer Symposium (SABCS). What’s more, it’s no farther than the medicine cabinet.

“Current breast cancer prevention agents have substantial side effects and do not prevent estrogen receptor [ER]-negative breast cancer,” said presenter Dr. Marie Wood, an oncologist at the University of Vermont. “Aspirin is a promising breast cancer prevention therapy. It’s cheap, safe, and well-tolerated, and there’s strong biologic and epidemiologic evidence for a prevention effect on both ER-negative and ER-positive breast cancers.”

Wonder drug?

Wood and colleagues — including Dr. Emily Conant of the University of Pennsylvania — evaluated the effect of aspirin on mammographic density using medical records for 26,000 women from 36 primary care and ob/gyn practices. Subjects were included if they had undergone routine screening mammography between 2012 and 2013 and had a confirmed list of their medication use. Aspirin dose was categorized as above or below 300 mg per day, and each woman’s BI-RADS breast density category was taken from her latest mammogram.

Dr. Marie Wood

Dr. Marie Wood from the University of Vermont.

“Studies have shown that aspirin is associated with a reduction in cancer mortality and has also been shown to prevent colon cancer,” Wood told AuntMinnie.com. “The data for breast cancer are unclear. We wanted to evaluate the link between aspirin use and breast density — an important risk factor for breast cancer.”

Of the cohort, 19.7% reported current aspirin use. Forty-one percent of the women were African-American, a group that tends to be at greater risk for ER-negative breast cancer. The mean age of the study participants was 57 years, and mean body mass index was 29.

Wood and colleagues found an independent inverse association between aspirin use and mammographic density (p < 0.001). Women who took 300 mg of aspirin or more per day had a 38% lower likelihood of having extremely or heterogeneously dense breasts. This association between aspirin use and lower density was more pronounced for women younger than 60 and for African-American women, according to the researchers.

“The effect of aspirin on density was strongest for two groups at greater risk for ER-negative breast cancer — which is good news, especially since current [U.S. Food and Drug Administration]-approved breast cancer prevention drugs like tamoxifen only prevent ER-positive cancer,” Wood said.

The study results are promising, but more research is needed, she concluded.

“Our findings suggest the need for further study of aspirin for breast cancer prevention, and support the use of mammographic density as a research end point,” she said.