While we’re used to seeing Jenna Fischer nail comedic timing as Pam Beesly on NBC’s “The Office,” her latest news is no laughing matter. Fischer recently announced via Instagram that she was diagnosed with breast cancer in December 2023 after an inconclusive mammogram because of dense breast tissue.
She’s sharing her journey to encourage more women to schedule their annual mammograms and to understand their individual risk factors including breast density. “You can also ask your doctor to calculate your breast cancer risk assessment score and get any additional screenings required,” she wrote in an Instagram post.
What is dense breast tissue?
One such screening is a breast ultrasound, which is typically recommended for women like Fischer, who is 50 years old, with dense breast tissue.
Breast density is a term that describes the relative amount of fibroglandular breast tissue to the background fat, as seen on a mammogram. There are four density categories - fatty, scattered, heterogeneously dense (areas of dense glandular and fibrous connective tissue, with some areas of fatty tissue), and extremely dense (almost all dense glandular and fibrous connective tissue). The more fibroglandular breast tissue relative to fat, the denser the breast is considered, and the less sensitive the mammogram is in detecting breast cancer.
According to the National Cancer Institute, about 40% of women have heterogeneously dense breast tissue; and about 10% of women have extremely dense breast tissue. This means half the population qualifies as dense.
What causes dense breast tissue?
Breast density can be inherited, but there are two other factors that can influence dense breast tissue: age and hormone replacement therapy.
When we’re younger, we have higher levels of hormones which contribute to dense breast tissue. Even though you can have dense breasts at any age, density more likely decreases as one gets older.
Women who use hormone therapy for menopausal symptoms are also more likely to have dense breast tissue. Women who have a low body mass index are also more likely to have high breast density.
How do I know if I have dense breast tissue?
A mammogram is the only way to know if you have dense breast tissue. The radiologist will determine the ratio of fibroglandular (dense) to fatty (non-dense) tissue and assign the appropriate density category.
How accurate are mammograms performed on dense breasts?
During a mammogram screening, cancers typically appear as white, making it difficult to distinguish them from normal glandular tissue, which is also white. In order to obtain an accurate picture of the breasts, a radiologist may suggest additional screening tests such as ultrasound or MRI.
In Fischer’s case, her doctor ordered a breast ultrasound after her initial routine mammogram. “Three weeks later they said there were a few spots that were difficult to see [because] you have very dense tissue. We would recommend you would do another mammogram and maybe follow-up with a breast ultrasound,” she said on Today. “After the ultrasound they said, ‘Well, we found something. We’re going to need to do a biopsy.’” The biopsy revealed stage 1 triple positive breast cancer. Fischer went on to undergo surgery, chemotherapy, and radiation, and is now cancer-free.
If we know you have dense breast tissue and we have your doctor’s order, we can couple the mammogram and ultrasound appointments on the same day.
Does breast cancer risk increase because of dense breast tissue?
Those with dense breasts do have a higher risk of developing breast cancer compared to those with fatty breasts.
If you’ve been told you’re at higher risk for breast cancer due to family history, having dense breasts, or other factors, contact Stamford Health’s Breast Center’s high-risk breast cancer screening team.
And remember that annual screenings play an important role in catching any abnormalities or cancer early as in Fischer’s case. “My tumor was so small it could not be felt on a physical exam. If I had waited six months longer, things could have been much worse,” she wrote. “Take it from Pam and her Pam Pams…Get ‘em checked ladies.”
Stamford Health has five convenient breast imaging locations in Stamford, Norwalk, Darien, Greenwich, and Wilton – offering day, evening, or weekend times. Request an appointment today.
Featured Expert/ Author
