While mammograms have reduced deaths by detecting breast cancers when they're small and easier to treat, it's less effective for women with dense breasts. Breast density is associated with the amount of fibroglandular tissue in the breast observed through a mammogram. Fibroglandular tissue appears white on the mammogram making it harder for doctors to visually detect breast cancers.
Who Is More Likely to Have Dense Breasts?
Statistically, more Black women have breast density than white women. This is likely due to the racial differences in BMI, which is associated with density.
This could be why Black women have a higher mortality rate with breast cancer even though their incidence rate is lower than white women.
"The overall 5-year relative survival rate for breast cancer diagnosed between 2002 and 2008 was 90% for white women and 78% for Black women, according to the Journal of the National Cancer Institute. Black women younger than 45, however, experience the same incidence and mortality rate as white women.
Your breast density can change over time, but essentially you're also more likely to have dense breasts if you:
- Are younger
- Are pregnant or breastfeeding
- Are taking hormone replacement therapy
- Have a lower body weight
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Testing dense breasts
Mammography is less sensitive in women with extremely dense breasts than in women with fattier tissue. Women with extremely dense breasts also have as much as six times the risk of developing breast cancer compared to women with fatty breasts. Their risk is twice that of the average woman.
However, a new study finds that supplemental MRI screening can make a difference for these women, who are more likely to
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develop breast cancer. And new technology is being used to speed the process.
Artificial intelligence can quickly and accurately sift through MRIs to rule out breast cancer in the majority who don't have it -- freeing up radiologists to work on the more complex cases, Dutch researchers report.
This news will also be groundbreaking in detecting triple-negative breast cancer (TNBC), which often affects women with dense breasts and is associated with a poor prognosis due to the cancer spreading beyond the breast and recurring after treatment. There are also few targeted medicines for triple-negative breast cancer, which affects more Black and Hispanic women.
READ: 3 Important Health Reasons Why Your Breasts Itch
The study analyzed MRIs of nearly 9,200 extremely dense breasts. Of those, more than 8,300 had no growths and 838 had at least one. Of those, 77 were cancerous.
The model flagged 91% of the MRIs with lesions for a radiologist's review. It dismissed about 40% of the lesion-free MRIs without missing any cancers, according to the study.
"We showed that it is possible to safely use artificial intelligence to dismiss breast screening MRIs without missing any malignant disease," Verburg says in a journal news release. "The results were better than expected. Forty percent is a good start. However, we have still 60% to improve."
Verburg says this AI-based system has the potential to significantly reduce radiologists' workload.
"The approach can first be used to assist radiologists to reduce overall reading time," Verburg adds. "Consequently, more time could become available to focus on the really complex breast MRI examinations."
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What should you do if you have dense breasts?
If you have dense breasts, talk to your doctor about your risk factor of developing breast cancer. He or she will look at risk factors such as your age and family history of cancer. Your doctor will also recommend how you should be screened for breast cancer and which tests may be right for you, but keep in mind that false positives may happen with these tests and you may need to get a biopsy to confirm that you don't really have cancer.
Your doctor may suggest one of the following:
- Breast ultrasound: A machine that uses sound waves to make pictures, called sonograms, of areas inside the breast.
- Breast magnetic resonance imaging (MRI): A kind of body scan that uses a magnet linked to a computer. The MRI scan makes detailed pictures of areas inside the breast.
