If your mammogram reported that you have dense breast tissue, you may wonder, what exactly does that mean for my breast health?
“Having dense breast tissue is not uncommon; about 40% of women over the age of 40 years have dense breasts,” said Dr. Preeti Banga, breast imaging fellowship-trained ARS radiologist at MSU Health Care at McLaren Greater Lansing Breast Imaging Center.
A woman’s breast is composed of three different tissue types: glandular tissue which has milk-producing glands; fibrous tissue which forms the supportive network; and the intervening fatty tissue. Women with dense breasts have more fibrous and glandular tissues compared to the fatty tissues. Dense breast tissue therefore makes it harder for the interpreting radiologist to detect early breast cancers.
“Dense breasts may obscure small breast masses and reduce the sensitivity of the mammograms,” said Dr. Banga. “Effective September 10, 2024, it has been mandated by the FDA that mammographic facility notify their patients of their breast density, requiring reports to include "not dense" or "dense" statements, and to inform patients about potential limitations of screening. Those who have dense breasts are made aware of this and are encouraged to have supplemental screening such as a complete breast ultrasound in addition to mammograms to improve the sensitivity of early breast cancer detection.”
The dense breast tissue not only makes it challenging to interpret the mammograms, but it is also an independent risk factor that increases the risk of breast cancer.
Digital breast tomosynthesis, also called 3D mammography, provides multiple tomographic images of the breast that can be thought of as image slices from many different angles, similar to flipping through the pages of a book instead of just looking at the whole book by its cover. This mammographic screening tool is particularly useful for women with dense breasts.
“3D mammography improves early cancer detection. It can pick up architectural distortion which could be the only imaging finding in some types of breast cancer,” said Dr. Banga. “Additionally, it also reduces the need to perform additional call-back screenings.”
There are no predisposing factors to have dense breast tissue other than pregnant and lactating women who physiologically have denser breast tissue. Although it may be seen that breast density decreases with age, however even women in their 60s, 70s, and beyond may have dense tissue. Hormone replacement therapy is one of the factors that may cause dense breasts in this subset of women.
It is recommended that women over the age of 40 receive yearly mammogram regardless of the breast density. Supplemental screening such as a complete breast ultrasound in addition to mammograms, may be of added benefit in women with dense breast tissue.
The best prevention of breast cancer is through early detection. If you are over 40, now is the time to schedule your mammogram. To learn more about the MSU Health Care at McLaren Greater Lansing Breast Imaging Center, or to schedule an appointment, click here.
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