Breast Cancer Awareness: Dense Breast Tissue
Deborah Breakell, MSN, FNP-BC, CWHS
Breast Cancer Awareness Month is a time for us to reflect on those family members and friends that have been diagnosed with breast cancer. It is also a time to explore what we can do to further prevent breast cancer and be proactive in early breast cancer detection. Identifying and appropriately screening dense breast tissue is key to early detection.
The statistics are daunting. Average-risk women have about an 8% chance of developing breast cancer by the age of 70, and up to 12% by age 85. According to the Social Security Administration Actuarial Life Table, approximately 82% of American women will live to age 70, and close to 50% will live to age 85. Knowing one's risk empowers women and allows them to make changes with modifiable risk factors.
Dense Breast Tissue Risks
One of those risks is dense breast tissue. Dense breast tissue refers to breasts that have more connective tissue and fibrous tissue than fatty tissue, which makes it harder to spot tumors or abnormalities. Over 50% of women have clear signs of dense breast tissue. We now know that having dense breast tissue is an independent risk factor for breast cancer. Not only does dense breast tissue mask the detection of tumors, but the types of cells that comprise the tissue are more susceptible to cancer in and of themselves, and there is a greater volume of them.
Categories of Breast Tissue
When getting a mammogram, the American College of Radiology is required to use the Breast Imaging Reporting and Data System (BI-RADS) to classify breast density into 4 clear categories:
Category A is primarily fatty tissue and only 10% of women have this breast tissue that can easily identify abnormalities.
Category B is scattered fibroglandular density which are small areas of dense glandular tissue with the majority still being fat and includes about 40% of women.
Category C is heterogeneously dense. Large widespread areas of dense tissue is among fatty tissue and includes about 40% of women. The detection rate of your screening is about 80-85%. This means you have a 15% chance that cancer could be missed. By having a bilateral breast ultrasound in addition to your mammogram you increase your cancer detection rate by 95%
Category D is extremely dense breast tissue with very little fat. About 10% of women have this condition. The detection rate of your screening mammogram is about 70-75%. This means there is a 25% chance that cancer could be missed.
Breast Ultrasounds
Category C and D make it more difficult for a radiologist to see an abnormality. Fortunately there is an additional screening method available to get a better look. It’s called a bilateral breast ultrasound. Having a bilateral breast ultrasound in addition to your mammogram increases your cancer detection rate by 95%. Unfortunately breast ultrasounds are considered “diagnostic” so many insurance companies will not pay for this additional preventative screening….even though it could save your life!
What To Do Next
If you think or know you have dense breasts, you can ask your provider to order this additional test to have a more complete breast screening. You can also schedule a consultation to discuss other risk assessment tools (thermogram, thyroid testing, estrogen metabolite testing, gut health) to reduce your overall breast cancer risk. If you don’t know what type of breast tissue you have, now is a great time to schedule a well-woman visit. Your provider can give you additional insights based on your exam and medical history and order a mammogram if necessary. Regular screenings are key to prevention and early detection.
To schedule an appointment with Deb Breakell, call us at 303-499-9224.
Deb Breakell is a Board Certified Family Nurse Practitioner with an emphasis on Women’s Health. During the past 25 years she has worked in Women’s Health and Family Practice with a focus on the integration of conventional and alternative therapies.
