Don't BE dense,
be DENSE AWARE
to your questions
|WHAT IS BREAST DENSITY?|
Breasts are made up of three types of tissue – fatty, fibrous and glandular tissue. Every woman is unqiue and has a different amount of these three types of tissue. A person with dense breasts (on a mammogram) has less fatty tissue and more glandular and fibrous tissue.1
As you can see from the mammogram images below, some breasts are mostly made up of fatty tissue. Others are mostly made up of glandular and fibrous tissue, and these are known as dense breasts.
|FATTY BREAST TISSUE.
|WHY DOES HIGH BREAST DENSITY HIDE CANCERS?|
As you can see in the image below, dense breast tissue appears whiter on a mammogram image, making it more difficult for radiologists to interpret and often resulting in the need for follow-up imaging.9
Imagine dense breast tissue as clouds in the sky and breast cancers as white planes in flight. When a plane flies through wispy clouds, you can still see the plane in the air, but when a plane flies through thick clouds, it can be nearly impossible to visually detect.
|NOT DENSE BREAST.
|IS BREAST SIZE RELATED TO BREAST DENSITY?|
You may be surprised to learn that breast density isn’t based on how your breasts feel e.g. the size or firmness.1 In fact, breast density is seen only on mammograms.1 Breast density relates to the type of tissue present, not to the size or firmness. Dense breasts have a lot of fibrous or glandular tissue and less fatty tissue.1 While you can’t tell whether your breasts are dense from looking at them or feeling them, it is still important for all women to know the normal look and feel of her breasts. If you notice any changes in your breasts, you should visit your GP.
|HOW DO I KNOW IF I HAVE DENSE BREASTS?|
Breast density is seen only on mammograms.9 Dense breasts have a lot of fibrous or glandular tissue and less fatty tissue.9 Breast density is often included in the report from the radiologist following a mammogram so you can ask your doctor about your breast density.
|HOW COMMON ARE DENSE BREASTS?|
|WHO IS MORE LIKELY TO HAVE DENSE BREASTS AND CAN I CHANGE MY BREAST DENSITY?|
Breast density is often greater in women who are younger.1 Other factors that may increase the likelihood of having dense breasts include being pre-menopausal, use of certain drugs such as menopausal hormone therapy, being pregnant and as a result of genetics.1 While some women’s breasts become less dense with age, others experience little change.1 In general, the best way to deal with the inceased risk associated with having dense breasts is not to try to reduce your breast density, but to talk to you doctor about a breast cancer screening program that suits your individual needs.
|WHY IS BREAST DENSITY IMPORTANT?|
Women with dense breasts (on mammogram) have a four to five times increased risk of breast cancer compared with women with average breast density.4,5 It is currently unclear as to why this is, so more research is needed in this field.4 There is also an increased risk of breast cancer not being detected by a standard mammogram in women with dense breasts.6,8 As you can see in the image below, dense breast tissue appears whiter on a mammogram image. This makes it more difficult for radiologists to interpret and often results in the need for follow-up imaging.1
|NOT DENSE BREAST.
|WHAT DOES IT MEAN FOR ME IN TERMS OF BREAST CANCER SCREENING IF I HAVE DENSE BREASTS?|
3D mammography is a newer technology that helps to eliminate most detection challenges associated with standard 2D mammography in a diagnostic setting.6,10
3D mammography has been shown to detect 41% more invasive breast cancers and reduce the need for unnecessary further testing by up to 40%.6,10 This means two simple things: earlier detection than ever before and less anxiety about unnecessary further testing.7,11
3D mammography may be performed in conjunction with an Ultrasound and/or MRI exam.
Discuss with your doctor whether a 3D mammography exam, MRI or ultrasound might be right for you.
|WHY ARE STANDARD MAMMOGRAMS LESS ACCURATE IN WOMEN WITH DENSE BREASTS?|
|WHAT IS AUSTRALIA DOING IN REGARDS TO BREAST DENSITY?|
However, in Australia, there is currently no requirement for breast density to be provided on mammogram reports.3 That means that it is up to you to ask that this information be included in your mammogram report. You and your doctor can then use this information to help plan a breast cancer screening approach that is most suited to your individual needs.
Understanding Breast Health
with Shelly Horton
– Shelly Horton, 43, journalist
In August 2017, Pink Hope commissioned a nationally-representative survey that explored women’s awareness, or lack thereof, regarding breast density, breast cancer risk and screening options available. In total, 1,010 women from all states and territories across Australia completed the online survey.
