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Topic: Women with extremely dense breasts and TNBC

Forum: Triple-Negative Breast Cancer —

Share with others who have ER-/PR-/HER2- breast cancer.

Posted on: Feb 3, 2021 12:37PM

BanR wrote:

Hi!

How many of us are ladies who were told by the doctor- You got extremely dense breasts.

Dense breasts as per latest studies makes women 4 times more prone to get cancer vs genetic mutations.

Please share your experiences and conversations with your doctors.


Thank you

Theory of randomness...so unfair! Dx 9/12/2013, IDC, 1cm, Stage I, Grade 3, 0/3 nodes, ER-/PR-, HER2- Surgery 9/30/2013 Lumpectomy: Right Chemotherapy 11/5/2013 AC + T (Taxol) Radiation Therapy 3/10/2014
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Feb 3, 2021 01:04PM NinjaMeow wrote:

I had extremely dense breasts and zero family history of cancer, breast cancer, genetic factors or TNBC and have wondered if it was a factor

Diagnosed at 40 Dx 10/9/2013, DCIS, Right, 1cm, Stage IA, Grade 3, 0/4 nodes, ER-/PR-, HER2- Surgery 11/19/2013 Mastectomy: Left, Right; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Chemotherapy 12/15/2013 AC + T (Taxol)
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Feb 3, 2021 01:57PM BanR wrote:

Hi Ninja..

Unfortunately extremely dense breasts is a big risk factor- 4 times more than BRCAs too.

Lactation increases the density of the breast and thats why many of us have reported TNBC after pregancy/during breast feeding/ soon after breastfeeding years.

Theory of randomness...so unfair! Dx 9/12/2013, IDC, 1cm, Stage I, Grade 3, 0/3 nodes, ER-/PR-, HER2- Surgery 9/30/2013 Lumpectomy: Right Chemotherapy 11/5/2013 AC + T (Taxol) Radiation Therapy 3/10/2014
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Mar 29, 2021 02:01PM Katiha wrote:

As far as I know, dense breasts get more dense during pregnancy However, after giving birth and after breast feeding, breasts tend to become less dense.

Dx 3/6/2004, IDC, Left, <1cm, Stage IA, Grade 2, ER+/PR+, HER2- Dx 7/8/2020, IDC, Left, 1cm, Stage IA, Grade 3, 0/6 nodes, ER-/PR-, HER2- (FISH) Chemotherapy 9/13/2020 Carboplatin (Paraplatin), Taxol (paclitaxel) Surgery Lumpectomy Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Left; Lymph node removal: Sentinel
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Mar 29, 2021 02:02PM Katiha wrote:

So is it better not to breastfeed then?

Dx 3/6/2004, IDC, Left, <1cm, Stage IA, Grade 2, ER+/PR+, HER2- Dx 7/8/2020, IDC, Left, 1cm, Stage IA, Grade 3, 0/6 nodes, ER-/PR-, HER2- (FISH) Chemotherapy 9/13/2020 Carboplatin (Paraplatin), Taxol (paclitaxel) Surgery Lumpectomy Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Left; Lymph node removal: Sentinel
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Mar 29, 2021 04:18PM moth wrote:

The benefits of breastfeeding are great, so no, IMO it's not better to not breastfeed. (conflict disclosure: I'm a lactation consultant)

Breast density is affected by so many factors, incuding genetics & specific variants in genes such as VEGF and IGFR among others.

I think having dense breasts is something to be aware of & to discuss additional screening modalities with your primary provider. I like this handout from Are You Dense? which covers the various screening options. https://www.areyoudense.org/files/9015/1483/6013/A...


I take weekends off

Initial dx at 50. Seriously?? “Sometimes the future changes quickly and completely and we’re left with only the choice of what to do next." blog: Never Tell Me the Odds

Dx 12/2017, IDC, Left, 1cm, Stage IA, Grade 3, 0/5 nodes, ER-/PR-, HER2- (IHC) Surgery 12/12/2017 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 2/14/2018 AC + T (Taxol) Radiation Therapy 8/13/2018 Whole-breast: Breast Dx 2/2020, IDC, Stage IV, metastasized to liver/lungs, Grade 3, ER-/PR-, HER2- Chemotherapy 3/18/2020 Taxol (paclitaxel) Immunotherapy 3/19/2020 Tecentriq (atezolizumab) Chemotherapy 11/26/2020 Abraxane (albumin-bound or nab-paclitaxel) Dx 12/9/2020, IDC, Right, Stage IV, metastasized to lungs, Grade 3, ER+/PR-, HER2- (IHC) Radiation Therapy 12/9/2020 External Hormonal Therapy 12/16/2020 Femara (letrozole) Dx 1/28/2021, IDC, Left, Stage IV, metastasized to bone Radiation Therapy 3/3/2021 External: Bone
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Mar 29, 2021 07:50PM - edited Mar 29, 2021 07:51PM by Katiha

Hi, Moth!

