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Olubukola Ayodele: Dense Breasts, Screening Limitations and Equity in Breast Cancer Outcomes

Olubukola Ayodele/LinkedIn

Apr 7, 2025, 18:36

Olubukola Ayodele: Dense Breasts, Screening Limitations and Equity in Breast Cancer Outcomes

Olubukola Ayodele, Consultant Medical Oncologist at the University Hospitals of Leicester NHS Trust, shared a post on LinkedIn:

“Let’s talk about dense breasts.

As a breast oncologist, I’ve witnessed firsthand how a lack of awareness around breast density continues to impact early detection and survival, particularly among young women and women of certain ethnic backgrounds.

Breast density refers to the proportion of fibroglandular tissue to fat in the breast, visible on a mammogram. Women with dense breasts (heterogeneously or extremely dense) face two major challenges:

Increased Risk – Dense tissue not only raises the risk of developing breast cancer but also
Masked Detection – It can obscure tumors on mammograms, making early diagnosis more difficult.

This masking effect leads to delayed diagnoses, often resulting in more advanced-stage presentations that could have been caught earlier with supplemental imaging.

What’s rarely talked about is how ethnicity plays a role. Studies have shown that women of African, Asian, and Hispanic descent are more likely to have dense breast tissue. Yet, these same populations often face disparities in access to advanced screening tools like ultrasound or MRI, which are more effective in detecting cancer in dense breasts.

This is where health equity becomes crucial.

Too many women are told their mammogram is “normal” without being informed about their breast density or the implications for cancer risk and screening accuracy. Worse still, many are unaware that dense breasts require more than just routine mammography for comprehensive evaluation.

As oncologists, clinicians, healthcare leaders and the public, we must:

Advocate for mandatory breast density reporting post-mammogram
Educate patients, especially in underserved communities, about what dense breasts mean
Push for equitable access to supplemental screening for high-risk women
Encourage ongoing research into tailored screening protocols for women of all backgrounds

Breast cancer outcomes should not depend on geography, ethnicity, or whether a patient happened to see a highly informed provider.

Let’s normalize talking about dense breasts, broaden access to appropriate screening, and remove the blind spots, literally and systemically in breast cancer detection.

Please join me in signing the petition for the government to fund breast cancer screening from age 40 and alternative screening options.

Kindly repost and share to your wider community. We all have a role to play.”

Olubukola Ayodele