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Topic: Heterogeneously dense breast???

Forum: Not Diagnosed but Worried — Meet others worried about developing breast cancer for the first time.

Posted on: Sep 24, 2012 03:27PM

crystalred7 wrote:

What does Heterogeneously dense breast mean? Picked up a copy of mammo that was done in February because I'm being referred to new doctor. I was told nothing showed up. I have a bi-rads 2 benign findings with Heterogeneously dense breast... But they told me that no lump showed up. I'm so very confused any help???

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Sep 24, 2012 05:21PM geebung wrote:

Breast Density: BI-RADS type 3.

Hi Crystal, I found this on one website: "The breast tissue in type 3 may be termed 'heterogeneously dense', ranging 51%-75% of the breast tissue. 'Heterogeneous' means something contains many different items and has many different variations. With respect to breast density it implies that the fibrous tissue is prevalent throughout the breast, but not clustered together." http://www.breast-cancer.ca/screening/breast-density-pattern-classification.htm

Hope that is helpful. I would say that, although you have a bit of fibrous tissue in your breasts, none of it is clustered together to form anything that looks suspicious. 

 

Dx 2/26/2007, DCIS, 6cm+, Stage 0, Grade 3, 0/2 nodes, ER+/PR+
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Sep 24, 2012 05:49PM, edited Sep 24, 2012 05:50PM by Lou10

Hi Crystal,

The BI-RADS system is used both for overall assessment and for breast density. Sounds like the BI-RADS 2 you received was the fomer, but the radiologist also commented on your breast density (without assigning it a BI-RADS score but using the term for type 3).

Having dense breast tissue makes it harder to detect cancer on a mammogram PLUS it is a risk factor for getting breast cancer. It depends to some extent on what age you are, as young women naturally have denser breasts. There are some good topics/threads on this board that explain these issues. One is called "Dense Breast Tissue Reminder" but do a search as there are others. There's also a website areyoudense.org

Knowing what I know now, I'd discuss this with my doctor, in particular the need for additional screening (e.g., ultrasound, MRI) because of the density issue. 

Diagnosis: 12/15/2010, IDC (plus DCIS & ILC), 2.5cm IDC, Stage IIb or III (unknown -- radiation to lymph nodes instead of ALND surgery), Grade 2, 2/2 nodes (sentinel and intramammary fully involved with extracapsular extension), ER+++/PR+++, HER2-

Surgery 01/25/2011 Lumpectomy (Right); Lymph Node Removal: Sentinel Lymph Node Dissection (Right)Chemotherapy 04/13/2011 Cytoxan, Ellence, fluorouracil, TaxotereRadiation Therapy 09/14/2011 ExternalHormonal Therapy 11/07/2011 TamoxifenHormonal Therapy 08/22/2012 Femara
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Sep 24, 2012 06:31PM Beesie wrote:

It's important to not confuse the BIRADs rating for a mammogram (or ultrasound or MRI) with the BIRADs classification of density.  They are two completely different things. 

BIRADs ratings for films range from BIRADS 0 (not enough information) through to BIRADS 6 (a known malignancy).  BIRADs 2 is a benign finding, with the addition of comments. (A BiRADs 1 is a benign finding with no comments).  In your case, it sounds as though the comment related to your breast density.

The BIRADs classifications for breast density are as follows:

1. the breast is almost entirely fat (<25% glandular)
2. scattered fibroglandular densities (25-50%)
3. heterogeneously dense breast tissue (51-75%)
4. extremely dense (> 75% glandular) 

BI-RADS Introduction to the Breast Imaging Reporting and Data System

It is true that higher breast density does present a breast cancer risk, but this is a particular issue for women who are post-menopausal who still have extremely dense breasts. Younger women usually have dense breasts so heterogeneous density is actually a normal condition of women in their 40s and younger.

crystalred7, how old are you?  You age will indicate whether your breast density is something to be concerned about or not.   

It is also true that higher breast density can make 'reading' a mammogram more difficult for the radiologist.  If the radiologist has concerns that he or she may be missing something, usually that's noted on the report, and often a follow-up ultrasound or MRI will be recommended.  If there are no comments about this on your report, then it's likely that the radiologist is satisfied with the mammogram.

