Health
Breakthrough in Breast Cancer Detection: New Method Offers Hope for Dense Tissue Diagnosis
Approximately 50% of women over 40 possess dense breast tissue, a condition linked to an elevated risk of breast cancer, according to the Breast Cancer Research Foundation. In response to this, the U.S. Food & Drug Administration (FDA) will require, starting in September 2024, that all mammography reports indicate whether a patient has dense breasts. This measure aims to enhance women’s understanding of their risk factors and encourage additional screenings.
Despite this advancement, the challenge remains that radiologists’ methods for interpreting mammograms haven’t evolved significantly. This is why a recent study’s discovery of breast texture patterns in dense tissue, which may correlate with increased cancer risk, is so significant.
Dense breast tissue consists of less fatty and more fibrous and glandular tissue, influencing how breasts appear on mammograms. This condition is not physically detectable and does not cause discomfort or changes in the breast. The Cleveland Clinic highlights that both dense tissue and tumors appear white on a mammogram, complicating cancer detection for radiologists.
Moreover, having extremely dense breast tissue inherently raises the risk of breast cancer. “That’s because breast cancer often starts in your fibroglandular tissue, a type of dense breast tissue,” explains the Cleveland Clinic. “The more fibroglandular tissue that you have in your breast, the greater the chance you’ll develop breast cancer.”
Under the FDA’s 2024 mandate, mammogram reports must classify breast tissue into one of four categories. These categories range from scattered fibroglandular tissue, which is mostly fatty, to heterogeneously dense tissue, with slightly more dense than fatty tissue, potentially obscuring small masses.
Women falling into the latter two categories may be advised to undergo additional screenings, such as a 3D mammogram, breast ultrasound, or breast MRI, according to the American Cancer Society.
Dense breast tissue is more prevalent among younger women, those with a lower body mass index, individuals with a family history of dense tissue, pregnant or breastfeeding women, and those on hormone replacement therapy.
A groundbreaking study published in the journal Radiology aimed to delve deeper into the distinct patterns and characteristics of breast tissue beyond just density measurement. Researchers analyzed mammograms from over 30,000 women with no prior breast cancer history, identifying 390 radiomic features. These features were grouped into six breast tissue patterns, or phenotypes, associated with an increased risk of breast cancer.
The study revealed two important findings: these patterns heightened breast cancer risk in both Black and white women, and they were linked to false-negative mammograms and interval cancer diagnoses. “We were surprised to find that these radiomic phenotypes showed suggestion of a stronger risk among Black vs. white women,” noted co-senior author Despina Kontos, PhD.
“This is particularly important as breast cancer tends to be more aggressive in Black women, highlighting the need for novel risk factors in this population.”
Understanding who is most at risk for invasive breast cancer, particularly the aggressive types, is vital for prevention and early diagnosis, potentially leading to less intensive treatments. “Understanding who is at greatest risk of invasive breast cancer, especially the most aggressive types, is crucial for preventing cancer and diagnosing it early for potentially the choice of less intensive treatments,” added co-senior author Karla M. Kerlikowske, MD.
The researchers plan to extend their study to a larger U.S. cohort, focusing on 3D mammograms and integrating radiomic risk factors with genetic and lifestyle factors to better identify individuals at increased risk of invasive breast cancer. “Especially examining 3D mammograms, and combining these radiomic risk factors with genetic and other lifestyle factors to improve our ability to define who is (and who is not) at increased risk of invasive breast cancer,” shared senior author Celine M. Vachon, PhD.
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