Dense breasts: What they mean for you and your mammogram choices

Dense breasts are common and may need a 3D mammogram for more effective breast cancer screening.

Breasts are pretty complicated. Large or small, they all are made up of lobules, ducts, fatty tissue and fibrous connective tissue. And some are denser than others, meaning they have more fibrous tissue and less fatty tissue.

“Breast density is very common and not abnormal,” said Michele Myers, diagnostic imaging manager at Norton Women’s & Children’s Hospital. “As many as 50 percent of women have a moderate to high level of dense breast tissue.”

You don’t know if your breasts are dense unless your doctor has told you based on a radiologist’s review of your mammogram.

So why does breast density matter? It may increase the risk for breast cancer, and it makes it harder for doctors to see cancer on a mammogram. However, even though dense breast tissue can hide tumors on mammography, a mammogram is still a proven method of detecting breast cancer and reducing breast cancer deaths.

“Women with dense breasts shouldn’t be alarmed,” Michele said. “The gold standard in detecting breast cancer is still mammography.”

The key is to be diligent about getting yearly screening mammograms. It’s important for your doctor to be able to compare your mammograms from one year to the next to monitor any changes. If a change or abnormality is found on a mammogram, further tests can be done. Digital tomosynthesis, breast magnetic resonance imaging (MRI) and ultrasound testing are highly sensitive and can help find potential trouble spots.

Breast health and dense breasts

Mammography screening plays a key role in early breast cancer detection. 

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3D mammograms more effective for dense breasts

 “Tomosynthesis, or 3D mammography, is a simple but state-of-the-art test in which consecutive images are taken from different angles across the breast to essentially create a 3D ‘slice’ image. It’s very effective in finding abnormalities within breast tissue,” Michele said. “At this time the recommendation is women with dense breasts do not need additional testing if there are no issues, unless they are in the high-risk category — meaning they have a family history of breast cancer, a gene mutation or other factors deemed high risk.”

According to Sarah H. Callahan, M.D., a radiologist with Norton Healthcare imaging services, 3D mammograms are especially helpful for women with dense breast tissue because they have improved sensitivity in detection of a breast cancer.

“3D mammograms also help radiologists detect smaller breast cancers, aiding in diagnosing at an earlier stage — which often leads to a better prognosis and survival,” Dr. Callahan said. “And a final reason 3D mammograms are recommended is women are less likely to be called back for a second diagnostic mammogram.”

Whether or not you have dense breasts, there are things you can do to lower your cancer risk:

  • Maintain a healthy weight.
  • Exercise most days of the week.
  • Limit alcohol.
  • Eat a healthy diet.
  • Don’t smoke.

Norton Breast Health Centers 

These comprehensive, one-stop breast imaging centers offer state-of-the-art diagnostic imaging capabilities, specialized treatment and support services, and a holistic approach to care. The centers offer digital mammography, which provides improved ability to screen breast tissue over traditional mammography; 3D tomosynthesis; breast ultrasound; and breast MRI. They also perform stereotactic, ultrasound-guided and MRI-guided breast biopsies led by a dedicated team of physicians.


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