Breast Size Doesn’t Increase Breast Cancer Risk: Here’s What Does As Per A Breast Cancer Expert

Breast cancer is one of the most common cancers in women. Although it is more prevalent during the postmenopausal years, women as young as 20 years old can develop it. This could be attributed to major risk factors including a personal history of breast conditions, a family history of breast cancer, inherited genes, such as BRCA1 and BRCA2, which are passed down from parents to children, and radiation exposure. While obesity too contributes to the risk of the disease, many assume that their breast size determines their risk of breast cancer, that if they have large breasts, they are likely to develop cancer. But is this true?

In an exclusive interaction with the OnlyMyHealth team, Dr Rohan Khandelwal, Lead Consultant-The Breast Centre, CK Birla Hospital, Gurugram, says there is no correlation between the two and discusses the factor that actually increases one’s risk of breast cancer. 

Also Read: Breast Cancer Vs. Breast Cysts: How To Distinguish Between The Lumps?

“No Correlation Of Breast Size And Breast Cancer”

Breasts can be of different shapes, sizes, and colours - all normal. Interestingly, throughout your life - from hitting puberty to experiencing pregnancy to reaching menopause - your breasts will change during all of these transitions. 

It is normal and natural to have questions, to be curious about your breasts, to want to understand and know about the factors that put you at risk of breast cancer. And one of the most common queries is whether breast size has anything to do with breast cancer risk? 

To which, Dr Khandelwal answers, "There is no correlation of breast size and breast cancer. Whether a lady has small breasts or large breasts, that does not determine their risk of breast cancer."

In fact, a study published in the International Journal Of Epidemiology found no evidence of a relationship between breast size and breast cancer risk, except when using the weighted median and weighted mode methods (BMI). 

But if not breast size, what increases a person’s risk of breast cancer? 

Breast Density And Breast Cancer Risk

Breast density refers to the proportion of various types of tissue present in a woman's breast. According to Dr Khandelwal, it comprises two main things: fatty and glandular tissues.

Fatty breast tissue has a higher proportion of fat tissue and a lower proportion of glandular and connective tissue. On the other hand,  dense breasts have a very high proportion of glandular and connective tissue. 

"The more the gland, the more dense the breast, more is the risk of breast cancer," says Dr Khandelwal. 

A study published in the JAMA Network Open found that extreme (almost all dense glandular and fibrous connective tissue) or heterogeneous (areas of dense glandular and fibrous connective tissue) breast density was associated with increased risk of breast cancer compared to scattered fibroglandular breast density. 

Also Read: Breast Cancer Awareness Month: 7 Tips To Maintain Healthy Breasts To Prevent Breast Cancer

"Women with almost entirely fatty breasts had a decrease of approximately 30% in the risk of invasive breast cancer compared with women with scattered fibroglandular breast density," the study noted, adding, "Associations between breast density and breast cancer risk were not significantly modified by BMI."

Therefore, women with higher breast density may be at a slightly higher risk of developing breast cancer. As per the doctor, it has also been seen that asian women have one of the most dense breasts all across the globe, which puts them at a higher risk of breast cancer. 

However, it is essential to note that breast density alone is not a definitive indicator of breast cancer risk. Other factors, such as family history and genetics, also play a significant role.

Diagnostic Challenges

Another challenge when it comes to dense breasts is that in dense breasts, mammography is not very sensitive, says Dr Khandelwal. This means dense breasts can make it harder to detect small tumours or other abnormalities on mammograms. Even if there are lumps, it becomes difficult to detect them, which is why women with dense breasts may be advised to undergo additional screening methods, such as breast ultrasound or Magnetic Resonance Imaging (MRI), in addition to regular mammograms, to improve the early detection of breast cancer. 

In addition, it may be better for women to discuss their breast density and screening options with their doctors to determine the most appropriate screening plan for their individual circumstances.