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Topic: New content on Dense Breasts!

Forum: High Risk for Breast Cancer — Due to family history, genetics, or other factors.

Posted on: Oct 9, 2020 02:38PM - edited Oct 9, 2020 02:54PM by Moderators

Moderators wrote:

We just added this content on Dense Breasts!

Dense Breasts

Having dense breasts means there is more fibrous tissue (or connective tissue) and glandular tissue (the type of tissue that produces milk) in your breasts than fatty tissue. That's why dense breast tissue is also called "fibroglandular tissue." In this section you'll learn about:

  • How breast density is measured?
  • Why breast density matters?
  • How to find out if you have dense breasts
  • Cancer screening for women with dense breasts
  • Other steps you can take

Read more by clicking on the above link and please let us know if it's helpful.

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Oct 9, 2020 03:21PM MinusTwo wrote:

Mods - great summary. Thanks for all the details. May I suggest one change? Add the date of this report at the top so down the road people will know if there might be updates.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Oct 9, 2020 04:03PM Beesie wrote:

Mods, excellent content. I really appreciate that you included this:

"You can't feel dense breast tissue through the skin, so if you have firmer breasts, it does not necessarily mean you have dense breasts.

Dense breast tissue can only be seen on a mammogram. While fatty tissue appears dark on a mammogram, dense tissue appears white."

The fact that we can't feel our dense breasts is not understood at all - many women think that the fibrocystic lumps and bumps that they feel are the same as breast density. So I'm glad that I will be able to refer posters to this section to explain this.

One change suggestion from me. What's missing - and is critically important, I think - is a discussion on age and breast density. Because while it's true that 40% of women have heterogenously dense breasts, among pre-menopausal women, it's closer to 60%. Over 15% of pre-menopausal women have extremely dense breasts. So until menopause, high breast density is normal. Still a screening issue, of course, but normal and already baked into the relatively low breast cancer rates of women that age.

The Relationship of Mammographic Density and Age: Implications for Breast Cancer Screening https://www.ajronline.org/doi/full/10.2214/AJR.10.6049

"Seventy-four percent of patients between 40 and 49 years old had dense breasts. This percentage decreased to 57% of women in their 50s. However, 44% of women in their 60s and 36% of women in their 70s had dense breasts as characterized on their screening mammograms."




This clarification is important because it's so common to see posts from younger women who are worried, some to the point of considering preventative measures, because they've been told that they have dense breasts.

“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke
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Oct 9, 2020 04:05PM MinusTwo wrote:

Beesie - right on !!!

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Oct 9, 2020 06:37PM Mavericksmom wrote:

I too think the summary is great! I also liked Beesie’s comments. I am a bit confused (maybe due to being tired from a long work week) but why, if dense breasts have more cancer risk, and younger women have more dense breasts,does the actual risk of breast cancer become the greatest as we age and the breasts become more fatty?

Dx 6/6/2003, IDC, Left, 1cm, Stage IA, Grade 1, 0/24 nodes, ER+/PR+ Dx 12/4/2018, ILC, Left, 1cm, Grade 2, ER+/PR+, HER2- (FISH)
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Oct 9, 2020 09:19PM Beesie wrote:

Mavericksmom, that's because other than being female, getting older is the single greatest risk factor for developing breast cancer. Breast cancer develops when our cells stop working properly. The chances of cells failing when we are younger is very low but as we age it's natural that our cells (or specific genes within cells) will start to break down.

Breast density is an additional risk factor that is added on top of the base risk that we face for being female and for being whatever age we happen to be. Younger women start off with an extremely low risk because they have young healthy strong cells. High breast density might increase a younger woman's risk by 50%, but 50% on top of a very small number is still a small number.

The following chart shows breast cancer risk by age. Since these figures are averages for the population at large, the 'higher risk' for the 74% of women in their 40s who have dense breasts is already built into these numbers. Similarly, the fact that older women have less dense and more fatty breasts is also baked into the these figures. That said, these risk percentages represent 'average' risk, and there is always a range. At whatever age, someone with extremely dense breast tissue may have a risk level that is somewhat higher than this average, while someone who has very fatty breasts may have a risk level that is somewhat lower than the average.





“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke
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Oct 10, 2020 09:07AM Moderators wrote:

Beesie, thank you for your insightful thoughts! We are taking this back to the editorial team to see if we can address your suggestions in the content.

--The Mods

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Feb 6, 2021 01:35PM Utahmom wrote:

Wonderful explanation of our breasts. My doctor always called then "knotty". It has always been hard for me to tell.what was what doing my SBE.

I am in the unfortunate 10 to 15% for extremely dense.

After giving birth to my first child at 43 and breastbfeesing for 26 months, it was on the first mammogram at 26 or 28 months that we found the first hyperplasia that ended up being mild along with PASH. Then I had about 3 years of screenings that were still holding and then ADH appeared in the other breast. Negstive for Brca 1 and Brca2 but my number is 57 based on history and family.

So, we have chosen as a family after a year to make a progressive decision and move forward with a double.mastectomy and diep.flap. While I am scared about the procedure, I am thinking about my young son who is 9 years old and that I am not a person that can live worrying all the time about the mammogram and then the mris every year. I know me and i become hyper focused and stop living in the present appreciating my blessings.

Every woman has to chart her journey. I am so grateful that you're have provided this forum for me to learn from others who have gone before. It has provided answers and help me grow.to every woman on this journey, may you be blessed and thank you for sharing your life with the rest of us.

DX ADH 10/2019 Left, DX 2014 Mild Hyperplasia Right & PASH
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Feb 6, 2021 03:02PM AngieB92 wrote:

I appreciate this topic and Beesie’s comments. Prior to being diagnosed, I had a conversation with the surgeon who performed all of my biopsies. This was just prior to the biopsy before I was diagnosed. We talked about my dense breasts and I made the comment that of a woman has dense breasts that should be considered high risk and the offer of a double mastectomy/reconstruction should be given (for insurance) much like surgeries that BRCA+ patients can get. He was adamant about how invasive BMXs were etc. I remembered that when I was diagnosed and scheduled to see him for surgery options. He was not a fan of BMXs - even though I had dense breasts. I went to another medical facility and my breast surgeon understood my stance on dense breasts and proactive surgery. Dense breasts aren’t something to take lightly.....no pun intended.

Dx 8/8/2019, IDC, Left, 1cm, Stage IA, Grade 2, 0/6 nodes, ER+/PR+, HER2+ (IHC) Targeted Therapy 9/16/2019 Perjeta (pertuzumab) Targeted Therapy 9/16/2019 Herceptin (trastuzumab) Surgery 3/3/2020 Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Targeted Therapy 4/9/2020 Kadcyla (T-DM1, ado-trastuzumab)

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