For many Korean women with dense breasts ‘breast cancer screening method’ [Healthy Hankyoreh]

Many Korean women receive the "dense breast" diagnosis after their health examinations, which can cause fear without necessarily indicating a disease or cancer. Dense breast refers to a condition where more of the breast tissue is made up of glandular fibrous tissue rather than fatty tissue. While dense breast does not indicate cancer, it can make cancer harder to detect during mammograms because the cancer appears white on the images, just like the fatty tissue.

Therefore, women with dense breasts should consider mammography as a supplementary examination based on their individual risk factors. Mammography is the basic method of breast cancer screening, involving compressing the breast and taking X-rays to detect small tumors or calcifications that cannot be felt. In mammography, fatty tissue appears darker and glandular tissue appears lighter.

The higher the proportion of glandular tissue in the breast, the whiter the image appears, which is referred to as dense breast. The classification of breast density is typically divided into four stages, with stages 3 and 4 classified as dense breast. In Korea, the rate of dense breast is higher, especially among younger women.

The problem is that cancer can be hidden within the dense breast tissue, making it difficult to distinguish from the white areas on mammogram images. In such cases, women with dense breasts may consider ultrasound as a supplementary examination based on their personal risk factors. Ultrasound can help identify lumps or calcifications hidden within dense breast tissue.

However, radiation exposure from mammography should not be a reason to avoid it in favor of ultrasound, as the findings of the two examinations may differ. For example, microcalcifications, which can be an early signal of breast cancer, are more likely to be detected by mammography than ultrasound. Therefore, the choice of screening method should be determined based on age, breast density, family history, and past medical history, rather than selecting one method over the other.

Having dense breasts does not necessarily mean having breast cancer, but it is associated with a higher risk of breast cancer. Women with high breast density have a greater risk of developing breast cancer compared to those with lower density. It is important to note that the presence of "microcalcifications" on a mammogram does not automatically indicate cancer.

Small white spots on the breast tissue, caused by calcium deposits, appear as small white dots on mammogram images, and most of the time, they are benign. However, depending on their shape and distribution, some may be related to early breast cancer, requiring further examination or monitoring. Ultimately, the key is not the choice between mammography and ultrasound, but using mammography as the foundation and adding supplementary examinations based on dense breast status and individual breast cancer risk.