Breast Density: Higher Risk & New Screening Options
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- Опубліковано 13 вер 2024
- We teach you how breast density is a risk factor for developing cancer and share new tools and technologies to better screen women with dense breasts.
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Questions for your Physicians or Breast Surgeon:
1. Do I have significantly dense breasts on my mammogram?
2. Shouldn’t I have a 3D mammogram?
3. What is my mammogram “BI-RADS density score?”
4. Should I see a breast surgeon to discuss this?
What is mammographic breast density?
Breast density is a term used to describe how much breast tissue is made up of glands and supportive tissue. Dense breasts have more of this “thicker” tissue, which appears white on mammograms. Mammograms in women with very dense breasts can be more challenging to interpret by breast radiologists. Up to 40 percent of women have significantly dense breasts.
Why does breast density matter?
We have learned over time that women with dense breasts have a higher risk of developing breast cancer in their lifetime. Studies have yet to narrow down exactly how much of an increased risk, but the best “calculator” is the BCSC Calculator outlined in detail below.
Dense breasts also make it more difficult for radiologists to see a small breast cancer because these growths can be overshadowed by the dense or white appearing tissue on a mammogram.
So dense breasts pose a “double-whammy” of increased risk and decreased ability to find breast cancers on mammograms. The take-home message for those with dense breasts is to get regular mammograms, and ask for 3D mammograms if they are available to you. This best applies to those who have high BI-RADS Density scores of 3 and 4 (see below).
What is my “BI-RADS” Density Score on my mammogram report?
This scoring system is the radiologist’s estimate of breast density. The BI-RADS scores for low density are 1 and 2. High density are 3 and 4. The images below are examples of low to high density from left to right. The “terms” used to describe density in the figure below correspond to the BI-RADS scores 1 - 4.
LOWER DENSITY terms used on every mammogram report:
BI-RADS 1 or “A” or “Almost Entirely Fatty Tissue”
BI-RADS 2 or “B” or “Scattered Fibroglandular Tissue”
HIGHER DENSITY terms used on every mammogram report:
BI-RADS 3 or “C” or “Heterogeneously Dense”
BI-RADS 4 or “D” or “Extremely Dense”
Should I see a breast surgeon for density?
Seeing a breast surgeon is not generally necessary just for dense breasts. However, if you have multiple other “high risk” factors, or are at risk for carrying the BRCA mutation, ask for a breast surgeon consultation.
Calculate your risk for breast cancer
The new, online Breast Cancer Surveillance Consortium (BCSC) Risk Calculator (link on our website) calculates your 5-year and 10-year risk of developing invasive breast cancer. It is the only “risk calculator” that includes breast density as a risk factor. It is designed for physicians, but you are free to use it also. We suggest you take a printout of “your calculated risk” to your physician to engage them in a discussion about your personal risk for developing breast cancer. Share this calculator with your physician in case they aren’t aware of this new tool.
To calculate your breast cancer risk online you will need a copy of your most recent mammogram report from your physician to complete the questions. Most radiologists will list a “BI-RADS” breast density score (1,2,3, or 4) or a description of the level of density as described above. Enter this “level” into the calculator in addition to the other information that is requested. The Breast Cancer Surveillance Consortium (BCSC) is a group of organizations that work together to advance breast cancer research.
Automated Whole Breast Ultrasound (ABUS)
Whole breast ultrasound was designed to screen women with dense breasts to improve the chance of finding a cancer that might be missed by mammography. It is not a replacement for mammograms. Mammograms are still essential to screen women with dense breasts. This type of ultrasound is designed to be used in addition to annual mammograms. When ABUS is added to mammographic screening, breast cancer detection can be improved by up to 50 percent.
The GE Healthcare Invenia ABUS system is the first FDA-approved device and is becoming more widely available in the community. Click (here) to find a facility near you that offers this ABUS service. More information about breast density and ABUS by GE Healthcare is located (here).
Sadly for me even the 3D mammo did not pick up my cancer. My primary Dr even ordered an ultrasound because we were concerned about a growing lump. The Radiologist told his Tech to send me on my way as all was good! The Radiologist denied my ultrasound order, did not even come & talk to me at any point, even when i asked the Tech, "What about the Lump?"
You HAVE to be your own Advocate! That hospital made me feel like i was crazy.
I'm still livid over that debacle.
1:18 What is density?
