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I am just wondering how many of you were told, as sort of an aside, that you had dense breasts but were not told the implications of that?

Alice Klobukowski Profile
Asked by

anonymous

Stage 2A Patient almost 8 years
 
  • Alice Klobukowski Profile
    anonymous
    Stage 2A Patient
    This is an article that was just published. ScienceDaily (Mar. 21, 2012) — Women aged 50 and over with breasts that have a high percentage of dense tissue are at greater risk of their breast cancer recurring, according to Swedish research presented at the eighth European Breast Cancer Conference (EBCC-8) in Vienna on March 21. Dr Louise Eriksson and her colleagues from the Karolinska Institutet (Stockholm, Sweden) found that women with denser breasts had nearly double the risk of their cancer recurring, either in the same breast or in the surrounding lymph nodes, than women with less dense breasts. They warn that doctors should take breast density into account when making decisions about treatment and follow-up for these women. When a woman has a mammogram, the resulting scan gives an image of the breast that shows areas of white and black. The white areas represent the dense tissue, made up of the epithelium and stroma [1]. The black areas are made up of fatty tissue, which is not dense. The percentage density (PD) of the breast is calculated by dividing the dense area by the area of the whole breast (dense and non-dense tissue included). Breast density varies from woman to woman, and it also decreases with age. Dr Eriksson explained: "Density can vary greatly, even between postmenopausal women. In the group of women I studied, those with the lowest percentage density had breasts that were less than one percent dense, whereas those with highest PD had 75-80% dense breasts. The mean average PD was 18%. However, density does decrease with age. Studies have shown a decrease by approximately two percent per year. The largest decrease is seen at menopause when PD decreases by approximately 10%." The researchers studied the mammograms and outcomes for 1,774 post-menopausal women who were aged 50-74 and who were part of a larger study of all women with breast cancer diagnosed between 1993-1995 in Sweden. "We found that if you have a PD at diagnosis of 25% or more, you have an almost two-fold increased risk of local recurrence in the breast and surrounding lymph nodes than women with a PD of less than 25%. However, density does not increase the risk of distant metastasis and has no effect on survival. We also see that although mammographic density is one of the strongest risk factors for breast cancer it doesn't seem to influence tumour development in any specific way; for instance, it isn't more associated with oestrogen receptor positive tumours than oestrogen receptor negative tumours, but seems to act as a general stimulator of tumour development," said Dr Eriksson, who is a PhD student at the Karolinska, as well as a physician at the Stockholm South General Hospital. "Our study shows that breast density before or at diagnosis should be taken into account even after diagnosis, for instance, when deciding on adjuvant treatment and follow-up routines; perhaps women with dense breasts should be followed more frequently or for a longer period of time in order to quickly spot any local recurrence. "As far as screening programmes are concerned, it is already known that breast density is a risk factor for the occurrence of breast cancer and that it decreases the sensitivity of mammograms. Our study confirms the importance of taking breast density into account in the screening setting." Until now, little was known about the association between density, tumour characteristics and prognosis once cancer had occurred, and results were conflicting. This study is important because of its size and detailed information on each woman. "This is one of the largest studies to date studying mammographic density, tumour characteristics, and prognosis, including almost 50% of all Swedish breast cancer cases diagnosed 1993-1995," said Dr Eriksson. Cancer researchers do not know why breast density is a risk factor for breast cancer. "It could simply be due to higher density being associated with more cells, which means that more cells are at risk of developing cancer," she said. "Another hypothesis is that it is the relationship between mammographic density and the stroma (which has been shown to be the main compound of mammographic density) that is central to the increase in risk. There is no leading hypothesis on why an increased amount of stroma would increase breast cancer risk, but it is known that the interaction between the epithelial cells and the stroma is crucial to the development of breast cancer. Based on the results from our study, we propose that mammographic density creates a beneficial environment for epithelial cells to transform into cancer cells; much like fertile soil giving a planted seed the needed nutrients to grow and develop." Professor David Cameron, from the University of Edinburgh (Edinburgh, UK), and chair of EBCC-8 said: "This study raises questions about how and why the appearance of normal breast tissue on a mammogram could influence the chances of a local recurrence of breast cancer. It is, therefore, more thought-provoking than practice-changing, since it is not clear what a patient, or her physician, should do if the mammogram shows a higher density of the normal breast tissue. A number of factors are known that influence mammographic breast density, but more research is needed to know which of these, if any, is responsible for this important observation." [1] The breast epithelium is the cellular tissue lining the milk-producing ducts of the breast. The stroma is the supporting cells and connective tissue in the breast. [2] The study was funded by Märit and Hans Rausing's Initiative against Breast Cancer, the Swedish Research Council, and the Swedish Cancer Society.
