Posts Tagged ‘risk’

Size doesn’t matter but density does

June 25, 2010

An article published recently in the Los Angeles Times, Breast Density Linked to Cancer Risk, reports that density of the breast tissue is a bigger indicator of breast cancer risk than family history.  And, this might be one of the best kept secrets.

The link between breast tissue density and breast cancer has been known since the 1970’s, but it has only been recently that researchers and cancer specialists have accepted the relationship as important. While the scientific community  admits is could help identify women of high risk, it isn’t yet a widely known nor measured clinically significantly marker. Part of the challenge is creating a universally accepted measurement of breast density.  While radiologists have traditionally measured the density of the breast, it was not to determine the cancer risk but as an indicator of how difficult the mammogram is to read.  So, even though the density has been recorded, it was not recognized as a useful reporting tool for screening until recently.

Last year, a law passed in Connecticut requires that breast density must be included in mammogram reports.  This allows a woman to track her density over time and take precautionary steps if she has dense breasts, such as more frequent clinical exams or MRI’s to supplement or replace mammograms.  Studies show that women’s breast density can change over time and so does the risk of breast cancer, so tracking an increase or decrease in density can change the precautions  and actions a woman chooses. For example, a woman with very dense breasts may choose to forgo taking hormone replace therapy during menopause as they may contribute to breast cancer risk as well.

There are several challenges to using the density of breast tissue to determine cancer risk.  The first is developing a workable rating system.  The system used by radiologists, while helpful, is subjective and very basic.  It a 4 level system, with 1 being predominately fat and 4 being very dense.  Finding an easily quantifiable and measurable tool that is universal will take some time to develop and ensure the usefulness of accuracy in assessment.  Secondly, educating women to the importance of knowing their breast density and utilizing that information to help decrease the risk is a long-term undertaking.

We can be pro-active.  Ask your doctor to request your density be included in the report at your next mammogram.