2:48 Screening challenges
4:36 3D Mammograms
5:46 Whole breast ultrasound
60 with a BIRADS score of 4. Been doing 3D mammograms for a few years now. It DID NOT catch my breast cancer. Trying to get an ultrasound in conjunction with the mammo takes an act of God with the insurance company. I got my first ultrasound after I found my lump. The cancer surgeon said that had I not found my lump, the 3D mammo would not have picked it up. Keep in mind if you have dense breasts, there is a large margin of error even with 3D mammography.
What A Great And Very Professional Lesson About Breast Tissue Density. Thank So Much Dr. John
I have very dense breast and 3D mammogram never detected lumps on my breast. In the past 10 years i found myself 3 lumps on my left breast were benign, and this time i found a lump on right breast and is cancer 😢IDC. I don’t believed in the mammogram anymore. My surgery is tomorrow, i choose lumpectomy.
👏🏻👏🏻👏🏻👏🏻 ✨ Great explanation! I have very dense breast tissue and the 3D mammogram was able to find a IDC (1cm). Now I’m waiting for the biopsy results. Thank you for this channel!
Most importantly, good luck on your journey. It is not easy, but make sure to use our website www.breastcancercourse.org to educate yourself through the process. Thank you for the feedback!
Hi…I hope u r OK Nov.2022 ? 🤔✨🤲🏻
Hello ! Lovely. How are you 🙏
At 75 I still have dense brests. Get a 3D mammogram every year.
So grateful for the sharing!!
I am 75 , have dense breaths, my sister died of Brest cancer. And wasn’t even told dense is not good
Wow thank you for this detailed video. I just found out I have breast density.
I have very dense breast I been having breast pain for a week now, my mammogram is not due until October however I do have an appointment with my Gynecologist on Monday I will definitely inform her of this pain, I even examined my breast, and it feels like something is there, I’m a little scare but I know I’m be alright I hope and Pray it’s not anything.
Tamoxifen (Selective Estrogen Receptor Modulator) has been shown to reduce breast cancer density. Consider talking about it to your physician.
That's if tamoxifen works. Took it for 4 mths. It got a tad bigger.
@@queue555
I wound not take Tamoxifen to reduce breast density. They give it to people who have had breast cancer to keep it from coming back. My mother was on it and it causes many side effect.
QT is the best option! Now available in California and worth the trip. No radiation and can see through density.
Am 46, Just found out both breast is very dense my doctor said it’s nothing to worry about , now the radiologist is making it mandatory for me to have mammogram yearly.I scored 1
Most women that I am talking to say they are told to have dense breast. It is unreal.
I am 51 and have “extremely “ dense breast. My mother was diagnosed at age 61 with stage 2 triple negative breast cancer. The radiologist recommendation is for me to have ultrasound. I will definitely be looking into this. Scary stuff:(
Scary and unreal. They said dense breast it’s natural occurrence in women reaching menopausal age, 🤔 not sure what to think, but I recently had total hysterectomy and once again, it’s normal for pre menopausal women to have all these scary things suddenly start happening to them.
@@hluvv7607 I have been having annual mammograms since I turned 40. My preventative choice. I have always gotten a letter back stating I have dense breast tissue. A letter, not the actual test results. I, too, had a total hysterectomy except my ovaries were left intact. I had a hysterectomy because of fibroid tumors and endometriosis. Afterwards, I started taking Divigel (estrogen). Now I have Stage 3 Invasive Ductal Carcinoma in my left breast. Cramming my brain now with a lot of research, I think I was always estrogen dominant. From reading, being estrogen dominant can cause the fibroids and endometriosis. I feel like now I’ve been “feeding” my cancer since I started taking the Divigel after my hysterectomy. My Breast Specialist/surgical oncologist thinks taking the Divigel did cause my cancer. I am now reading up on how to get estrogen out of my body, and I did stop taking the Divigel. My BS has told me, I will have to start taking anti-estrogen pills for 5-10 years!!! My menopause symptoms are practically nonexistent so far since quitting the estrogen. I just wish I would have weaned off it sooner. Also, after my two prior mammograms, I thought about asking my gyno to do an MRI. I can’t do anything about it now. I just have to keep looking forward into the future.
I’m 46 and was just told I need an ultrasound cause fibroglandual tissue. Peri menopause already diagnosed, just starting progesterone last month
I have heterogeneously dense breasts, my doctor has me have a mammogram and breast ultrasound every year. I’m always so nervous at this appointment every year
I had my first screening mammogram today and was told I have heterogeneously dense breasts. I am learning about it now so I’ll be diligent about my yearly mammograms.
