Breast Density Notification Laws Should Consider Body Mass Index

New BCSC study examines impact of BMI on prevalence of dense breasts by race and ethnicity

Posted by Michael Bissell at 10:00 AM on Jun 8, 2023


In a new Breast Cancer Surveillance Consortium (BCSC) study published in Cancer, Epidemiology, Biomarkers & Prevention, researchers evaluated whether differences in body mass index (BMI) account for differences in the prevalence of dense breasts by race and ethnicity. Using the large BCSC cohort, the study evaluated more than 2.6 million breast density measurements from 866,000 women aged 40 to 74 years and without a personal history of breast cancer performed between January 2005 and April 2021 at 140 radiology facilities around the country. The study found that clinically important differences in the prevalence of dense breasts across racial and ethnic groups that remained after adjusting for age, menopausal status, and BMI.

The probability of dense breasts compared to the overall U.S. population for Asian women was attenuated but remained high following adjustment for BMI. The probability of dense breasts in Non-Hispanic Black women increased after adjustment for BMI. Hispanic/Latina women had significantly lower probability of extremely dense breasts compared to the general population with and without adjustment for BMI. Non-Hispanic White women were less likely to have dense breasts after adjustment for BMI, though absolute differences were small.

If breast density is the sole criterion used to notify women of dense breasts and discuss supplemental screening it may result in implementing inequitable screening strategies across racial and ethnic groups. This adds to the urgency to use both BMI and breast density when deciding whom to notify about dense breasts.


Kerlikowske K, Bissell MCS, Sprague BL, Tice JA, Tossas KY, Bowles EJA, Ho TH, Keegan THM, Miglioretti DL. Impact of BMI on Prevalence of Dense Breasts by Race and Ethnicity. Cancer Epidemiol Biomarkers Prev. 2023 Jun 7:OF1-OF7. doi: 10.1158/1055-9965.EPI-23-0049. Epub ahead of print. PMID: 37284771. [Link].


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Posted by: Michael Bissell