Madrid, 27 January 2020. Every year more than 32,500 new cases of breast cancer are diagnosed in Spain, according to data from the Spanish Association Against Cancer (AECC), making it the most common type of cancer in women. The incidence has increased mainly due to lifestyle, obesity, stress or sedentariness. In spite of this, early detection thanks to the mammographies that are carried out periodically and the improvement in the treatments has meant that the death rate in Spain is one of the lowest in Europe.
There are certain factors that can increase the risk of breast cancer, such as mutations or other genetic syndromes. Thus, family or personal history may pose a risk, but in a large percentage of the tumours detected there is no family relationship. For this reason, it is essential that all women are screened for breast cancer not only according to their age, but also according to their breast type.
“The test that can never be missed is the mammography, a test that is able to detect cancer when it is not yet palpable because, when a cancer is palpable, it usually has a more advanced stage, worse prognosis and requires more aggressive treatments,” explains Dr Silvia Pérez Rodrigo, head of the Breast Radiology Service in MD Anderson Cancer Center Madrid. However, it is precisely at this early stage of detection where the difficulties are found in finding possible abnormalities according to the patient's breast type.
Currently there is a system called BI-RADS (Breast Imaging Reporting and Data System) which, in addition to facilitating the interpretation and communication of the results of a mammography/breast scan, classifies the breasts according to their density (amount of fat or breast tissue) into four groups.This will tell us what the risk is depending on the type of breast and how difficult it is to detect a possible tumour.
Types A y B
- Breast fat: fat predominates over breast tissue. In this case, the diagnosis is very simple.
- Breast fat with scattered fibroglandular densities: as with type A, fat predominates, but most of the breast tissue is non-dense. It has scattered areas of fibrous and glandular tissue.
Types C and D
- Heterogeneously dense breast: this type of breast has heterogeneously dense tissue and its composition may make it difficult to detect lumps that could be malignant.
- Very dense breast: breast with extremely dense tissue. This is the most difficult type of breast to diagnose.
“Breast types C and D have up to five times the risk of breast cancer than breast types A and B and a greater risk that, when it does appear, it will not be detected in time because of the density of its tissue,” explains Dr Pérez Rodrigo. The dense breast type is more common among young women, where tumours are also growing more quickly, which makes it advisable to monitor it annually. “When you have this type of breast it is convenient to add some other test to the mammography, such as for example the ultrasound or a magnetic resonance imaging,” adds the doctor.
Therefore, early detection is key to diagnosing this disease before any symptoms appear, which makes it easier and more effective for the patient to be treated. “It is essential to know the type of breast, because this allows us to know the individual risk of each person and, therefore, it is possible to recommend a personalised monitoring for each woman,” concludes the doctor.