BREAST CANCER / DENSE BREASTS

 

BREAST CANCER / DENSE BREASTS

It had been an annual routine. Papa used to take the whole family to Kunthirical, Thalavady to spend some time with his parents. One day I heard Papa admonishing Mummy for visiting an ailing lady in the neighbourhood who had been on her final days tormented by terminal cancer.. That was the first time in my life, I learned there existed an illness known as cancer. Papa in his ignorance had thought that cancer was infectious.

But cancer caught us unawares. In the year 1977, Mummy had a severe headache. She had till then been toiling in the kitchen happily for the entire family. The headache morphed into paralysis. We were all poorly oriented. We took her to Ayurveda and Allopathy doctors. They were of the opinion it was nothing but paralysis that required time for cure. But when a close relative castigated us for not taking Mummy to Super Speciality Doctors, we took her at once to the Kottayam Medical College Hospital.

She was examined there by a Neuro Physician who put three questions to us.

Didn’t you take her to doctors earlier?

We replied, ‘Yes’.

 

Didn’t they have a look at her eyes with a pen torch?

We said, ‘Yes’.

 

What did they see there?

We answered, ‘We have no idea ’.

The Professor was emphatic. He said the patient was afflicted  with Brain Tumour and CMC Vellore was the only place that could take care of her.

At CMC Vellore, it was diagonised that she had Glioblastoma, a highly aggressive and malignant form of Glioma.

There was Surgery followed by Chemotherapy, Radiation, Physiotherapy and a host of medicines. The treatment enabled her to get up and gradually move around. However following a relapse, she breathed her last nine months after the splitting headache had surfaced.

More was in the pipeline. This time it was breast cancer that caught my sister in law at the beginning of the century. The malignancy was Stage 2. But Mastectomy coupled with Chemotherapy, Radiation and medicines along with close monitoring cured her of the ailment. She lived on for two decades. However a cardiac indisposition took her away.

Whenever we hear of brain tumour and breast cancer we are on an alert.

Recently, we came across an article in the Times of India of 20^th June 2025 by Lata Mishra.

“The hidden breast cancer risk all Indian women should know about.”

I am not from the medical field. My awareness on that domain is not even skeletal.

I present what I have learned from the article.

Unlike in US, women in India are not told if they have dense breasts. This could mean a missed cancer diagnosis. In dense breasts additional screening is crucial as mammograms may miss early tumours. Dense breasts are biologically more active and harder to image. Dense breasts are breasts  that have a higher proportion of fibrous and glandular tissue compared to fatty tissue. Fibrous tissue in the breast is a normal component of breast tissue and a natural part of breast structure providing support and structure. Glandular tissue in the breast is responsible for milk production and is a key component of breast tissue. Fatty tissue in the breast is a normal and natural component of breast structure, composed of fat cells.

 Dense breasts are more common than we think.

 Dense breasts make self examination difficult.

 Regular mammograms can be the difference between Stage I and Stage IV.

 Nearly half of women aged 40 and above are found to have dense breast tissue in               mammograms.

 Breast density is directly linked to an increased cancer risk.

 US FDA has mandated mammogram reports to include breast density details since last year (2024).

 Breast density cannot be identified through appearance or physical examination.

Women with extremely dense breasts have a 1.5 to 2 times risk of breast cancer than those with fatty breasts – a composition where the majority of the tissue is fat, with relatively little fibrous or glandular tissue. (Breast tisuue is made up of three main components: fatty tissue, fibrous tissue and glandular tissue. Fibrous and glandular tissues are collectively referred to as fibroglandular tissues). Fatty breasts are associated with a lower risk of breast cancer compared to breasts with higher density as it’s easier to detect abnormalities on a mammogram.

 Looking for a tumour in dense breasts is like spotting a snowball in a snowstorm.

 Breast cancer begins when a single cell in the breast undergoes mutation.

 Women with dense breasts face a higher risk because of increased cell population.

 Oestrogen plays a key role in making breasts dense.

 Women with a first degree relative with breast cancer or dense breasts are more likely to          have dense tissue.

 Breasts have glandular cells that produce milk and hormonal stimulation till a certain age.     These cells can multiply.

 Contrast Enhanced Digital Mammography (CEDM) can reveal hidden tumour. It is a cost         effective alternative to MRI. But it is not available in India.

 If India imposes rules on breast density disclosure for every mammography it would improve   transparency in diagnosis.

 Dense breasts as seen on a mammorgram refer to breast tissue that has a higher proportion   of glandular and fibrous connective tissue compared to fatty tissue. It’s a normal variation in   breast composition and not an abnormal condition or disease.

 Breast size doesnot determine breast density. Younger women tend to have dense breasts,     but not always.

 Diet and exercise do not directly change breast density.

 Dense breasts do not cause any noticeable symptoms like pain or changes in breast             appearance.

 While dense breasts are not cancerous, they may slightly increase the risk of developing         breast cancer.

 Dense breasts have more glandular and fibrous tissue, which appear white on a                     mammogram, and less fatty tissue which appear darker.

 On a mammogram, dense tissue can make it harder to detect tumours because both dense     tissue and tumours can appear white.

 Women with dense breasts may benefit from supplemental screening options like ultrasound   or MRI in addition to mammograms for  improving early detection.

Over 50% of Indian breast cancer cases come to light at Stage III or Stage IV due to late detection.

 22% of Indian women aged 40 – 49 have dense breasts.

 All breasts have milk producing glands and fibrous tissues, while non dense breasts mostly     have fatty tisuues.

Dense breasts are not related to breast size or firmness.

You can’t tell if you have dense breasts based on how your breasts look or on their firmness.