Dense Breast Structure and Breast Cancer

When compared, women with a dense breast structure carry a higher risk of breast cancer. Those with a dense breast structure should consult their doctor about the risks and benefits of further examination methods and decide accordingly.

Radiology Specialist Dr.Işıl Tunçbilek from The Private Medsentez Polyclinic gave information on the relationship between dense breast tissue and breast cancer.

What Does Dense Breast Tissue Mean?

The breast tissue is mainly made up of 3 different tissues;

• Fat tissue
• Connective tissue
• Glandular tissue

The connective and glandular tissues appear as white on a mammography whereas the fat tissue appears as black. If the tissue viewed on the mammography is mostly made up of connective and glandular tissues, then the breast tissue is considered to be dense.

Cancer tissue also appears as white on the mammography thus making it difficult to diagnose the disease in women with dense breast tissue. The detection of cancer in dense breast tissue can be as low as 30-69%.

Is Dense Breast tissue Common?

In mammographies, according to the quantity of the type of breast tissue, the breast tissue is classifed in 4 categories between: Type 1 (mostly fat tissue) and type 4 (mostly glandular and connective tissues). Fifty percent of the women have "dense breast tissue" classified as type 3 and type 4. Although dense breast tissue is mostly seen in younger women and small breast types, it can be seen in all age groups and breast types.

How is a Dense Breast Tissue Determined?

The most accurate way is by mammography screening. Manual examination alone will not give accurate information about the density of the tissue.

Is There a Relation Between Dense Breast Tissue and the Risk of Breast Cancer?

When compared, women with a denser breast tissue are at a higher risk of breast cancer. In this group, there are frequent benign changes we call fibrocystic changes and breast cancer risk can increase between 1-6 times according to the different subgroups of these fibrocystic changes.

What Should Women with Dense Dreast Tissue Do?

Women who have been diagnosed as having a dense breast tissue by their doctor should be informed about breast cancer and additional screening methods.

Ultrasonography, 3 dimension mammography (tomosynthesis) and breast MRI can detect some cancers that were not detected in a mammography. However some of these methods also have disadvantages. As these methods are very sensitive, they can show non-cancerous tissues as cancer and detect the need for a biopsy in some parts (giving wrong positive results). Also there is not enough scientific evidence to prove that the treatment of cancers detected through such methods in women with dense breast tissue has lowered the risk of mortality from breast cancer.

As a result; women with dense breast tissue should discuss the benefits and risks of additional examination methods with their doctor and decide accordingly.

Should Women Who Don’t Have a Dense Breast Tissue Also Have regular Check-ups?

Yes. All women, women who don’t have a dense breast tissue can also contract breast cancer so therefore must have regular mammograophy scannings.Regular mammography scanning is the only effective screening method known that reduces the mortality rate from breast cancer.All women in the appropriate age range are advised to go through mammography screening whether they have a dense breast tissue or not.

Işıl Tunçbilek, MD-Radiologist