Breast Density: What Women Should Know
Especially during Breast Cancer Awareness Month, you may hear the term “dense breasts” in the media and you may wonder what it means and if it’s something you should worry about. Dr. Avice O’Connell, director of UR Medicine’s Women's Imaging, explains.
Dense breasts have less fat and more glandular tissue. This means that on a mammogram, the breast has a lot of white, making it more difficult to see cancer, which also appears white. Women with dense breasts are slightly more likely to get breast cancer compared to women with non-dense breasts.
Women under age 50 who have not gone through menopause are more likely to have dense breasts compared to women over 50 who’ve gone through menopause. To explain further, about two-thirds of pre-menopausal and one-quarter of post-menopausal women have dense breasts.
Additionally, women with smaller breasts are more likely to have dense breasts, although this cannot be seen or felt from the outside. The only way to determine if you have dense breasts is with a mammogram.
If your mammogram reveals this, your doctor will be notified of it in your mammogram report. Your doctor is then required to send you a letter to inform you, according to a law that went into effect in 2011. That’s because on a mammogram, it is more difficult to detect cancer in denser breasts and women with dense breasts may want to consider additional screening.
The letter may say that your mammogram was normal but you have dense breasts and will make recommendations for any follow-up visits. Or it could say your breasts are dense and an abnormality was found, then suggesting a “callback” for possible further testing. Getting a callback after a mammogram does not mean you have cancer; it simply means further testing is recommended to be certain. In fact, only 5 percent of all callbacks are actually found to have cancer.
For future screening, women with dense breasts may consider having an ultrasound as well as the mammogram. Another option is 3D mammography or tomosynthesis, which is better for dense breasts than regular mammography, and can be done in a single appointment, reducing the number of callbacks (although there is often an additional charge to get either of these tests). It’s important to check with your insurance to find out what your out-of-pocket cost will be.