Dense breasts/mastectomy/ongoing survei

TBH, I don't believe breasts become less dense as we age ... or that they become more dense because of having children - as I didn't have any .....

I was told I had 'lumpy' breasts in my 20s ('lumpy' being a pseudonym for dense breasts) and have never had children or been pregnant, so there have been no hormonal changes to my breasts.  I am now in my late 60s and do not anticipate my breasts becoming less dense as I age - altho they mention that breasts become less dense after menopause.  Well that was over 20 years ago for me - I started menopause in my early 40s.

Technically the Onc saying dense breasts doesn't cause cancer would be correct - but having dense breasts are responsible for the BC being more advanced when identified, in some cases even Stage 4 at first diagnosis. 

So it stands to reason that those with dense breast tissue SHOULD have more advanced detection methods earlier, including at the very least, Ultrasound & MRI etc.

I've had mammograms ever since hitting 50 (yes, I also didn't know they were available from 40!) and my tumours were detected by my GP just 3-4 months after my 'clear' mammogram.  I had Invasive Lobular Cancer (which is more difficult to detect again!) and had a lumpectomy with 'immediate recon', followed by radiation & now on tablets.  If my GP hadn't found the tumours 2 years ago - they would have most likely been missed again by the mammogram reminder I had last Oct!

The FDA in the USA have proposed that women with dense breast tissue be advised of the fact & have US and/or MRI as additional screening aids.  When this comes in - I can only hope that all breast screening in Australian states follow suit.  So far, only WA advises their women of their breast density.
https://www.health.harvard.edu/womens-health/dealing-with-high-density-breasts

But we still need stay 'in tune' with our body changes re aches & pains, as @primek says - having mastectomies doesn't reduce the chances of mets - so, stay vigilant!

Hi @PV123
I had a masectomy even though it was caught early. 
Surgeon recommended due to high density, location if the lump and size 9f my breast.
I believe they become less dense with age but i was 46, so assuming im beating this and live for a while yet that was my best option 
They did offer lumpectomy when.i was very confused and over analyzing everything.
Unfortunately nothings easy. I.hope this help 

Because my breast cancer was not visible on mammograms 5 weeks before I felt a lump it was a big part of my decision to remove both breasts. It doesn't reduce Mets risk but does reduce risk of new cancer developing and going undetected.

i also have very dense breasts and have been reading about the increased risk of BC and the difficulty in detection in the future due to dense breasts. My BC is HER2 positive and ER+.  I have already had a lumpectomy in October 2019, I have my last chemo next week and will be having Herceptin till September. I am due to start radiation in early February, however given that I have very dense breasts I am now confused if I should have a mastectomy now instead of radiation.  I am 59 years and post menopausal so I don’t believe my breasts will get any less dense in the future.  

Did you have a lumpectomy or mastectomy Megs04? Does anyone else have thoughts/suggestions about having a mastectomy now?

 I have spoken to my Onco who does not believe that dense breasts increases cancer risk, she agrees that detection is difficult.

@emcree that’s interesting isn’t it, shame MRI doesn’t show your DCIS. I wonder how good they are at picking up LCIS, I’ve read a few studies that it seems to show up for some and not for others 

Hi @Megs04 I too had dense breasts.  My surgeon would have been OK with annual MRIs to monitor cellular changes however,  in my case,  the density and busyness of breast tissue meant my DCIS was "occult on imaging" (that is,  none of it showed up on MRI,  even though we knew of at least some of the  DCIS following biopsies.  I had my mastectomy 11 days ago and the histology report shows my breast was riddled with DCIS irrespective of the no-show on MRI.  Now,  I believe this to be relatively uncommon and MRI is generally very helpful in identifying cancerous cells but I think it pays to press your breast surgeon on the nature of the precise risk with MRI.  Wishing you really good luck.  

Hi all i really appreciate your input. Thanks for links to articles. Ive booked an extra appt with the surgeon in 2 days time. Then will see recon surgeon in a few weeks.Hopefully ill get more answers.  I forgot to add that i have small breasts and that is some of the consideration but minor compared to the type of cancer and breast density. My main concern is what type of surveillance for rest of life regardless of masectomy or lumpectomy especially on other breast. 

I wish I'd had an MRI when I was diagnosed. It would have made the next six months a lot less agonised.

@Flaneuse Same here and totally relate to the cost of parking

Sorry, I should add I was talking about MRIs BEFORE surgery. I'm not aware anyone has them as a matter of course, for ongoing monitoring after treatment. I have annual 3D mammograms and ultrasounds in the public system. They ultrasound my left chest wall (where I had the mastectomy) as well as the right breast.