A woman’s breasts are made of fat and glands that are held together by fibrous tissue. Women who have a higher proportion of glands and fibrous tissue vs. fat have breasts that are considered “dense”.
Dense breasts are normal. It’s estimated that approximately 45% of women over age 40 have dense breasts.
Although normal, dense breasts make it harder for radiologists to detect early-stage cancer on a mammogram. Because of this, cancers can be larger and more advanced when detected in women with dense breasts.
Yes, dense breasts are a risk factor for breast cancer, and the risk increases with the level of breast density.
Additionally, cancer in women with heterogeneously dense or extremely dense breasts may not be diagnosed as early as in women who have breast tissue considered fatty or with scattered density.
The radiologist who analyzes your mammogram determines the ratio of non-dense tissue to dense tissue and assigns a level of breast density.
Despite concerns about detecting cancer in dense breasts, mammograms are still effective screening tools and annual mammography allows the radiologist to detect changes in breast tissue.
Along with a mammogram, other screening tests like Ultrasound or breast MRI can be used to detect early-stage cancers in women with dense breasts. You and your doctor may consider additional or supplemental testing based on your other risk factors and your personal preferences.
Breast MRI. MRI uses magnets to create images of the breast. MRI doesn't use radiation. Breast MRI is recommended for women with a very high risk of breast cancer, such as those with genetic mutations that increase the risk of cancer.
Breast ultrasound. Ultrasound uses sound waves to analyze tissue. Diagnostic ultrasound is commonly used to investigate areas of concern discovered on a mammogram.
Breast density is one of many known risk factors for breast cancer. Dense breasts increase the risk of cancer, but also make it more difficult for the radiologist to detect early cancer.
Several risk models are included in your annual screening mammography results based on family history and other known risk factors for breast cancer 1) Gail Model and 2) Family History Score. Talk to your health care provider about your overall risk for breast cancer as you decide if additional testing is warranted.
If your overall risk for breast cancer is high and you have heterogeneously dense or very dense breast tissue, your health care provider may recommend additional screening measures in addition to annual screening mammography. Patients with a high risk for breast cancer may also be referred to the TriHealth High-Risk Breast Program.
If your overall risk for breast cancer is low and you have heterogeneously dense or very dense breast tissue, you can still request additional imaging.
You may be responsible for co-pay and deductible for supplemental imaging. We recommend that all patients check with their insurance provider.
No. Ultrasound and breast MRI are considered supplemental testing that can be scheduled 6 months after your screening mammogram.