Women with extremely dense breasts have a significantly higher risk for breast cancer, according to the National Cancer Institute. Nearly half of women age 40 or older are found to have dense breasts, and 10 percent of women are found to have extremely dense breasts.
Breast density refers to the relative amount of glandular, connective and fat tissue in the breast that can be seen on a mammogram. A mammogram is the only way to determine breast density.
Patients who have dense breasts are notified when they receive their mammogram results as required by state law. The results are also included in the patient’s medical record and can be securely accessed by their physicians.
Characteristics of dense tissue
Breast density refers to the composition of the breast as seen on a mammogram. There are four categories radiologists use when they describe a person’s mammogram: fatty, scattered fibroglandular density, heterogeneously dense and extremely dense.
The high amounts of glandular and connective tissue found in dense breasts make it harder for radiologists to see indications of breast cancer on a mammogram. A breast MRI is sometimes recommended for women with extremely dense breast tissue, in addition to a mammogram.
“Extremely dense breasts double a woman’s risk for breast cancer,” said radiologist Jennifer Bergin, MD. “The risk of having breast cancer within 10 years increases from one in 42 women to one in 21 for women over the age of 50.”
Heterogeneously dense breasts are less dense than extremely dense breasts, and increase breast cancer risk only slightly. If there is no additional risk factor for breast cancer, a woman with heterogeneously dense breasts may not require additional screening, Dr. Bergin said.
Cancer risk assessments
Women who have dense breasts or other risk factors – such as a family history of breast cancer – are advised to ask their doctor about receiving a cancer risk assessment. Cancer risk assessments may include genetic testing, a review of family medical history, discussions about ways to lower cancer risks and recommendations for additional cancer screening.
“The average woman has a one in nine chance of developing breast cancer in her lifetime, while a woman with a 20 percent risk of breast cancer has a one in five chance,” Dr. Bergin said. “Women with a higher risk of breast cancer are candidates for an annual breast MRI screening.”
According to the Society of Breast Imaging, breast MRI is the most sensitive test available to detect breast cancer. The society recommends that women at higher risk for breast cancer have both a yearly mammogram and breast MRI. Each test shows greater detail related to unique aspects of the tissue.
Breast MRI allows radiologists to evaluate the tissue inside the breast using contrast dye injected into a vein. The technology produces a thousand images, or image slices, of the breast from different angles. The test takes about 15 minutes. It does not involve flattening the breast and no radiation is involved.
Women should consult with their health care providers to determine the health screenings that are right for them, and with their health plans to verify coverage.
At ProHealth Care, a woman’s health care provider discusses individual screening results and additional recommendations with each patient found to have extremely dense breasts. While MRI has traditionally been an expensive and long exam, ProHealth offers a low-cost, shorter screening breast MRI for women who are at moderately increased risk of breast cancer.
ProHealth provides breast MRI, mammography, 3D mammography and breast ultrasound services at ProHealth Oconomowoc Memorial Hospital and the ProHealth Medical Group clinic in Pewaukee. Mammography and 3D mammography also are available at the ProHealth Medical Group clinics in Brookfield, Mukwonago and New Berlin.
To schedule a mammogram, call 262-928-3000 or visit ProHealthCare.org/BreastImaging. Evening appointments are available. Immediate results are provided for weekday screenings that are completed before 4 p.m.
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