Me too I have the same type of density. I think is like #3. And I’m scare. But thanks to this video I’m gonna ask about the 3D mammogram and the automated whole breast untrasound and just have it done every year.
I will have to ask about my score (If I recall, they said it was a 3 or 4 - will verify this afternoon at my appointment). I have been told I need an MRI as they cannot see well enough to determine from a mammogram whether or not I have abnormalities. Then yesterday I spoke to a lady representing the (Ciano) oncology place that Baptist runs (Gulf Breeze, Florida). She said that they are planning to do some kind of blood draw to see if I have any genetic markers for cancer.
Well . . . my grandmother had breast cancer, and like the power house she was, she kicked its butt. Lol. I have known that I have high breast density since I was 38. I am now almost 52. I am really concerned at this time. However . . . I am using this situation to praise God, knowing that no matter what happens, He's got me. But I can't lie - this is scary. I did find out that my insurance will put fakies in should I need to have the procedure nobody wants.
My biggest issue is that I keep crying, not knowing. As you saw above, I am very much leaning on God. This is great - but I am human, so even though I know He is always here for me, I still fear my future. If anyone has advice, I would surely love that. Thanks.
I hope your test was okay and just keep the faith
I did my 3D for the 2nd year in a row for a side by side comparison, and just had my ultrasound! Waiting for my ultrasound results in a few days.
Linn. Good luck on your results!
Linn MacDonald Did you get your results ?
What was the results if you don't mind please share I have an appointment in two days I'm scared
What are your results? I had a mammogram and have density.They are taking me for a ultrasound because i have a 9mm one in the 9 o clock position and they want to look at.And im little worried but im praying its because im on my period
Very informative. Thank you
Thank you for the information dokter.
Well it said extremely dense breast cancer..but I have a lump i can see and a groove so if it's cancer.. it's there
. Sunday scan will tell me..
There are ratings of density? How come the doctor didn't tell me?
I’m 6o and density level 4. I won’t have mammograms anymore but just MRI
U right
I just had a mammogram
done thank you for explaining all I needed to know. Now I can make my decision on what to do
I will talk with my Dr @ the letter I received today. DR you were the greatest!! I appreciate you so very much!!! 🙏🙏 are for you
have a blessed day as you would a rainbow 🌈✨day
Be safe..
In Australia they don’t reveal to patients their breast density. I don’t know why
If I may ask, why is mammography the threshold test for breast cancer if breast density is such a common phenomenon?
I was ordered by my OBGYN (who is obviously not trained in radiology as a radiologist is) to do mammogram and the US, but I didn't want another radiation dose of a mammogram and did only the US. The sonographer told me after my US, that the US examined everything in details and I didn't need the mammogram if I had the US already. I want to ask the same question - why to bother with the mammogram if US is better for dense breasts.
Because it’s cheap and readily available
THANK YOU
They said I had dense breast but told me don’t worry about it my aunt passed away of breast cancer
I'm sorry
I thought BIRADS score is assigned specifically to label risk of cancer dense breasts or not. Is there a different BIRADS score specifically for dense breasts?
I just found out my breast are extremely dense. I knew they were dense, just now at 46 being told they are very extremely dense. I did get a 3d scan this time with ultrasound on my left because of what turned out to be a cyst. Thank God!!
Would I have to do ultrasound every year? Insurance doesn't cover ultrasound, it's considered diagnostic. Seems ridiculous.
Would I need cash for the newer scans?
I’ve been wondering if it might be more effective to have a bilateral mastectomy, rather than going through this yearly palaver. I mean I was told out would take two hours for an ultrasound, breast removal would only take two or so hours and I would never need any further expensive and humiliating examinations.
I have dense breast&also use Birth control for many years does that put me at risk..I had cyst be for but the doctor aspirated & drained them
How can I differentiate between a 3D or 2D mammogram report if I have CD from radiologist.
Still a little confused.Does very large breasts equate with dense breasts please anyone?
I started in my 30’s I’m 31 I’ve already gotten a biopsy.. I’m afraid I just want to live to see 120
Had a mammogram done had to go back and have a ultrasound done cause I have dence breast on my left breast waiting for my doctor to call me back with results
What were your results?
The tremendous problem I learned is that sonographer or radiologist want you to talk about the results to your referring doctor who will only read to you what you already read in the report. If you have any questions regarding specifics of your ultrasound or mammogram - you have no-one to talk to.
see a breast specialist for a second opinion you certainly do
Please hw can will get you
What about women who breast feed children in the past they said that those women are less likely to develop breast cancer, is this true today and I do have dense breast.