    almost 8 years Comment Flag
  • Sharon Danielson Profile
    anonymous
    Survivor since 2007
    I was told the same thing... dense breast. My breast cancer was missed at my annual mammogram appointment and I found it later in a self exam. A warning to you....if you are are aware of the density, if there is ever a question, DEMAND another type of test such an an MRI or as Anonymous a Molecular Breast Imaging (something I have never heard of but just learned about.) My breast cancer would have been found much earlier if I would have known about these options. BE YOUR OWN BEST ADVOCATE! It is not that the density is a cause but if you do develop breast cancer, it can hide out in that density and be so much more difficult to see on a regular mammogram.
    almost 8 years Comment Flag
  • Thumb avatar default
    anonymous
    Survivor since 2012
    Good question. I also know, now that I had dense breasts that made it difficult to read my mammograms. I did not know this, nor the implications of it. Women need to be better informed of this.
    almost 8 years Comment Flag
  • Thumb avatar default
    anonymous
    Stage 1 Patient
    Women with dense breast tissue may need additional testing as mammograms alone may not be able to detect cancer. An advanced technology called Molecular Breast Imaging (MBI) helps doctors catch cancers that other tests can't. According to the National Cancer Institute, "women who have a high percentage of dense breast tissue have a higher risk of breast cancer..." throughout the country, various states are taking action by requiring doctors to inform patients of their breast density. Molecular Breast Imaging can detect cancers missed by the two most common breast imaging studies, mammography and ultrasound. Please discuss this with your physician
    almost 8 years Comment Flag
  • Alice Klobukowski Profile
    anonymous
    Stage 2A Patient
    There's an advocacy group areyoudense.org with lots of info and status of legislation for each state.
    about 7 years Comment Flag
  • Alice Klobukowski Profile
    anonymous
    Stage 2A Patient
    I hope I don't get kicked on this board, but here is an article that makes me furious: California OKs Dense Breasts Notification Bill September 15, 2011 Written by: Steve Millburg, Filed in: Breast Imaging, Medical Ethics A bill requiring that California women be told if a mammogram reveals they have dense breasts has one last hurdle to meet before it can become law: Governor Jerry Brown’s signature. The bill passed the Legislature on Monday, despite opposition from the California Radiological Association and California Medical Association, among other medical groups. They succeeded in blocking the original bill, but its sponsor, State Senator Joe Simitian, D-Palo Alto, incorporated the bill’s language into another bill at the last minute and managed to get it passed. According to Senator Simitian, the bill requires that, when mammograms reveal dense breast tissue, doctors must add two sentences to the federally required letter that a radiologist must send a patient after performing the mammogram: Because your mammogram demonstrates that you have dense breast tissue, which could hide small abnormalities, you might benefit from supplementary screening tests, depending on your individual risk factors. A report of your mammography results, which contains information about your breast density, has been sent to your physician’s office and you should contact your physician if you have any questions or concerns about this notice. Dense breast tissue has been identified as a risk factor for breast cancer. So why would the medical groups object? They listed several reasons, not necessarily in this order: The grading of breast density is subjective, leaving doctors open to lawsuits if patients with breasts not classified as “dense” are later diagnosed with breast cancer. Dense breast tissue is common, and many patients who otherwise are at low risk (no family or personal history of breast cancer, no precancerous changes, etc.) will suffer needless anxiety. “Doctors are all going to be overwhelmed by calls, and many of them are not going to be necessary because of their low risk” (per Ruth Haskins, MD, an obstetrician and gynecologist who is chairwoman of the Council on Legislation for the California Medical Association, as quoted by the San Jose Mercury News). Follow-up screening will be expensive and may not be covered by insurance (for those who even have insurance). As Dr. Haskins (whose association favored giving physicians discretion to inform patients about dense breasts based on other risk factors and the doctors’ medical judgment) put it before the bill was passed: The problem with this bill is that it gives a boatload of power to a lot of women who then become powerless to use that information. To which Senator Simitian replies: “To tell a patient she has no right to know information already held by the radiologist and physician is indefensible. These are two sentences that can save thousands of lives.” Simitian introduced the legislation at the request of Amy Colton, a now-50-year-old registered nurse who got a mammogram every year starting at age 40. Each year, she got an all-clear—and then, two years ago, she was diagnosed with late-stage breast cancer. That’s when she learned that she had breast dense tissue, and that both her radiologist nor her primary-care physician had known, but hadn’t told her. (She received successful treatment and says she feels “great.”) “I’m the patient,” Colton said. “It’s my body. But I was never informed.” Related seminar: Breast Imaging and Intervention: A Comprehensive Review (for a limited time, discounts and free shipping) Permalink: http://www.radiologydaily.com/?p=7186
    almost 8 years Flag
    • Alice Klobukowski Profile
      anonymous
      Stage 2A Patient

