Breast Density Associated with Cancer Risk for Women 65 and Older

Women aged 65 and older with dense breasts have an increased risk of invasive cancer unrelated to body mass index (BMI), according to a study published August 26, 2021, in JAMA Network Open.

A research team led by Dr. Shailesh Advani, M.D., Ph.D., of the Terasaki Institute of Biomedical Innovation in Los Angeles conducted the prospective study from Jan. 1, 2018, through Dec. 31, 2020, using a cohort of 193,787 women aged 65 years or older who underwent screening mammography. Their data was collected as part of the Breast Cancer Surveillance Consortium from Jan. 1, 1996, through Dec. 31. 2012.

“In this cohort study…heterogeneous or extreme breast density vs scattered fibroglandular density was associated with an increased risk of invasive breast cancer among women aged 65 to 74 years and among those aged 75 years or older with a BMI of 25 or higher. No interaction between BMI and breast density was found in either age group,” wrote the team.

in an invited editorial commentary, Dr. Catherine Tuite, M.D., of the ChristianaCare Helen F. Graham Cancer Center and Research Institute, Newark, DE, put the findings into a clinical context. ” The American Cancer Society, the American College of Radiology, and the Society of Breast Imaging do not recommend stopping screening solely based on age. The benefits of screening mammography may take years to be fully realized and decrease when significant comorbidities are present. Therefore, screening recommendations should account for life expectancy and comorbid conditions, with screening mammography remaining appropriate when a woman’s life expectancy exceeds 5 to 10 years and when treatment would be sought for a new breast cancer diagnosis. … Ultimately, the decision of when to stop screening is personal, and each woman deserves the agency to weigh her own wishes, values, and life experiences with an accurate and unbiased discussion of risks and benefits of screening mammography in making that decision.”


Advani SM, Zhu W, Demb J, et al. Association of Breast Density With Breast Cancer Risk Among Women Aged 65 Years or Older by Age Group and Body Mass Index. JAMA Netw Open. 2021;4(8):e2122810. doi:10.1001/jamanetworkopen.2021.22810. Accessed August 31, 2021, at

Tuite CM. Breast Density, Risk of Breast Cancer, and Screening Mammography in Women 75 Years and Older. JAMA Netw Open. 2021;4(8):e2124385. doi:10.1001/jamanetworkopen.2021.24385 Accessed August 31, 2021, at

Allegretto, Amerigo. Dense breasts means higher cancer risk for elderly. August 26, 2021, Accessed August 31, 2021, at

BI-RADS 3 Image