What you should know about dense breasts

So many of us have been forced to fight our corner when doctors fail to take us seriously and it's something we'll likely face for years to come.

We have had no choice but to educate ourselves about our own healthcare issues because the education and awareness simply aren't up to scratch.

Many women in Ireland are calling for better breast care and awareness in Ireland, especially when it comes to dense breasts.

The HSE currently doesn't report on breast density to women after their BreastCheck screening.

Dr Alan Smith, Specialist in Public Health Medicine, National Screening Service explained that an evaluation is underway.

"NSAC is currently evaluating an application for the reporting of breast density in our population screening programme, an application that was submitted in 2021."

What is breast density?

According to medical experts, our breasts are made up of two types of tissue- fatty and non-fatty tissues. The density of your breasts depends on how much of the non-fatty tissue type you have.

The HSE confirmed that the risk of breast cancer is higher in women with the densest breasts compared to those with less dense breasts.

How common are dense breasts?

Dense breasts are common, according to the National Cancer Institute. Your breast density will change as you age and is also determined by your genetics.

According to the Marie Keating Foundation, breast density can be categorised into four types.

10% of women in Ireland will fall into the mostly fatty breast density category.

Around 40% of women in Ireland will have a scattered density.

Heterogeneously dense applies to less than 40% of women and less than 10% of women will have extremely dense breasts.

Unfortunately, breast density cannot be measured by look or feel, only by mammography, where dense breast tissue appears white and fatty breast tissue appears dark.

The Marie Keating Foundation confirmed that breast density is one of the strongest independent risk factors for developing breast cancer.

It is reportedly stronger than your family history and age.

They confirmed that women with ‘extremely dense’ breast tissue are four-to-six times more likely to develop breast cancer compared to women with ‘mostly fatty’ breasts.

High breast density can also have the effect of ‘masking’ breast cancers, as they also show up as white on a mammogram, and are harder to see.

Breast density cannot be measured by look or feel. It can be measured by mammography, but this is not available in Ireland.

Those most at risk

The HSE explained why it may be harder to diagnose people with cancer when they dense breasts.

"Dense breast tissue appears white on a mammogram. But, and here’s the big but. Cancer also appears white on a mammogram. This can make it more difficult to spot breast cancer in the mammogram of women with dense breasts. So essentially if you are someone with dense breasts a screening mammogram may be less effective for you."

10% of women between the ages of 40 – 74 have extremely dense breasts. A further 35% have heterogeneously dense breasts. Both groups are at risk of cancer not being picked up by a mammogram as dense breasts also look white on your mammogram just like cancer.

What affects your breast density?

Breast density is mainly inherited but some factors can influence breast density.

The main factors include:

• your age - your breast tissue becomes less dense as you age but this doesn't happen to everyone
• a lower body mass index - if you have less body fat then you'll more than likely have less fatty tissue and more dense tissue around your breasts
• taking hormone therapy for menopause - taking hormone therapy for menopause may also influence breast density

What to do if you have dense breasts

It is important to note that having dense breasts is not an abnormal condition or disease.

It doesn't mean there is something wrong but it may mean your risk of developing breast cancer is higher.

There is also the risk of a cancer diagnosis being missed or delayed because it isn't detected on your mammogram.

Doctors have stressed that having dense breasts does not increase the risk of dying of breast cancer.

However, women in Ireland are calling on the HSE to notify women about their breast density during their BreastCheck.

In response, the HSE said: "It is important to know that no breast density information is currently captured for women attending population breast screening in Ireland.

"This is an area of considerable ongoing international research and many ongoing clinical trials will inform us how breast density can be incorporated safely and effectively to inform breast screening strategies in a way that is equitable for all."

The European Society of Breast Imaging stressed that all women should be notified about their breast density.

"After careful consideration of the evidence, particularly the results of the Dutch DENSE trial, EUSOBI now recommends that women with extremely dense breast tissue are offered screening with breast MRI. In these women, breast MRI can reduce the mortality from breast cancer and is highly cost-effective."