Thank you for your response. I have already increased risk of breast cancer (my mom was diagnosed with bc twice) and have an extra dense breasts. I do screening every six months, mammogram and then MRI, but if risk goes up so high- is it better to do preventative mastectomy after I have a child ( going trough IVF at the moment)?

Just trying to see the best way to prevent it.

Dx 3/6/2004, IDC, Left, <1cm, Stage IA, Grade 2, ER+/PR+, HER2- Dx 7/8/2020, IDC, Left, 1cm, Stage IA, Grade 3, 0/6 nodes, ER-/PR-, HER2- (FISH) Chemotherapy 9/13/2020 Carboplatin (Paraplatin), Taxol (paclitaxel) Surgery Lumpectomy Radiation Therapy Whole-breast: Breast Surgery Lumpectomy: Left; Lymph node removal: Sentinel
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Mar 29, 2021 09:14PM moth wrote:

what a very difficult decision Katiha, with both your personal history and the family history. If it were me, I'd breastfeed at least a year and after weaning I'd consider a bmx but I'd want to talk to a couple breast oncologists about this because I think at this point it wouldn't be a true prophylactic mx (as people do before they have cancer) and while it would prevent a regional recurrence, I'm not sure if it would affect the risks of a stage 4 recurrence, which is the one to really worry about. But I don't even know if we have enough data on this. But if a mastectomy doesn't prevent stage 4 recurrence at dx then would it a huge impact on it later? So hard. I'm sorry you're facing all this uncertainty.

I take weekends off

Initial dx at 50. Seriously?? “Sometimes the future changes quickly and completely and we’re left with only the choice of what to do next." blog: Never Tell Me the Odds

Dx 12/2017, IDC, Left, 1cm, Stage IA, Grade 3, 0/5 nodes, ER-/PR-, HER2- (IHC) Surgery 12/12/2017 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 2/14/2018 AC + T (Taxol) Radiation Therapy 8/13/2018 Whole-breast: Breast Dx 2/2020, IDC, Stage IV, metastasized to liver/lungs, Grade 3, ER-/PR-, HER2- Chemotherapy 3/18/2020 Taxol (paclitaxel) Immunotherapy 3/19/2020 Tecentriq (atezolizumab) Chemotherapy 11/26/2020 Abraxane (albumin-bound or nab-paclitaxel) Dx 12/9/2020, IDC, Right, Stage IV, metastasized to lungs, Grade 3, ER+/PR-, HER2- (IHC) Radiation Therapy 12/9/2020 External Hormonal Therapy 12/16/2020 Femara (letrozole) Dx 1/28/2021, IDC, Left, Stage IV, metastasized to bone Radiation Therapy 3/3/2021 External: Bone
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Mar 30, 2021 07:15AM Beesie wrote:

BanR,

Do you have a source for your comment that "extremely dense breasts is a big risk factor- 4 times more than BRCAs too"? I've read a lot of research on breast density, and I've never seen that. Depending on the BRCA mutation, risk can range from 25% to 95%. For women with dense breasts, the highest risk figure I've ever seen in research, and it was one study only, is "6 times the risk" but this was comparing the risk level of post-menopausal women with the highest breast density to those with the lowest breast density - it was not a comparison against the average woman. The following more recent very large study found approx. 1.5X to 2X the risk for those with extreme breast density (Cat.4 ) compared to those with scattered fibroglandular density (Cat.2). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC55408...

To my understanding, breast cancer risk increases for those who have consistent (i.e. life long) breast density that is greater than the average for one's age. Pregnancy related density, since it is temporary, would not create this risk, and overall pregnancy is considered to be beneficial in reducing risk. It's also important to keep in mind that most women start out with dense breasts when they are young. This is normal. The low breast cancer rates for the "average" young woman (20s and 30s) already factors in this high level of breast density, since the "average" young woman has dense breasts. Where breast density becomes more concerning is that as we get older, our breast density normally goes down - but for some of us, it doesn't. The reduction in breast density as we age is why mammograms, which are not very effective on dense breasts, aren't routinely used for young women, but become part of standard screenings once women are in their 40s or hit 50.

Since I'm always trying to stay up to date on research and breast density is a particular area of interest for me (as someone who's had extremely dense breasts well into menopause), I'd really appreciate seeing the source of your information.

Dx 9/15/2005 Right, 7cm+, DCIS-Mi, Stage IA, Gr 3, 0/3 nodes, ER+/PR- ** Dx 01/16/2019 Left, 8mm, IDC, Stage IA, Gr 2, 0/3 nodes, ER+/PR-, HER2- (FISH) ** Surgery 11/30/2005 MX Right, 03/06/2019 MX Left ** Hormonal Therapy 05/2019 Letrozole

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