What Women Should Know About Breast Density And Cancer Risk – Patch.com

In 2009, Connecticut was the first state to pass a law that requires radiologists to notify women who have had screening mammograms if they have dense breasts. Since then, more than 30 states, including New York, have followed suit. Breast density has to do with the amount of fibrous and glandular tissues that a woman has in her breasts compared with the amount of fat. Having dense breasts is a risk factor for breast cancer.

Below, Sandra Brennan, M.D., Director of Radiology at Memorial Sloan Kettering (MSK) Westchester, explains what doctors know about breast density and what steps women with dense breasts can take to increase the likelihood that any cancer they might develop is detected early.

Having dense breasts is relatively common and makes it more difficult for cancer to be picked up by a mammogram. The dense tissue looks white on the image, and that can obscure cancerous masses.

Women with dense breasts also have an elevated risk of breast cancer. The 10 percent of women who have the most-dense tissue have a risk that's four to six times higher compared with those whose breasts are the least dense. This is because glandular tissue is more likely to become cancerous. But even women with breasts that are mostly fatty can develop breast cancer.

Mostly it's just part of the body's natural makeup. Density is affected by age and hormones. Taking hormone replacement therapy will increase breast density. Conversely, taking an estrogen-receptor drug to treat breast cancer will decrease it. A woman's breasts may become less dense as she ages, but that doesn't always happen. Some women may have changes in the amount of fat in their breasts if they lose or gain weight. Women with a low body mass index tend to have dense breasts.

Tomosynthesis, also known as 3-D mammography, is better at detecting masses in dense breasts than traditional 2-D mammography. This is because it looks at the breasts in visual slices and removes some of the masking effect of the overlying dense tissue. We offer 3-D mammograms as an option for women who get screened at any of MSK's locations, including MSK Westchester.

Women with dense breasts should discuss with their doctor whether they should have supplemental screening with ultrasound. It can pick up cancers that we might not see on a mammogram in women with dense breasts.

We offer 2-D and 3-D mammography, and screening breast ultrasounds. For women at a higher breast cancer risk unrelated to their breast density, we offer breast MRIs, which can detect small tumors that are not seen on a mammogram.

For those who need a breast biopsy, we perform a number of nonsurgical procedures at MSK Westchester. These include percutaneous ultrasound-guided core biopsies, fine-needle aspirations, stereotactic breast biopsies and MRI-guided biopsies. People who are having surgery at MSK in Manhattan can have their preoperative seed localizations and sentinel node injections done at MSK Westchester.

We also offer contrast-enhanced digital mammography (CEDM) at MSK Westchester. This advanced breast-imaging technique creates a vascular map of the breast, similar to an MRI. It's a specialized procedure that highlights areas of increased blood flow that can be associated with tumor growth. MSK research has shown that CEDM is as sensitive in detecting breast cancer as breast MRI when both were compared with standard mammograms. MSK is unique among breast-screening facilities in Westchester County in offering CEDM, which is not widely available.

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What Women Should Know About Breast Density And Cancer Risk - Patch.com