Yes. It is.
I breast feed my 4 babies and I have dense breast also
Can I be on low dose bhrt with breast density?
Hi Dr. Williams. I had a lumpectomy 9mo. ago n my breast is still sore n my nipple is very sensitive. IDC at 72 has not been fun. I feel that nobody hears me when I say it Hurts! Any suggestions?
I gave dense breasts but my doctors have never said it was a possible issue. I did not gave yea get my as they always said my mammogram was good. This year my mammogram was disturbing to then and they NIW want to do a 3D one. I am scared I man at have breast cancer. Wish someone would if told me dense breast FC would cause issues. I kept getting good mammograms but with the message I have dense tissue. Even after I got the o II at letter my doctor said all was good
I have dense breasts and had a 3d mammagram due to my finding a lump, which i thought was a kernal of popcorn that fell into my bra as i was munching on homemade popcorn. The mamo showed nothing. Then they did an ultrasound and still couldn't figure it out. They found nothing.They then recommended a biopsy, i think it is a cyst ...i did not agree with they're recommendation and have not gone back. I am 62.
Breast thermography offers good data and is noninvasive.
Thank you!
An mri is good too
Be careful with cyst I have dense breast and they found a small cyst and said it was nothing to come back in six months at six months. They said it was still there, but the outline of it was a little jagged that I could wait or have a biopsy! I had a biopsy and it was cancerous -3
Hi to all..I'm 52 and just had my first mammo last week. It was a 3D one..I got a call from my doctor this week telling me that something was seen in both sides, and I have to have a different mammo and an ultrasound..I received a letter today from the medical place telling me that I have dense breast tissue on both sides and they recommend a bilateral mammo and ultrasound. I'm scheduled to have that done in 2 weeks. I'm trying to worry but do I need to worry? I don't fully understand what all this means...
Do not worry. Most people are called back.
Thank you Jane...I've had the 2nd one already ..that one did hurt and on the same day they decided to do an ultrasound too..all turned out well..🥰
@@toxic44talks35 Next week will be my turn. I will do the same think you did. You are welcome.
@@toxic44talks35 I had one July 21 for the first time and I have to go back this wed. I am praying about it. Please pray for me as well. God bless you!
@Jane Brazil...I will be praying for you everyday...pls let me know how you are...God bless you always too..✝️
Do breasts get denser as we age? If we have non-dense breasts in our mid-40s, is that likely to change over time?
What is IDC please? 🤔
I have high density you should get with some people and try to change to age for women to start their exams 👍🏾
I'm 37 and have very dense breast plus surgical biosepy but went for annual pap nurse was examining my breast said she couldn't feel anything
My nurse checked my breast manually as well, didn't feel anything, however I got a call back after having my mammogram, because they saw something. I went back for another mammogram and also an ultrasound and said it was nothing and for me to come back In 6 months to check on it. A week later I got a letter to see a surgeon...I dont understand for what...if they said to go back in 6 months
My mammogram result just said dense Breast but no specific score.
Mine also said dense , that I need other test I'm so scared 😔
Mine also said dense , that I need other test I'm so scared 😔
@@Mizz810 are you okay??
@@tiarawashington810 I have to go for another test waiting for my appointment
Mine said dense to I'm scared
Ahhh Dear Doc. Am really out of this am getting nothing totally nothing 🤦♀️🤦♀️now what is density 🤷🏻♀️🤔
He told us 3 times what he is going to tell us... ugh
What if you get a call back bc you have asymmetrical density? So one appears more fibrous. Is it abnormal to have asymmetrical density, under 40 years of age?
After 2nd mammo and biopsy everything came back all clear. Asymmetrical density means a cyst/lump/mass was seen. Most likely for younger women, it’s an adenoidfibro cyst.
@@explaincauseidontgetit3294 so are you safe from any problem?
@@bellealcalallaguno8669 yes, during a biopsy, they will implant a metal marker, almost smaller than they eye can see, into the cyst after the removal of some cells to test. Any future mammo, they will know that very lump was checked and they can also check for size to see if it’s grown.
@@explaincauseidontgetit3294 oh thank God. Glad everything is fine with your case. My right breast is bigger than the other. Even though I kind of notice this since I was 17, it still worries me a lot. I’m 22 rn.
@@explaincauseidontgetit3294 is there a connection between dense breast and the size of the breast? Was your other breat bigger than the other?
🙏❤️
Is that good or bad? Is that fat? I have that. My family history is no cancer