Dense breasts, age 70+ linked to suspicious breast lumps —UCH study

Researchers at the University College Hospital (UCH), Ibadan, have identified heterogeneously dense breasts, advanced age, and having had at least five pregnancies as significant predictors of suspicious breast changes, including lumps, among women undergoing three-dimensional mammography.

The study found that women with heterogeneously dense breasts had about 10 times the odds of having suspicious breast changes compared to those with other breast patterns.

Women over the age of 70 also had about 10 times the odds of presenting with suspicious lesions, while grand multiparity—defined as having had five or more pregnancies—emerged as another significant predictor.

The findings were presented at the I-Research and Innovation event organised by the College of Medicine, University of Ibadan.

The study examined sociodemographic, reproductive, and radiological factors independently associated with suspicious findings—classified as BI-RADS 4A to 5—compared to benign findings, classified as BI-RADS 4A–5, compared with benign findings classified as BI-RADS 1–3, among women undergoing digital breast tomosynthesis (DBT), commonly known as 3D mammography.

Speaking about the research, Dr Ayo Idowu, a Consultant Radiologist at UCH, stated that the study was designed to identify factors that could help predict suspicious findings among women undergoing DBT.

According to her, DBT uses multiple X-ray images taken from different angles to create a three-dimensional view of the breast, reducing the effect of overlapping tissues and helping radiologists detect and evaluate abnormalities.

The researchers conducted a retrospective, cross-sectional analytical study involving women who underwent DBT at UCH. They found that heterogeneously dense breast tissue was the strongest independent predictor of suspicious findings.

“Among the factors we assessed, heterogeneously dense breast tissue emerged as the strongest independent predictor of a suspicious final assessment,” Idowu said.

She noted, however, that menopausal status, family history of breast cancer, and previous breast disease were not significantly associated with suspicious findings in the study.

READ ALSO: I have dense breasts

Idowu stated that the findings underscore the need for further research involving Nigerian women, noting that risk factors identified in studies conducted in other populations may not necessarily yield the same results in Nigeria.

“We need our own data to look at our women and identify which clinical factors can predict suspicious findings during mammography,” she said.

She explained that DBT was available at UCH and could be useful for further evaluation of women with dense breasts.

However, she emphasised that women must first undergo mammography to determine whether they have dense breast tissue.

“You need to undergo mammography before you know whether you have dense breasts. In our study, dense breasts were associated with about 10 times the odds of detecting a suspicious lesion,” she said.

The radiologist advised Nigerian women to begin regular mammography screenings at age 40 and to continue with annual examinations thereafter.

“When you turn 40, you should start getting mammograms. It’s not like taking an anti-malaria drug once and forgetting about it. You need to come back annually so we can monitor your health,” she said.

Idowu stated that women with dense breasts could undergo further assessment using digital breast tomosynthesis (DBT) to help radiologists identify suspicious abnormalities that may require additional investigation and treatment.

She said the study aimed to improve breast cancer screening and clinical decision-making by generating evidence specific to Nigerian women.

Idowu urged women to undergo regular breast cancer screenings even when they have no symptoms, stressing that early detection and appropriate follow-up can improve treatment outcomes.