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Dense Breasts

The breast is made up of different types of tissue: glandular tissue, connective tissue, and fat. Breast density describes the relative amount of different tissues in the breast. A dense breast has less fat and more glandular and connective tissue. 

Research shows that women who have dense breasts have an estimated 4-6 times increased risk of developing breast cancer compared to women who do not have dense breasts.

Breast tissue changes as we age, generally becoming less dense the older we get and as we go through menopauseMenopause:
A natural part of a woman's aging process, when the ovaries start to make less estrogen and progesterone and the menstrual periods stop. This change typically occurs between the late 40s and mid-to-late 50s.
, though some women continue to have dense breasts regardless of age.

Other factors, such as taking combined hormone replacement therapyHormone replacement therapy (HRT):
Is a hormone treatment intended for women who have reached the age of menopause, to reduce its symptoms. It involves taking small doses of estrogen and progesterone (combined) or just estrogen alone.
(HRT) during menopause, can also affect breast density. Women who use HRT have higher breast density than women who do not use HRT during menopause. However, evidence shows that breast density decreases when HRT is stopped.

How can I tell if I have dense breasts?

Knowing if you have dense breasts is an important part of your overall breast awareness. However, you cannot determine your breast density by yourself. It has nothing to do with the size, look or feel of your breasts. It also has nothing to do with the usual changes you may experience as part of the menstrual cycle, when the breasts can feel tender or lumpy. 

Having “dense breasts” is a clinical diagnosis that can only be assessed by mammographyMammogram (also called mammography):
A low-dose X-ray of the breast. It is used to take images of the breasts and is an important screening tool for the earlier detection of breast cancer.
. Since dense breasts may run in some families, if multiple members of your family have been diagnosed with dense breasts, Canadian Breast Cancer Foundation encourages you to speak to a health care provider about your family history and about having a mammogram to assess your breast density. 

I have dense breasts. What can I do?

If you have been diagnosed with dense breasts, you are at an increased risk for breast cancer and would benefit from regular breast screeningScreening:
The search for diseases such as breast cancer in people without symptoms. Mammography is an important tool for breast cancer screening and earlier detection.
. Wherever it is available, ask to be screened using digital mammographyDigital mammography:
A low-dose X-ray similar to screen-film mammography, equipped with a digital receptor and a computer instead of film.
, as this newer technology is better at detecting breast cancer in women with dense breasts.

Having dense breasts can make it more difficult to detect breast cancer by mammogram alone, and additional screening methods, such as ultrasoundUltrasound:
An imaging technique that uses sound waves to take a picture of structures in the body, such as the breast.
or MRIMagnetic Resonance Imaging (MRI):
An imaging technique that uses powerful magnetic fields and radio waves to create detailed, 3-dimensional images of the organs and tissues in the body, such as the breast.
, may be recommended in combination with mammography. Currently, few guidelines exist for when and how often women with dense breasts should be screened for breast cancer. Some provincial breast screening programs have started to include women with high breast density in their high risk screening programs, but this is not yet standard across Canada. Speak to a health care provider to discuss screening options available to you and for a referral to a breast cancer screening clinic.

Canadian Breast Cancer Foundation encourages you to learn about your breast health, breast cancer risk, ways to reduce your risk, and the benefits and limitations of screening for the earlier detection of breast cancer. To inform your decisions, we also encourage you to consider speaking to a health care provider.


Sources:

Boyd, N.F. (2013). Mammographic Density and Risk of Breast Cancer. In 2013 ASCO Educational  Book (pp. e57-e62).

Canadian Breast Cancer Foundation. (2010). Earlier Detection and Diagnosis of Breast Cancer: A Report from It’s About Time! A Consensus Conference. Toronto, ON: Canadian Breast Cancer Foundation. 

Susan G. Komen. Breast density on mammogram. Accessed February 22, 2014.

Susan G. Komen. The ABCs of Breast Density. Accessed March 31, 2014.