Breast density: What African women need to know

 

Women with dense breasts have a higher risk of getting breast cancer.

 

 

Overview

A woman’s breast density is observed and determined during an X-ray test (called mammogram) performed on the breast usually during routine screening for breast cancer.

When you get the breast X-ray report, you may be told that you have low or high breast density.

What does this mean?

Why is it important to know your breast density?

Before you dive into answers to these questions, it is worthwhile to learn some basics about the different tissues of the breast.

 

 

What are the different tissues of the breast?

A woman’s breast is made up of the following tissues:

• Fibrous tissue – which is a strand-like connective structure that holds the other breast tissues together.

 

• Glandular tissue – which is a component of the breast that contains collections of cells called lobes. Breast milk that is secreted by the cells in the lobes, is passed into tubes that are called ducts. The ducts carry the milk to the nipple.

The fibrous and glandular tissues are together called fibroglandular tissue.

 

• Fatty tissue – are made up of fat cells. These fill the space between the fibrous tissue, lobes and ducts and gives the breast its size and shape.

 

So, you are now in a good place to learn about breast density.

 

 

What Is breast density?

Breast density as determined during mammogram, is the amount of fibroglandular tissue in a woman’s breast compared with the amount of fatty tissue in the breast.

The mammogram usually reports breast density in one of the following ways:

• The breast is mostly fatty (seen in about 10% of women).
• Scattered areas of dense tissue occur in the breast (seen in about 40% of women).
• Evenly dense areas occur throughout the breast (seen in about 40% of women).
• Extremely dense breast (seen in about 10% of women).

 

Women in the first two categories are said to have low-density, non-dense, or fatty breasts.

Women in the last two categories are said to have high-density or dense breasts.

Nearly half of women who are 40 years or older have dense breasts.

 

 

Why Is breast density important?

 

Breast cancer risk is a major reason why breast density is important.

Studies have shown that women with dense breasts have a higher chance of getting breast cancer. The denser your breast is, the higher your risk.

Scientists don’t know why this is so.

Regardless of the higher risk of breast cancer associated with breast density, a breast cancer patients with dense breasts is no more likely to die from breast cancer than patients with non-dense (fatty) breasts.

 

Missed cancer in mammograms

This is a second reason why it is important that you know your breast density.

Dense breast tissue can hide a small cancer.

Fibroglandular tissue appears white on a mammogram. So does a possible cancer.

For this reason, it may be hard for the specialist doctor reporting on a mammogram to tell the difference between a small cancer and dense breast tissue.

This therefore increases the likelihood of a small cancer being missed in a woman with dense breast density.

 

 

Who is at high risk of dense breast?

You are more likely to have dense breasts if you—

• Are younger than 35 years of age.
• Are pregnant or breastfeeding.
• Are taking hormone replacement therapy.
• Have a lower body weight.

 

 

 

What you should do if you have dense breast

 

1. Ask your doctor about your personal risk of getting breast cancer. 

Because having dense breasts is just one of several risk factors for breast cancer, your doctor will weigh and discuss other factors of breast cancer with you.

 

2. Get additional tests done

You may ask your doctor for other tests that may be able to find breast cancer that may be missed on a mammogram.

Your doctor may suggest one of these tests—

• Breast ultrasound. A machine that uses sound waves to make pictures, called sonograms, of areas inside the breast.

 

• Breast magnetic resonance imaging (MRI). A kind of body scan that uses a magnet and radio waves linked to a computer to take pictures of the breast. The MRI scan makes detailed pictures of areas inside the breast.

 

These tests may produce false positive results (i.e., a report of abnormality when you really do not have cancer) and raise your anxiety level unnecessarily.

They can also lead to unnecessary additional test like a breast biopsy (tissue sample taken from your breast surgically) when you do not really need it

 

According to the United States Preventive Services Task Force (USPSTF), if you are 40 to 49 years old and at high risk for breast cancer, you should talk to your doctor or other health care providers about when to start and how often you should be screened for breast cancer.

Given that the average age of diagnosis of breast cancer in Sub-Saharan African women is within the third to the fifth decades of life (i.e., 50 years and younger), two yearly breast cancer mammogram screening may be highly recommended in women from age 40 – 49 in the region.

 

The USPSTF also recommends that if you are 50 to 74 years old and are at average risk for breast cancer you should get a mammogram every two years.

 

If you are 75 years and older, the USPSTF finds no current and sufficient evidence to assess the balance of benefits and harms of screening mammography.

 

 

 

Takeaways

Breast density is determined during X-ray test on the breast (a procedure called mammogram).  It compares the amount of fibroglandular tissue in a woman’s breast with the amount of fatty tissue to define the density of the breast. It is important to know your breast density because the higher the density the more likely it is that you may have breast cancer and that a small breast cancer can be missed during mammogram screening.

 

 

Resources:

• What are the risk factors for breast cancer? (CDC)
• Dense Breasts: Answers to Commonly Asked Questions (National Cancer Institute)
• Breast cancer: Screening (USPSTF)
• Adeoye, P.A. : Epidemiology of breast cancer in Sub-Saharan Africa. Breast Cancer Updates [Working Title]. doi: 10.5772/intechopen.109361 (2023).

 

 

 

Published: March 14, 2023

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