Breast Density and the Efficacy of Secondary Screening

Abstract

The topic of density in relation to breasts has become a major issue of discussion as of late. Dense breast tissue refers to the breast tissue appearing on a mammogram. When a patient is told their breasts are dense this means that additional screening options may be appropriate as cancerous masses can hide behind the tissue. Masses appear white in color on a screening, or hyperechoic. Breast tissue results in the same imagery, so imagine looking for a snowball within a blizzard. Malignant tumors can be masked in these situations; resulting in a mammogram with a negative finding, hence the recommendation for adjunct screening. Roughly 40% of women have dense breasts.1 Breast density is one of the strongest risk factors associated with breast cancer. It is a highly established predictor of cancer risk and a mammogram misses every other cancer in dense breasts.2 The density can be categorized into 4 levels; A, B, C, D. The category of A would be a classification of a breast being almost entirely fatty, whereas the classification of D would be extremely dense. About 1 in 10 women fall into this latter category.