Yes. Because cancer is more often missed on mammograms in women with dense breasts, it is more often found as a lump or because of other breast symptoms in the interval between screens (i.e., “interval cancer,” see Table 1). Such interval cancers tend to be more aggressive with worse outcomes. Cancers found in dense breasts are more often advanced (stage IIb and III), are more often multifocal or multicentric, and a mastectomy is more often needed for treatment [1]. Increasing breast density also increases the risk of recurrence in women with a history of breast cancer (especially if no radiation therapy is given) [2-5].
TABLE 1. INTERVAL CANCERS AND BREAST DENSITY [6]
| Visually Estimated Breast Density |
Odds Ratio of Interval Cancer (95% Confidence Interval) |
| < 10% | 1.0 |
| 10 to 24% | 2.1 (0.9 to 5.2) |
| 25 to 49% | 3.6 (1.5 to 8.7) |
| 50 to 74% | 5.6 (2.1 to 15.3) |
| ≥ 75% | 17.8 (4.8 to 65.9) |
References Cited
1. Arora N, King TA, Jacks LM, et al. Impact of breast density on the presenting features of malignancy. Ann Surg Oncol 2010; 17 Suppl 3:211-218
2. Eriksson L, Czene K, Rosenberg L, Humphreys K, Hall P. Possible influence of mammographic density on local and locoregional recurrence of breast cancer. Breast Cancer Res 2013; 15:R56
3. Cil T, Fishell E, Hanna W, et al. Mammographic density and the risk of breast cancer recurrence after breast-conserving surgery. Cancer 2009; 115:5780-5787
4. Huang YS, Chen JL, Huang CS, et al. High mammographic breast density predicts locoregional recurrence after modified radical mastectomy for invasive breast cancer: A case-control study. Breast Cancer Res 2016; 18:120
5. Lowry KP, Braunstein LZ, Economopoulos KP, et al. Predictors of surveillance mammography outcomes in women with a personal history of breast cancer. Breast Cancer Res Treat 2018; 171:209-215
6. Boyd NF, Guo H, Martin LJ, et al. Mammographic density and the risk and detection of breast cancer. N Engl J Med 2007; 356:227-236