Having stout breasts is associated with cancer. But tips on breast density may depend on where you live

Having dense breasts it clear risk factor For breast cancer. It can also hinder mammogram tumors.

Perhaps you do not know that you have dense breasts, even after mammography.

In Australia, advice for women with dense breasts and their healthcare workers may be inconsistent and misleading.

This is due to the fact that currently there is no agreement as to whether women have stout breasts, but without symptoms, they apply further images such as ultrasounds. Fears include the potential cost of these tests and the risk that false positives can produce.

What is breast density?

The breasts consist of fat and fibroglandal tissue (including glands that produce milk, kept together by fibrous tissue).

On the mammogram-X-ray-radiation, the Fibrogland breast seems white, and the fat tissue seems murky. White areas are referred to as breast density.

A higher percentage of fibroglandal tissue means that your breasts are stout.

There are four categories for breast density classification:

• A: Almost completely greasy
• B: Distributed areas of fibrogland density
• C: heterogeneous or consistently stout
• D: Extremely stout.

Breast density is very common. About 40% of women It is estimated that at the age of 40-74 they have “dense breasts”, which means that they belong to the C or D category.

What is the link to cancer?

Breast density is associated with the risk of breast cancer in two ways.

First, breast density it usually decreases With age. But if a woman has a high density of breasts of her age, then increases her The probability of breast cancer.

One examination He looked at the risk of breast cancer over the age of 50. It was found that there is a 6.2% risk of one -third of women with the lowest density. For 5% at the highest density, the risk was 14.7%.

Secondly, the “masks” of breast density if they develop. Both tumors and breast density seem white on mammogram, Very difficult to see cancer.

Screening tests of breast cancer Saves life through early detection and improved treatment options. But we do not know yet whether telling women about their breast density leads to earlier detection of cancer or saved life.

In Australia, mammography shows are free for all women* at the age of 40 and older. It is conducted by Escreen Australia, a joint national, state and territorial initiative. At the age of 50-74 they are invited to the mammogram, but it is available for free without a referral from the age of 40.

However, Australian women now receive breast density – and whether they are recorded – depends on where they live.

What do advice say?

In 2023, Royal Australian and Modern Zealand College of Radiologists updated his own Position statement To recommend breast density recorded during screening and diagnostic tests in Australia and Modern Zealand.

Meanwhile, Escreen Australia claims that “should not routinely record breast density or provide additional tests for women with dense breasts.” However, this position statement comes from 2020 and is currently under review.

Some thoracic screen and territory programs, including Western AustraliaIN South Australia and soon VictoriaNotify women if they have stout breasts. Victoria is currently at an early stage of introduction.

While the messages about breast density differ depending on the condition, none currently recommends further imaging women with dense breasts without talking to a doctor about individual risk.

What are the problems?

Giving recommendations for women with dense breasts is hard.

Recommends a European breast imaging society Women with extremely thick breasts At the age of 50-70 he receives MRI every two to four years, in addition to mammography tests. This is based on Large randomized controlled test from the Netherlands.

But Royal Australian and New Zealand College of Radiologists describes This recommendation as “aspiration”, recognition of costs, staff and availability as a challenge.

This means that it is not possible to provide an additional MRI for everyone in the screening population in category D with extremely dense breasts (about 10%).

In addition, there is no agreement as to the relevant screening recommendations for women in category C (heterogeneous density).

We need a national approach to reporting breast density in Australia and better to identify who will most likely take advantage of further tests.

Australia Australia currently passing Review of his policy and financing.

One of his goals is to enable a consistent approach to thoracic examination practices. We hope that the reporting of breast density, including financing for the support of national implementation, will be a priority.

*This includes registered women after birth and which are diverse sex.