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Dense breast tissue is an independent risk factor for breast cancer, both increasing our risk of breast cancer and decreasing the sensitivity of mammography to detect breast cancer. Increased breast density, as identified by mammography, can negatively impact the ability of mammography to detect breast cancer. Further, women with dense breast tissue have a 3-5 fold increased risk for breast cancer, over those without significant breast density.
Our breast tissue is comprised of a combination of both fatty tissue and stromal or fibroglandular tissue. The mammographic evaluation system, BI-RADS, categorizes breast density as ‘heterogeneously dense’ (50-75% fibroglandular tissue present) and ‘extremely dense’ (>75% fibroglandular tissue present.) This highly fibroglandular/dense breast tissue appears more ‘cloudy’ on mammography, and can obscure the findings of a small breast cancer lesion on mammography.
Patient advocacy groups have taken this concern to their legislators, and their concerns have been heard. Presently, 21 states have passed Dense Breasts Notification Laws, requiring mammography facilities to notify patients of their dense breast findings, and of their increased breast cancer risks. Most states encourage these women to address their findings with their healthcare provider, as well as their individual breast cancer risks, to determine if additional breast cancer screening is indicated. Congressional laws regarding all state mandates for Dense Breast Notification are pending.
If you are contacted by your mammography facility regarding a finding of dense breasts, contact your healthcare provider to determine if additional breast cancer screening is warranted.
Suzanne Hall, MD (@drsuzyyhall)
Eastside Gynecology Obstetrics, PC
Offices located in Roseville, Macomb, Grosse Pointe, Rochester MI