Asked by anonymous
Stage 2A PatientThis 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...
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.
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...
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.
Asked by anonymous
Learning About Breast CancerArrgh! Hate the call-backs. I would suggest one more test and that would be an MRI.
It can show up small changes very clearly. MOST of these call-backs turn out to be NOTHING! Take care, Sharon
No one likes call backs BUT better to go and get a "nothing" than to go and miss breast cancer. Mine was found in a call back the 3 other call backs were clear number 4 was invasive lobular and rarely shows up even the MRI said show about 2 cm the cancer turned out to be 7.3 cm.
Comment 0Asked by anonymous
Learning About Breast CancerDonna,
Having had a biopsy, the area of your breast in question is numbed with the same stuff they use at a dental office for your teeth. I can best describe is as a "pinch". It gets numb very quickly. When they do the actual biopsy, you do not feel pain, you feel pressure. The biopsy itself...
Donna,
Having had a biopsy, the area of your breast in question is numbed with the same stuff they use at a dental office for your teeth. I can best describe is as a "pinch". It gets numb very quickly. When they do the actual biopsy, you do not feel pain, you feel pressure. The biopsy itself is very quick. The waiting for the doctor to come in and the numbing agent to take effect is what takes the longest. I would not be concerned about any discomfort happening after the area is numbed. After the biopsy is done, they put a bandaid on it. Your post-op instructions will be to put a cold pack on the area. They may say to take Tylenol for any discomfort but it is very minor if any. Everybody has a different pain threshholds but that is how mine went. Your breast might be sore for a couple of days but IT IS SORE...l. not throbbing pain. Just march in that office like you own the place. This is nothing near to what you are imagining. You WILL be ok. If you feel pain, you just let them know and they will put more anesthetic in. Again.... you will be ok, this is a very very, minor procedure they do a thousand times. Hang in there, and take care Sharon
Donna,
Birad scores go from 0 - 6. What I read is with a score of 4, you will need a biopsy. Even with that, THIS DOES NOT MEAN YOU HAVE BREAST CANCER! Ba-zillions of women get this type of news from their mammogram's and ultrasounds. It just means they can't tell from just a look at the...
Donna,
Birad scores go from 0 - 6. What I read is with a score of 4, you will need a biopsy. Even with that, THIS DOES NOT MEAN YOU HAVE BREAST CANCER! Ba-zillions of women get this type of news from their mammogram's and ultrasounds. It just means they can't tell from just a look at the pictures. As we age, boobs change. Doctor's are really careful about not letting anything slip by. So many of my friends have received this type of notice, had to go through having a biopsy and the only one who ended up with breast cancer was ME. ( I have a lot of friends with boobs!) There are a lot more "false positives" in the world of breasts than a diagnosis of breast cancer. I would make an appointment for as soon as they can get you in. It usually takes a few days for the results .... yes, you will worry. Try to stay in the glass half full place. Lots more of these turn out to be nothing. Doctors just have to be very, very, careful. Hang in there Donna. Take care, Sharon
Asked by anonymous
Learning About Breast CancerIt means pretty much just that. Usually cancers have blood flows because that is how they are nourished to grow. You NEED to contact your doctor for a definite meaning in your specific case. Take care, Sharon
Comment 2Ask your doctors all of the questions you can think of. Write them down and take the list to your appt. if they don't answer them in a way you can understand or don't want to spend the time them get another doctor!
Comment 2Asked by anonymous
Learning About Breast CancerCallie,
It is one of those "things" that so many times turns out to be benign. Lots of big scary words to describe the "thing". You won't know what it is until the biopsy comes back. Believe me, getting a biopsy done it far better than a doctor who says, "Wait and see for 6 months." You do...
Callie,
It is one of those "things" that so many times turns out to be benign. Lots of big scary words to describe the "thing". You won't know what it is until the biopsy comes back. Believe me, getting a biopsy done it far better than a doctor who says, "Wait and see for 6 months." You do nothing but worry for 6 months. Hang in there and try not to let worry overtake your life between the time of the biopsy and its outcome. Take care, Sharon
My mammogram nothing. the terms on the ultrasound don't sound familiar. Mine just had an empty space. Where the ultrasound didn't go thru. Then they scheduled me for biopsy. I got to chose needle or surgeon. I could feel my lump and just wanted it out. Most are not cancerous so good luck and prays.
2 comments 1Asked by anonymous
cont) I used to do mammograms and know dense breast tissue can hide things. Mine have always been very dense and my one that remains is still 50-75% dense breast tissue. It makes me wonder how they saw the 2 cancerous areas they saw 2 years ago but thankfully (in some ways) they did. I know I...
cont) I used to do mammograms and know dense breast tissue can hide things. Mine have always been very dense and my one that remains is still 50-75% dense breast tissue. It makes me wonder how they saw the 2 cancerous areas they saw 2 years ago but thankfully (in some ways) they did. I know I asked when we were injecting the local for the first biopsy if my dense tissue could have obscured it from being seen earlier and the Radiologist wasn't sure as they compared them back for at least 3 years. I was hoping now that I'm 64 it would have decreased some but that's not the case (in mine anyway).
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