In fact, 40-50% of women
aged 40-74 have dense
breasts8,11 – that’s over two
million Australian women.12
Yet four out of five women
(84.4%) are unaware dense
breasts increase the risk of
Almost two thirds (65.8%) have
no idea breast density can
obscure a lesion or lump on a
More than three quarters of
Australian women (78.1%) don’t
know, or are unsure, if they’re at
increased risk of breast cancer.7
When it comes to women
over the age of 50 – for
whom a mammogram is
highly recommended given
risk increases with age
(approximately 75% of new
cases of breast cancer develop
in women over the age of 50)16
– a third of Australian women
have not had a mammogram
Almost half of women over the
age of 50 haven’t even checked
their own breasts via self-exam
(45.3%). In fact, when looking at
all women over the age of 30,
one in three Australian women
haven’t checked their own
Three quarters of women over
the age of 50 (79.4%), who are
at increased risk of developing
breast cancer, don’t know, or
are unsure, whether or not they
have dense breasts.7
Only a small number of women
have ever undergone more
personalised breast screening
Read what the scientific community says regarding breast density
What Do Our Patients Need to Be Told and Why?
A Survey Study of Practicing Radiologists.
Implications of Breast Density.
1. American Cancer Society. Available at: https://www.cancer.org/cancer/breast-cancer/risk-and-prevention/breast-cancer-risk-factors-you-cannot-change.html. Accessed June 2017. 2. Breast Cancer Network Australia. Available at: https://www.bcna.org.au/about-us/advocacy/position-statements/family-history-and-hereditary-breast-cancer/. Accessed September 2017. 3. BreastScreen SA. Breast density Information for consumers. Availabe at: http://www.sahealth.sa.gov.au/wps/wcm/connect/6e1a80804e78310ebd28fdc09343dd7f/Breast+Density+Consumer+Information-v3_FORMATTED.pdf?MOD=AJPERES&CACHEID=6e1a80804e78310ebd28fdc09343dd7f. Accessed September 2017. 4. Boyd NF et al. N Engl J Med 2007;356:227–36 5. Yaghjyan L et al. J Natl Cancer Inst 2011;103:1179–89. 6. Skaane P et al. Radiology 2013;267:47–56. 7. Rose S et al. AJR Am J Roentgenol 2013;200:1401–8. 8. Ciatto S et al. Lancet Oncol 2013;14:583–9. 9. American Cancer Society. Available at: https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/mammograms/breast-density-and-your-mammogram-report.html. Accessed June 2017. 10. Friedewald S et al. JAMA 2014;311:2499–507. 11. Australian Institute of Health and Welfare 2013. BreastScreen Australia monitoring report 2010– 2011.Cancer series no. 77. Cat. no. CAN 74. Canberra: AIHW. 12. American College of Radiology. Available at: https://www.acr.org/Advocacy/eNews/20170217-Issue/20170217-State-Breast-Density-Reporting-Laws-Proliferate. Accessed September 2017. 13. Freer PE. Radiographics 2015;35:302–15. 14. Pink Hope PureProfile Consumer Survey. August 2017. 15. Ho JM, Jafferjee N, Covarrubias GM, Ghesani M, Handler B. Dense breasts: a review of reporting legislation and available supplemental screening options. AJR Am J Roentgenol. 203(2):449-56, 2014. 16. Boyd NF, Guo H, Martin LJ, et al. Mammographic density and the risk and detection of breast cancer. N Engl J Med. 356(3):227-36, 2007. 17. Yaghjyan L, Colditz GA, Collins LC, et al. Mammographic breast density and subsequent risk of breast cancer in postmenopausal women according to tumor characteristics. J Natl Cancer Inst. 103(15):1179-89, 2011. 18. Sprague BL, Gangnon RE, Burt V, et al. Prevalence of mammographically dense breasts in the United States. J Natl Cancer Inst. 106(10), 2014. 19. Australian Bureau of Statistics Population Data. Women 40-74 years. 20. McDonald ES, Oustimov A, Weinstein SP, et al. Effectiveness of Digital Breast Tomosynthesis Compared With Digital Mammography: Outcomes Analysis from 3 Years of Breast Cancer Screening. JAMA Oncol. 2016 Jun 1;2(6):737-43. 21. Cancer Screening. Breast Density and Screening Position Statement. Available online at: http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/BD289E88F9F95876CA25803E001FC4E6/$File/Position%20Statement%20on%20breast%20density%20and%20screening%20within%20the%20BreastScreen%20Australia%20Program.pdf 22. Cancer Australia. Your Risk and Breast Cancer: Family History: Available online at: https://breastcancerrisk.canceraustralia.gov.au/risk-factors/family-history. Last accessed August 7, 2017. 23. Cancer Institute NSW. Breast cancer cases by age group. Available online at: https://www.cancerinstitute.org.au/understanding-cancer/cancer-in-nsw/breast-cancer. Last accessed August 7, 2017.