      This was me at age 71, I had no risk factors except dense breasts. No breast cancer in the family, semi-vegetarian life-style, excellent health, regular yoga and Pilates practice for many years, no smoking, hardly any alcohol, and aggressive...

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      This was me at age 71, I had no risk factors except dense breasts. No breast cancer in the family, semi-vegetarian life-style, excellent health, regular yoga and Pilates practice for many years, no smoking, hardly any alcohol, and aggressive ER/PR - HER2+ stage 2a breast cancer.

      almost 8 years Flag
    • Mary Cay Brock Profile
      anonymous
      Learning About Breast Cancer

      I have also learned the hard way about dense breasts and getting so called 'peace of mind' from yearly mammograms. I was recently diagnosed with Advanced Stage Breast Cancer with mets to the bones. Currently undergoing chemo, then...

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      I have also learned the hard way about dense breasts and getting so called 'peace of mind' from yearly mammograms. I was recently diagnosed with Advanced Stage Breast Cancer with mets to the bones. Currently undergoing chemo, then surgery/reconstruction and hormone therapy. I'm angry that I was never given the information that it would be a better screening if I had a supplemental ultra sound or MRI. I would have paid for it myself, especially if I could avoid what I'm going through now. No history of breast cancer in my family. Doing well, staying positive and not letting this cancer get me!

      almost 7 years Flag
  • Diana Foster Payne Profile
    anonymous
    Stage 4 Patient
    Hi Alice. I experienced that as well. I was told I had small calcifications therefore I was going every six months for a diagnostic mammogram with ultrasound. I was never told my breasts were on the dense side. Five months after a "clear" mammo with ultrasound...I found my lump. I was diagnosed with stage 3C invasive Ductal carcinoma at age 49. I was never given a good excuse why my cancer was missed...except that my breasts were on the "dense side". I wish I had been more aware of the implications. It's scary to know there are so many woman that are being diagnosed much too late. My cancer should have been detected so much sooner. There is a website that advocates laws being made to let every woman know when she has her mammo her breast density. I think it's a wonderful idea.
    almost 8 years Flag
    • Alice Klobukowski Profile
      anonymous
      Stage 2A Patient

      I also didn't know the significance of calcifications. I feel like I was not educated about the dangers of breast density or the calcifications when I received my mammogram results letter. This must be a common problem because my sister who lives...

      more

      I also didn't know the significance of calcifications. I feel like I was not educated about the dangers of breast density or the calcifications when I received my mammogram results letter. This must be a common problem because my sister who lives half way across the country from me received a letter to come back in six months because she had calcifications. When I was diagnosed, I called her to make sure she had gone back in. She hadn't at that time but had her annual mammogram. This time her letter said to come back in four months. She threw the letter away thinking they just wanted her money. For all the emphasis on early screening, there are some big education gaps.

      almost 8 years Flag
    • Diana Foster Payne Profile
      anonymous
      Stage 4 Patient

      You are so right Alice! I had no idea of the significance of calcifications. We hear so much about awareness and early detection. We need more education on this vital issue!!! I met a woman at a retreat I recently attended. She had been going for...

      more

      You are so right Alice! I had no idea of the significance of calcifications. We hear so much about awareness and early detection. We need more education on this vital issue!!! I met a woman at a retreat I recently attended. She had been going for a diagnostic mammo every 6 months as well. Then her Dr. told her every year. She never missed. She kept having bone pain & finally they diagnosed her with breast cancer. It had metastasized to her bones. It's shameful with our modern technology.

      almost 8 years Flag
    • Alice Klobukowski Profile
      anonymous
      Stage 2A Patient

      I so agree

      almost 8 years Flag
  • Lou Cam Profile
    anonymous
    Survivor since 2013
    Now, after being diagnosed with cancer, I'm told I have dense breasts - no one ever mentioned this to me before.
    almost 7 years Comment Flag

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