How to tell if your breast cancer is hiding

Updated 8/5/2022 10:01 AM

Nearly half of women are at increased risk for breast cancer, and many of them have no idea.

According to the CDC about 50% of women over 40 have dense breasts - an independent risk factor for developing breast cancer. Dense breasts have less fatty tissue and more glandular or supportive tissue compared to breasts that aren't dense. The density of your breast tissue varies with age, body mass index and a host of other factors. But, research suggests that most women don't know their breast density or understand that having dense breasts may increase their risk for cancer.


The good news is that determining your breast density is easy. The first step is talking to your doctor about getting a mammogram.

"We recommend that most people start having the discussion about mammograms before age 40," explains Dr. Sumit Chhadia, a radiologist at Advocate Good Shepherd Hospital in Barrington, Ill. He cautions that some patients should consider screening earlier especially if they meet certain risk criteria including having a genetic mutation such as the BRCA gene or strong family history of breast cancer.

"Mammograms save lives, but for some people, a mammogram is not enough," says Dr. Chhadia. "The more breast tissue you have, the harder it may be to detect breast cancer with a traditional mammogram."

Your annual mammogram produces four black and white images of your breasts. When you look at the images, fat displays as black while breast tissue displays as white. Unfortunately, breast cancer also typically shows up as white on mammograms, making it extremely difficult to distinguish cancer from dense healthy breast tissue using a mammogram alone.

Depending on your breast density and other risk factors, your doctor may recommend supplemental screening, including breast ultrasound, magnetic resonance imaging (MRI) and molecular breast imaging (MBI).

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An ultrasound uses sound waves to look at the breast. It is commonly used to investigate areas of concern after a mammogram. "Ultrasound can fight through the density of the breast well and works as a great screening tool in the densely breasted population" explains Dr. Chhadia.

"However, for people with an elevated lifetime risk of breast cancer due to family history or genetics, breast MRI and MBI are our best screening tools," continues Dr. Chhadia. Breast MRI uses magnets and contrast administration to create detailed pictures of the breast. Breast MRI is our most sensitive exam, and the best tool we have for detecting breast cancer according to Dr. Chhadia.

An alternative to an MRI, MBI utilizes a gamma camera to detect cells that are metabolically active, like breast cancer cells. "It is the next best screening for patients who are unable to have an MRI," says Dr. Chhadia. "At Advocate Good Shepherd, we're proud to be one of only a few hospitals in Illinois where MBI is available."

To detect breast cancer at its earliest stage, Dr. Chhadia recommends that eligible patients are screened at least annually.

"We understand that mammograms and breast imaging can be time consuming and anxiety provoking, but breast cancer is a treatable disease if detected early enough," emphasizes Dr. Chhadia. "The goal of every breast cancer screening is to give patients more options and better outcomes. That's why we do everything we do."

To understand your risk for breast cancer, take our short breast health quiz


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