Dr. Alison Chetlen, left, head of breast photos in Penn State Well being Milton S. Hershey Medical Middle, positions a affected person for a mammogram.
For girls 40 years or older, mammograms are one of the simplest ways to detect early breast most cancers, when the illness is extra treatable. Mamographies additionally reveal one other essential element: if in case you have dense breasts and may benefit from the extra detection of breast most cancers.
April 30, 2025
“Having dense breasts is regular: it implies that their breasts include extra cloth than fats,” says Dr. Alison Chetlen, Chief of Breast Picture Radiology at Penn State Well being Milton S. Hershey Medical Middle and Professor of Radiology at Penn State Faculty of Medication. “Nonetheless, for dense breasts, mammograms alone will not be sufficient to detect breast most cancers.”
The rationale? Girls with very dense breasts have between 4 and 6 occasions extra more likely to develop breast most cancers than girls with non -dense breasts. Breast most cancers can be tougher to detect in dense breast cloth.
What are dense breasts?
The breasts include fats and fibrous materials of fibroglandular tissue and milk producing glands. The breasts of every lady range within the proportion of fats versus fibroglandular tissue, mentioned Chetlen. The density of the breasts is described in one of many 4 totally different classes:
- Dense breasts: primarily fibroglandular tissue
- Heterogeneously dense breast cloth: primarily dense tissue with some fats
- Dispersed fibroglandular density: particularly fats with slightly dense cloth
- Much less not dense: Principally fats
About 40% of ladies aged 40 to 74 have dense breasts. Genetics is the primary cause. You can not say in case your breasts are dense relying on how they give the impression of being or really feel. Solely picture exams can verify it. In a mammogram, dense breast cloth appears white, whereas fats appears grey, Chetlen mentioned.
Why are dense breasts linked to the chance of breast most cancers?
Breast most cancers is extra widespread, however tougher to search out, in dense breasts. Greater than 70% of breast cancers happen in dense breast cloth. In extraordinarily dense breasts, as much as 50% of cancers may be misplaced.
“In a mammogram, dense tissue and lots more and plenty seem white, so a suspicious mass may be hidden in dense cloth,” Chetlen mentioned. “Dense breast cloth causes a masking impact, which hinders radiologists to successfully learn their mammography, equivalent to discovering a snowball in a snowstorm.”
Breast cancers in girls with dense breasts additionally are typically extra superior, which requires a extra intensive therapy, mentioned Chetlen.
How do I uncover if I’ve dense breasts?
Since September 2024, the US Meals and Medicines Administration has required mammography experiences to tell sufferers if their breasts are dense.
“Sufferers can now have vital info to speak with their suppliers, make joint choices and defend themselves,” mentioned Chan Shen, a researcher on the Penn State Most cancers Institute and professor of surgical procedure and head of surgical outcomes, analysis and high quality at Penn State Faculty of Medication.
Some states, together with Pennsylvania, have required a breast density notification for years. Shen obtained a $ 100,000 subsidy from the breast most cancers coalition in January to review how these state legal guidelines have an effect on the outcomes of sufferers.
“Our purpose is to find vital concepts about how these insurance policies are affecting the detection and a focus of breast most cancers,” mentioned Shen.
What ought to I do if I’ve dense breasts?
Should you uncover that you’ve got dense breasts, you’ve gotten choices. “Now you might be empowered with this info, and you may select what to do with it,” says Chetlen.
Shen agrees. “Sufferers can speak with docs about whether or not they need to take supplementary detection, and that may have downstream results such because the punctuality of breast most cancers prognosis, the most cancers stage when identified and coverings and outcomes,” he mentioned.
What different detection choices can be found?
In case you have dense breasts, your physician might advocate supplementary breast most cancers exams. “Supplementary detection might help us discover these non -throbbing, small and invasive cancers earlier than metastasis,” Chetlen mentioned. Early detection can cut back the necessity for aggressive remedies equivalent to surgical procedure and chemotherapy.
An possibility is automated full breast ultrasound, a non -invasive take a look at that makes use of sound waves to create an in depth 3D picture of its breast. When utilizing utterly automated breast ultrasound with mammography, breast most cancers detection improves 35.7% on mammography alone.
This detection take a look at differs from a diagnostic breast ultrasound, which is used to look at the abnormalities discovered within the earlier exams. Diagnostic chest ultrasound supplies docs with a clearer picture of lots or different modifications, serving to them and sufferers resolve the very best therapy. Diagnostic mammograms may also be used to discover uncommon findings.
For girls with a really excessive breast most cancers danger, primarily based on genetics, household historical past or well being historical past, a breast magnetic resonance can be beneficial.
“Speak to your physician about your choices and, collectively, you can also make an knowledgeable determination,” Chetlen mentioned.
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