Breast size / density and radiation

Hello @dconradvlasak and welcome to Mayo Clinic Connect. You shared that you have recently been diagnosed with breast cancer. Are you willing to share what kind?

Also, can I confirm if what you are asking is if breast size/density and radiation (cancer treatment I am assuming) have any correlation with cancer reoccurrence?

With a little more information and background, I can help connect you to other members who may have information to share with you.

I have dense breast and diagnosed with breast cancer few years ago. Had lumpectomy , chemo and radiation. I finished treatment two years ago,

No one ever mentioned a relationship between dense breast and radiation treatment. Would be great question to ask your radiation oncologist.

As you probably are aware, dense breast tissue may make it more difficult to identify precancerous lesions or cancer through a mammogram. For that reason, I discussed with an oncologist and now for my rechecks (once a year) the oncologist orders both a mammogram and MRI.

I did run into some problems with my insurance company initially. They would not pay for a MRI prior to diagnosis. So I had to have biopsy to confirm cancer first. Then after diagnosis, they agreed to pay. They have paid for all MRIs since then.

Laurie

Hi Amanda I have invasive ductile carcinoma. Believed to be in stage 2 but have not had surgery or lymph nodes biopsies yet. My breasts are on the larger side D cup and very dense tissue. I want to understand if the size and density of breast tissue has an affect on the success of radiation after lumpectomy. Are there more reoccurances in women with large dense breasts if so mastectomy may be a better option for me.

I'm curious about that as well. I'm also a D with dense tissue. I'm also concerned about having my first diagnosis at 40 what that means long-term.

@dconradvlasak and @genea I found this research paper that you may find some value in reading.

- High mammographic breast density predicts locoregional recurrence after modified radical mastectomy for invasive breast cancer: a case-control study
https://breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-016-0784-3#:~:text=Conclusions,necessary%20to%20validate%20these%20findings

Have either of you inquired about this with your oncologist out of curiosity? If so, what were you told?

No, I haven't. I know they plan on doing an MRI in addition to an annual mammogram. Other than that, most of my recurrence discussions with the Dr were based on the oncotype test results more than any other factors.

MRI & Mammogram.
I have a mammogram and MRI each year. My insurance covers it because I have been medically categorized as “high risk”.

I am “high risk” because: (1) I have very large (G/DDDD), very dense breasts, (2) I had a family history genetics study done, which is heavy in breast and related cancers, (3) in 2010, I had an ALH pre-cancer which increases breast cancer risk. Genetics actually led the charge in getting me categorized as “high risk”.

I am 63 yrs old, and just diagnosed with two breast cancers in left breast. My routine mammogram found a DCIS (Stage 0). During my ‘second opinion’ visit at Mayo Clinic, an Invasive Cancer (Stage 1A) was found via MRI. Grateful to Mayo for finding the second cancer. (Undergoing TC Chemo right now, then surgery. Lumpectomy/Radiation or Double Mastectomy yet undecided.)

Anyway, through this, I was advised that, in general:
- Mammogram best detects non-invasive. My DCIS (indicated by calcifications) is visible by mammogram; the small Invasive mass is not visible.
- MRI is best at detecting Invasive. My small Invasive mass is visible via MRI; my DCIS (calcifications) are not.

Perhaps the above is particularly true with large, dense breasts. Hope this helps. Love and luck to all in this journey. ❤️

Super helpful information, @kk57. Thank you. How are you doing on the chemo? Side effects?

Hi @colleenyoung. Chemo not as bad as I thought. Mayo Clinic does an excellent job of giving you drugs to sidestep the nausea the first 3-4 days. Dexamethasone before for immune system, meant for immune system, also gives energy and quells inflammatory pain. Before the Chemo IV, they give me Zofran/Pepcid AC for nausea. Does the trick! Little loss of appetite, but not sick per se. I get a Neulasta injection next day (on body) for WBC - causes really bad muscle/bone pain, so I’ve added Claritin on days 1-5 plus Max Tylenol every 8 hours. Really helps.

Mostly I just very tired and “prodromal” (that feeling you have when you’re “coming down with something”) if I overdo it. Naps are my new friend. I do have 3-4 days of mild GI issues, 2-3 days of nosebleeds. But there’s kind of a cadence to it, that I’ve learned to expect/manage. I’m using the Paxman cold cap to reduce hair loss... shedding a lot still though. So we’ll see. You?

PS: I’m on TC Chemo which is every three weeks. 4-6 treatments.
TC=docetaxel (also called Taxotere)
+cyclophosphamide.