What it means to have dense breasts as Julia Bradbury backs AI cancer detection

Marie-Claire Dorking
·Contributor
Updated ·5-min read

Julia Bradbury has revealed her breast cancer had been missed twice on a mammogram due to her having "dense breasts".

The presenter and campaigner was appearing on Good Morning Britain to discuss the launch of a new NHS trial which aims to use artificial intelligence (AI) to detect breast cancer cases more quickly, and free up radiologists to cut waiting times.

The former Countryfile presenter, 54, was diagnosed with breast cancer in 2021 and later underwent a mastectomy, but is now in remission.

Speaking to hosts Susannah Reid and Ed Balls, Bradbury explained that after finding a lump she underwent two mammograms, which didn't detect any cancerous cells. It was only when her consultant offered an ultrasound instead that she was given a cancer diagnosis.

"I've got something called dense breasts, which I have to explain, because 40% of women have dense breasts," she shared. "It's nothing to do with the shape or size. It's to do with your tissue, the density of the tissue, and it makes it very difficult to detect cancer on mammograms, or that type of imaging, because dense breasts show up white on a mammogram, and cancerous tumours show up white. So the description by many medics is it's like looking for a snowball in a snowstorm."

Julia Bradbury, pictured, who has spoken about her breast cancer diagnosis.
Julia Bradbury has spoken about her breast cancer diagnosis and a new NHS trial to use AI to detect cancer. (Getty Images)

Having checked her breasts herself, which Bradbury recommends people do, she discovered a lump. "Two mammograms later, they thought it was a benign micro cyst, probably nothing to worry about. And it was only on a third visit to my consultant where he suggested he give me an ultrasound, because ultrasound is better with dense breasts, that he spotted it."

Read more: How to check your breasts for lumps (Yahoo Life UK, 6-min read)

Bradbury says the topic is "a bit of a contentious issue, because you don't get ultrasounds on the NHS, and actually you're not even told you have dense breasts on the NHS.

"So that's something that definitely needs to change in this new plan going forward with cancer care," she added.

If her cancer had been missed for a third time Bradbury says she may not be here or may be going through more severe treatment. "Your mind races as to what would have happened," she said. "Certainly, if it had been caught sooner, I probably would have had to have had a lumpectomy, not a mastectomy, because by the time they found my tumour, it was six centimetres and the position of it meant that I had to lose my left breast rather than going in for a smaller area of tissue that could be removed."

In a bid to encourage earlier breast cancer diagnoses Bradbury is in support of the new NHS trial which aims to transform breast cancer screening with artificial intelligence (AI), with almost 700,000 women expected to take part.

It is hoped the technology will help specialists catch cancer earlier as well as freeing up radiologists in a bid to slash waiting times.

"At the moment, you need two radiologists to look at each mammogram," Bradbury explained. "So when you go for your screening, which I would urge people still to do, two radiologists have to go through every single image, and they have to agree. But this AI machine is going to take the place of one of the radiologists, which means they are free to carry on with all the other stuff that's needed."

The presenter went on to point out that somebody dies every four minutes from cancer in the UK and we have one of the worst survival rates. "So we need all of this technology and all of the help," she added. "The AI will free up somebody, and it will make analysis, we think, better. The AI can spot 20% more cancers than the human eye, and it will make it faster."

Undergoing a mammogram. (Getty Images)
Women with dense breasts have a higher risk of breast cancer, but it is harder to detect on a mammogram. (Getty Images)

Dense breasts are normal. According to Prevent Breast Cancer all breasts contain glands, fibrous tissue, and fat. "Dense tissue is made of glands and fibrous tissue," the site explains. "Dense breasts have relatively more glandular/fibrous tissue than fatty breasts."

However, having dense breasts both increases the likelihood of developing cancer and of having cancer being missed by mammography. That's because mammograms are not as effective in detecting cancerous tumours within dense breast tissue.

Breast density is often inherited, but other factors can influence it. Around 40% of women 40 and over have either dense or very dense breasts. It's slightly less common in older women and after the menopause.

So how do you know if you have dense breasts? As well as a typical mammogram, you can also have a breast density test.

“A breast density test can be conducted using mammography, and will as it says in the name, test how dense your breasts are," explains Lester Barr, consultant breast surgeon and founder of Prevent Breast Cancer. "While dense breasts are not abnormal, higher density breasts have an increased risk of breast cancer."

Barr says breast density tests are a great advancement in breast cancer research and are a good option if you want to have a better understanding of your risk, but at the moment the NHS Breast Screening Programme (NHS BSP) in England does not currently include the assessment or recording of breast density on screening mammograms.

Other screening tests, such as ultrasound or MRI, when added to mammography, substantially increase the detection of early stage breast cancer in women with dense breasts.

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