What 'dense breast tissue' means for your health, according to a breast surgeon
BBC Countryfile presenter Julia Bradbury has said that her dense breast tissue delayed her cancer diagnosis. She's raising awareness about the issue as four in 10 women also experience the same tissue.
Bradbury, 54, was diagnosed with breast cancer in 2020 and had a single mastectomy in 2021 to remove a tumour. However, she says her diagnosis was delayed as two scans couldn't pick up the tumour because her breast tissue made it too hard to detect via mammogram. She was eventually diagnosed via an ultrasound.
'I’ve got something called dense breasts,' she explained on Good Morning Britain earlier this week. 'I have to explain because 40% of women have dense breasts. It’s nothing to do with the shape or size, it’s to do with your tissue, the density of the tissue.'
After Bradbury's explainer, you might be wondering how to tell if you have dense breast tissue and what this means for your health. WH has spoken to Mr Daniel Leff, a consultant in oncoplastic breast surgery at The Harley Street Clinic to explain everything you need to know.
What is dense breast tissue?
'Breast density is the relative proportion of firm, fibrous and glandular breast tissue relative to the amount of soft fatty breast tissue that makes up the composition of a woman’s breasts,' he explains.
'High breast density means the breasts are extremely dense, being comprised of a greater amount of firm fibroglandular tissue.'
How to know if you have dense breast tissue
You likely won't know if you have dense breasts until you go for a breast screening, which is offered to every woman between the ages of 50-71 on the NHS.
'Breast density can be determined on a mammogram by an expert breast radiologist. Density is graded on a four-point scale from A) fatty to D) extremely dense. Mammography reports usually include a grading of breast density,' explains Mr Leff.
How serious is dense breast tissue?
'High breast density is a risk factor for breast cancer. Compared to women with non-dense breasts, dense breasts carry a 1.6 to two-fold increased risk of breast cancer,' says Mr Leff.
This is for two reasons. Firstly, because breast cancer originates in glandular tissue, so a higher proportion of tissue means a higher chance of cell changes. And secondly because, as Bradbury pointed out, the dense tissue can 'mask' cancerous changes in the breasts during scans. That means cancer might be caught later.
'Fatty tissue looks black on a mammogram, whereas cancers appear white, so it’s often easy to see a white cancer on a black fatty tissue background.
'Dense tissue is not only harder to see through on a mammogram, it also appears white. It's often more challenging to make out a solid white lump on a white background in dense breasts,' says Mr Leff.
However, he keenly adds: 'This does not mean you should not go for screening if you have dense breasts.'
AI breast screening for dense breasts
This week, a trial begun on how AI tools can be used to catch breast cancer cases earlier. Over 700,000 women in England will take part. Bradbury said that AI could make screenings better and improve breast cancer outcomes.
A study from 2023 found that AI can detect breast cancer with 20% more accuracy than the human eye, and Mr Leff says studies show it can accurately 'classify breast density and [...] detect breast cancer.'
Dense breasts and lumps: what to do
If you have dense breasts and have signs of breast cancer, including lumps, the most important thing to do is book a GP appointment. Don't delay seeking help.
'If you have breast lumps and have dense breasts, there are tests that your doctors may recommend, such as ultrasound. This can find out if the lump is solid [like a cancer] or fluid-filled [like a harmless cyst]. Contrast-enhanced mammograms, in which a mammogram is performed after the injection of a dye into a vein, can highlight areas of abnormality in a dense breast that did not show up on a conventional mammogram.'
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