How Breast Density Impacts Cancer Risk and Can Help Guide Screening

BCSC investigators Drs. Kerlikowske, Miglioretti and Vachon, discuss breast density, its measurement, and its impact on breast cancer risk

Posted by Karla Kerlikowske, MD at 9:16 AM on Jun 12, 2019


In the JAMA Insights article published May 31, 2019, titled “Discussions of Dense Breasts, Breast Cancer Risk and Screening Choices in 2019,” Drs. Kerlikowske, Miglioretti and Vachon, define breast density (a radiological term that describes the proportion of parenchymal relative to fatty tissue in mammograms), how breast density is measured, and the impact of the amount of breast density on breast cancer risk and masking (breast cancer hidden by high breast density). The authors also describe how breast density is incorporated into risk prediction models to improve measurement of breast cancer risk and when supplemental imaging or more frequent screening may be indicated for women with high breast density. The article emphasizes while the prevalence of breast density is high (47%), most women with high breast density will not develop breast cancer suggesting the combined assessment of breast density and breast cancer risk should be performed to inform discussions of screening strategies with women. The authors state, “Women and primary health care providers should discuss breast density in the context of breast cancer risk so women can decide if their risk is sufficiently high such that the potential benefits of annual screening mammography and/or supplemental imaging are likely to outweigh the potential harms or their risk is low to average and more frequent screening and/or supplemental imaging will lead to more frequent harms with only a small additional chance of benefit.” 

Full Text Citation & Link: Kerlikowske K, Miglioretti DL, Vachon CM. Discussions of Dense Breasts, Breast Cancer Risk, and Screening Choices in 2019. JAMA. 2019 May 31. doi: 10.1001/jama.2019.6247. [Link to Article]

These findings were discussed on the JAMA Clinical Reviews Podcast. Listen here

Posted by: Karla Kerlikowski, MD