Does Breast Density Impact Breast Cancer Screening?
Dr. Melissa Pilewskie is a surgeon who cares for people with breast cancer at Memorial Sloan Kettering in Manhattan and Commack, NY.
The American Cancer Society estimates that well over 300,000 women will be diagnosed with breast cancer in 2017. Routine breast cancer screening, which is done before a person has any symptoms, can help detect the disease at an early, more treatable stage.
Annual mammography is the only screening method that has been shown to reduce mortality from breast cancer. To help improve breast cancer detection and prevention, New York State law requires radiologists to inform women if dense breast tissue is found on a mammogram.
Why is Breast Density Important?
Breasts are made up of different types of tissues. They are considered to be dense if most of the tissue seen on a mammogram is fibrous and/or glandular breast tissues, which appear white on a mammogram. Because cancer cells also appear as white on a mammogram, it may be harder to identify the disease on a mammogram in women with dense breasts.
Dense breasts are completely normal and tend to be more common in younger women and in women with smaller breasts. But anyone – regardless of age or breast size – can have dense breasts. While the risk for breast cancer is higher in women with very dense breasts, most women fall somewhere in between in terms of their degree of breast density. It’s nearly impossible to determine whether a particular woman’s breast density is a risk factor for breast cancer.
Screening Women with Dense Breasts
All women of appropriate age should have mammograms, regardless of their breast density. Some women with dense breasts may be asked to undergo additional imaging tests such as ultrasound or MRI, which can pick up some cancers that may be missed on a mammogram. However, there is no evidence to show that using screening tests other than mammography in women with dense breasts decreases the risk of death from breast cancer.
Each individual woman’s risk for breast cancer is different, and many factors – such as family history and lifestyle – must be taken into account when determining whether additional forms of breast cancer screening are necessary. Ultimately, women found to have dense breasts should talk to their doctor about their individual risk for breast cancer and together decide whether additional screening makes sense.