If your mammogram report says that you have dense breast tissue, you may wonder what that means and whether you need additional testing. Dense breasts are common, but breast density can affect both your breast cancer risk and the way your mammogram images are interpreted.

Understanding your breast density can help you have a more informed conversation with your healthcare provider about your personal risk factors and screening plan.

What Is Dense Breast Tissue?

Breasts are made of fatty tissue, fibrous connective tissue and glandular tissue. Breast density describes the proportion of fibrous and glandular tissue compared with fatty tissue.

Breast density is not determined by the size, shape or firmness of your breasts. It can only be identified through breast imaging. A radiologist evaluates your mammogram and assigns your breast tissue to one of four density categories:

1. Almost entirely fatty
2. Scattered areas of fibroglandular density
3. Heterogeneously dense
4. Extremely dense

Patients in the third and fourth categories are generally considered to have dense breast tissue.

Why Does Breast Density Matter?

Dense breast tissue is important for two primary reasons.

First, dense tissue and certain breast abnormalities can both appear white on a mammogram. This can make it more difficult for a radiologist to identify small masses or other changes within the breast.

Second, women with dense breast tissue have a higher risk of developing breast cancer than women with less-dense tissue. Breast density is only one risk factor, however. Your age, family history, previous breast biopsies, reproductive history and genetic factors may also affect your overall risk.

Having dense breasts does not mean that you have breast cancer. It also does not mean that a mammogram is unnecessary.

Do You Still Need Mammograms If You Have Dense Breasts?

Yes. Mammograms remain an important breast cancer screening tool for women with dense breast tissue. Mammography may detect breast changes before a lump or other symptom can be felt.

The United States Preventive Services Task Force recommends mammography every two years for average-risk women from ages 40 through 74. Other medical organizations may recommend different schedules, and patients with increased risk may need a personalized screening plan.

Your provider can help you determine when to begin screening and how often you should receive a mammogram based on your personal health history.

Women’s Health and Menopause Center offers 3D mammography in West Bloomfield. Three-dimensional imaging captures multiple views of the breast, giving the radiologist more information to review than a traditional two-dimensional image alone.

Could Additional Imaging Be Helpful?

Some patients with dense breasts may be candidates for supplemental imaging, such as breast ultrasound. Whether additional testing is appropriate depends on more than breast density alone.

Women’s Health and Menopause Center offers Automated Breast Ultrasound, also known as ABUS, for appropriate patients with dense breast tissue. ABUS creates ultrasound images of the breast that may help a radiologist examine areas that can be more difficult to evaluate with mammography.

Additional imaging can also identify findings that require further evaluation, even when those findings are not cancer. That is why the decision should be based on a conversation with your healthcare provider about the potential benefits, limitations and costs.

Review Your Mammogram Report

Your mammogram report should tell you whether your breast tissue is considered dense. If you are unsure what the report means, ask your provider the following questions:

• What is my breast density category?
• Does my family or medical history increase my breast cancer risk?
• Is 3D mammography appropriate for me?
• Should I consider ABUS or another form of supplemental imaging?
• How often should I receive breast cancer screening?
• Will my insurance cover the recommended imaging?

Insurance coverage can vary by plan, service and medical necessity. Contact your insurance company and the WHMC office before scheduling if you have questions about coverage or expected costs.

Mammograms and Breast Awareness Work Together

Even if your most recent mammogram was normal, pay attention to how your breasts normally look and feel. Contact a healthcare provider if you discover a new lump, skin dimpling, nipple changes, unusual discharge, swelling or another persistent change.

Screening is intended for people without symptoms. A new breast concern may require diagnostic imaging or another type of evaluation instead of a routine screening mammogram.

Talk With WHMC About Your Breast Screening Plan

Breast density should not be a source of panic. It is useful information that can help you and your provider make informed decisions about your care.

Women’s Health and Menopause Center provides 3D mammography, breast health services and ABUS at our West Bloomfield office. If you are due for a mammogram or have questions about dense breast tissue, call (248) 932-9223 or request an appointment.

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