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Most women are aware that having a family history of breast cancer increases their risk of the disease, but far fewer women understand that very dense breasts can increase their risk. few.

Ah Research A study published Monday in the journal JAMA Network Open found that the majority of the nearly 1,900 women who participated considered breast density to be a less important risk factor than family history.

However, studies show that women with very dense breasts, characterized by minimal adipose tissue, have a four times higher risk of breast cancer than women with the least dense breasts. About 10% of women who undergo mammograms have this level of breast density. In contrast, if a mother, sister, or daughter had breast cancer, her risk of breast cancer doubles.

Women with considerable, but not extreme, dense breast tissue — About 40% of people who get mammograms — Have a 20% higher risk of breast cancer For people with average breast density, studies show.

This is slightly lower than the associated risk. drink a glass of wine every nightDr. Phoebe Freer, director of breast imaging at the University of Utah’s Department of Radiology and Imaging Sciences, said she was not involved in the study.

“Everybody has different amounts of fibroglandular tissue and different patterns,” Freer said, referring to dense breast tissue. “It’s like a patient’s fingerprint.”

Mammography is the only way to tell if you have dense breasts. generally recommended Once every 1-2 years for women in their 40s and 50s.

In 2019, the Food and Drug Administration proposed a rule requiring mammography centers to inform patients about breast density and its importance. in October, FDA said We were optimistic that the final rules would be published by early 2023.

Although 38 states already require donors to provide information about their breast density after a mammogram, not all states require women to notify their donors if they have high breast density. is not.

Dense breast is so common that doctors may inadvertently downplay the risk, says Christine Gunn, a researcher at the Dartmouth Institute for Health Policy and Clinical Practice who conducted the JAMA study. .

“I have a lot of conversations with primary care doctors that say, ‘This is normal,’ which for some women translates to ‘Oh, don’t worry about that,'” Gunn said. .

In individual interviews conducted as part of Gunn’s study, 6 out of 61 women said dense breasts contributed to breast cancer risk.

There are two reasons why dense breasts increase the risk of breast cancer.

First, breast composition can predispose to cancer. It’s not clear why, but scientists believe cancer is more likely to form in the fibroglandular tissue, which is unique to the breast, as opposed to the fatty tissue found throughout the body.

Second, women with very dense breasts have almost all fibroglandular tissue, making it difficult to detect carcinomas and calcium deposits on mammograms. It makes it easier for cancer to grow or spread without being detected.

According to Melissa Durand, M.D., an associate professor in the Department of Radiology and Biomedical Imaging at Yale University School of Medicine, testing patients with dense breasts for cancer is like looking for white patches on a white wall.

Durand explained that both fibroglandular tissue and cancer appear white on mammograms, whereas adipose tissue appears black.

“With full fat breasts, mammograms show a lot of black areas, but you can get 98 percent accuracy,” she said. “But our sensitivity can be very low, even down to 30% in some studies.

According to radiologists, the ideal type of mammogram, especially for women with dense breasts, is digital breast tomosynthesis, which is often better at detecting cancer than a regular mammogram.

From there, your doctor may recommend an ultrasound or MRI. Radiologists say women with dense breasts will probably need additional screenings each year.

Ultrasound is safe and relatively cheap, but Freer says it can miss cancers or show false positives, which can confuse patients. MRI is the most sensitive option, but patients usually need to demonstrate additional risk factors, such as genetic mutations or a family history of breast cancer, in order to be reimbursed by insurance companies.

“The more often you get screened, the more likely you are to be recalled for additional imaging,” said Freer. “It certainly creates anxiety and it certainly takes time. Most patients are willing to take that risk for life-saving results.”

Women cannot change breast density, but it can change with age.

“In general, younger women have denser breasts,” says Durand. “Like the rest of our bodies, we gain more fat as we age, so breast tissue can gain more adipose tissue.

To lower your overall risk of breast cancer, doctors recommend limiting alcohol intake, exercising regularly, and maintaining a healthy diet. online tools It helps assess breast cancer risk based on multiple factors such as breast density.