By the way, there has been recent legislation in NY State that requires that the breast density level be given to patients.  Even though you are not in NY State, more and more facilities are including the breast density classification on the mammo report, just as a matter of course.  The problem however is that it doesn't come with any explanation, and as a result, it often raises unnecessary concerns.  

Dx 9/15/05, DCIS-MI, 6cm+ Gr3 DCIS w/IDC microinvasion, Stage I, 0/3 nodes, ER+/PR- “No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke

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Sep 24, 2012 09:12PM crystalred7 wrote:

That's a lot of information to take in lol. I am 29 so I expected my breast to be pretty dense. I will be asking for a MRI because of the lump and the fact it's gotten bigger. What I would like to know is did they find this in one area or just my whole breast in general? The bi-rads was not in reference to the density is what I gathered. I just want them to see it on some kind of imaging so that they can biopsy it so I have a definite answer. Thank you for the link I think I understand a little more now lol. You ladies are amazing!

Crystalred7

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Sep 24, 2012 09:15PM kayb wrote:

I posted this last night on the triple positive thread. It's another option for screening dense breasts. You might find it interesting. Don't be confused by my mention if BIRADS scores. I'm referring to the mammo score:

Wanted to share - good news for anyone with dense breasts - I was at a BC conference yesterday and saw a presentation on 3-D mammography (also known as tomosynthesis). I was excited to see that it's VERY effective for woman with dense breasts - not that I have them anymore -LOL- but still good news. Your breast still gets squished but the mammo creates images of the breast in slices, kind of like a CT. It makes it easier to isolate abnormalities from dense tissue. They showed image after image comparing regular 2-D mammo and 3-D side-by-side and the amount of detail seen in the 3-D was amazing. Some stuff that would have been categorized BIRADS 3 or 4 was clearly BIRADS 5 on the 3-D image. There were also some things that would normally require US and biopsy that were proven benign by the new mammo.

The radiologist said the cost is only about 10 dollars more than a regular mammo and radiation exposure is nearly identical.

So those of you who still have your breasts - check to see if there's a 3D mammo available in your area when you get your next scan. It looks like its WAY better! Very cool.

DX May/2010, synchronous bilateral cancer, triple positive

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Sep 24, 2012 10:51PM, edited Sep 24, 2012 10:54PM by Lou10

CrystalRed7 - Whatever type of scanning you get, I'm really glad you're going to follow up on this. As I'm sure you know, most lumps are benign, as I certainly hope yours is, but it would be good to know what it is. And while most young women have dense breasts, not all do. Some research is looking at what makes breast density a risk factor for young women. But whether or not your degree of density, at your age, increases your risk of getting cancer, it is a problem when it hampers identification of abnormalities in your breasts.

I'm in the "extremely dense" category, and older, and my cancer was not caught by mammogram. My situation is different than yours ... I'll tell you about it not to scare you but because I made the mistake of assuming I was getting appropriate scanning. After my first mammogram I had an ultrasound as they thought they might have seen something, but neither type of scan could see through my extremely dense tissue. Thereafter I had diagnostic mammograms. None of the reports ever suggested an alternative method of imaging, despite the fact the mammograms were virtually useless for me (yet their limited value due to my density was mentioned! I didn't know that then as I didn't ask for copies of medical records. I've learned ...) Even after my lump was palpable and showed up on digital mammogram, the image was poor and underestimated its size. An ultrasound image was a bit better, but still not great. So I had an MRI before surgery and a second malignancy was found that hadn't shown up on either mammogram or ultrasound. 

Diagnosis: 12/15/2010, IDC (plus DCIS & ILC), 2.5cm IDC, Stage IIb or III (unknown -- radiation to lymph nodes instead of ALND surgery), Grade 2, 2/2 nodes (sentinel and intramammary fully involved with extracapsular extension), ER+++/PR+++, HER2-

Surgery 01/25/2011 Lumpectomy (Right); Lymph Node Removal: Sentinel Lymph Node Dissection (Right)Chemotherapy 04/13/2011 Cytoxan, Ellence, fluorouracil, TaxotereRadiation Therapy 09/14/2011 ExternalHormonal Therapy 11/07/2011 TamoxifenHormonal Therapy 08/22/2012 Femara