Many women underestimate breast density as a risk factor for breast cancer, study shows - CNN

CNN  — 

Dense bosom insubstantial has been associated with up to a 4 times higher hazard of bosom cancer. However, a caller survey suggests fewer women presumption bosom density arsenic a important hazard factor.

The study, published successful JAMA Network Open, surveyed 1,858 women ages 40 to 76 years from 2019 to 2020 who reported having precocious undergone mammography, had nary past of bosom crab and had heard of bosom density.

Women were asked to comparison the hazard of bosom density to 5 different bosom crab hazard factors: having a first-degree comparative with bosom cancer, being overweight oregon obese, drinking much than 1 alcoholic beverage per day, ne'er having children and having a anterior bosom biopsy.

“When compared to different known and possibly much well-known bosom crab risks, women did not comprehend bosom density arsenic important of a risk,” said Laura Beidler, an writer of the survey and researcher astatine the Dartmouth Institute for Health Policy and Clinical Practice.

For example, the authors study that dense bosom insubstantial is associated with a 1.2 to 4 times higher hazard of bosom crab compared with a 2 times higher hazard associated with having a first-degree comparative with bosom crab – but 93% of women said bosom density was a lesser risk.

Dense breasts insubstantial refers to breasts that are composed of much glandular and fibrous insubstantial than fatty tissue. It is simply a mean and communal uncovering contiguous successful astir fractional of women undergoing mammograms.

The researchers besides interviewed 61 participants who reported being notified of their bosom density and asked what they thought contributes to bosom crab and however they could trim their risk. While astir women correctly noted that bosom density could disguise tumors connected mammograms, fewer women felt that bosom density could beryllium a hazard origin for bosom cancer.

Roughly one-third of women thought determination was thing they could bash to trim their bosom crab risk, though determination are respective ways to trim risk, including maintaining a healthy, progressive manner and minimizing intoxicant consumption.

Breast density changes implicit a woman’s lifetime, and is mostly higher successful women who are younger, person a little assemblage weight, are large oregon breastfeeding, oregon are taking hormone replacement therapy.

The level of bosom crab hazard increases with the grade of bosom density; however, experts aren’t definite wherefore this is true.

“One proposal has been that women who person much dense bosom insubstantial besides person higher, greater levels of estrogen, circulating estrogen, which contributes to some the bosom density and to the hazard of processing bosom cancer,” said Dr. Harold Burstein, a bosom oncologist astatine the Dana-Farber Cancer Institute who was not progressive successful the study. “Another proposal is that there’s thing astir the insubstantial itself, making it much dense, that someway predisposes to the improvement of bosom cancer. We don’t truly cognize which 1 explains the observation.”

Thirty-eight states presently mandate that women person written notification astir their bosom density and its imaginable bosom crab hazard pursuing mammography; however, studies person shown that galore women find this accusation confusing.

“Even though women are notified usually successful penning erstwhile they get a study aft a mammogram that says, ‘You person accrued bosom density,’ it’s benignant of conscionable tucked successful determination astatine the bottommost of the report. I’m not definite that anyone is explaining to them, surely successful idiosyncratic oregon verbally, what that means,” said Dr. Ruth Oratz, a bosom oncologist astatine NYU Langone’s Perlmutter Cancer Center who was not progressive successful the study.

“I deliberation what we’ve learned from this survey is that we person to bash a amended occupation of educating not lone the wide nationalist of women, but the wide nationalist of wellness attraction providers who are doing the superior care, who are ordering those screening mammograms,” she added.

Current screening guidelines urge women of mean hazard of bosom crab acquisition bosom crab screening each 1 to 2 years betwixt ages 50 to 74 with the enactment of opening astatine property 40.

Because women with dense bosom insubstantial are considered to person higher than mean crab risks, the authors of the survey suggest women with precocious bosom density whitethorn payment from supplemental screening similar bosom MRI oregon bosom ultrasound, which whitethorn observe cancers that are missed connected mammograms. Currently, sum of supplemental screening aft the archetypal mammogram varies, depending connected the authorities and security policy.

The authors pass that “supplemental screening not lone tin pb to accrued rates of crab detection but besides whitethorn effect successful much false-positive results and callback appointments.” They accidental clinicians should usage hazard appraisal tools erstwhile discussing tradeoffs associated with supplemental screening.

“Usually, it’s a treatment betwixt the patient, the objective team, and the radiologist. And it’ll beryllium affected by anterior history, by whether there’s thing other of interest connected the mammogram, by the patient’s household history. So those are the kinds of things we sermon often with patients who are successful specified situations,” Burstein said.

Breast crab screening recommendations disagree betwixt aesculapian organizations, and experts accidental women astatine higher hazard owed to bosom density should sermon with their doc what screening method and frequence are astir appropriate.

“I deliberation it’s really, truly important that everyone understands – and this is the doctors, the nurses, the women themselves – that screening is not a 1 size fits each recommendation. We cannot conscionable marque 1 wide proposal to the full colonisation due to the fact that idiosyncratic women person antithetic levels of risks of processing bosom cancer,” Oratz said.

For the astir one-third of women with dense bosom insubstantial that reported determination was thing they could bash to forestall bosom cancer, experts accidental determination are immoderate steps you tin instrumentality to trim your risk.

“Maintaining an active, steadfast manner and minimizing intoxicant depletion code respective modifiable factors. Breastfeeding tin alteration the risk. On the different hand, usage of hormone replacement therapy increases bosom crab risk,” said Dr. Puneet Singh, a bosom surgical oncologist astatine the MD Anderson Cancer Center who was not progressive successful the study.

The researchers adhd that determination are approved medications, specified arsenic tamoxifen, that tin beryllium fixed for those astatine importantly accrued hazard that whitethorn trim the chances of bosom crab by astir half.

Finally, bosom crab doctors accidental that successful summation to due screening, knowing your hazard factors and advocating for yourself tin beryllium almighty tools successful preventing and detecting bosom cancer.

“At immoderate age, if immoderate pistillate feels uncomfortable astir thing that’s going connected successful her breast, if she has discomfort, notices a alteration successful the breast, bring that to the attraction of your doc and marque definite it gets evaluated and don’t fto idiosyncratic conscionable brushwood you off,” Oratz said.