If you’ve recently been told that you have dense breast tissue, you might be wondering what that means for your health and what steps you should take next. Dense breast tissue is a common finding in mammograms, but it can affect the accuracy of breast cancer screenings and slightly increase your risk of developing breast cancer.
Understanding your breast density and knowing the appropriate screening options is critical for making informed decisions about your health. Dr. Shaher Khan, an expert in reconstructive surgery and breast implant removal at Executive Plastic Surgery, is committed to helping you understand what constitutes dense breast tissue and the importance of regular screenings.
What is dense breast tissue?
Dense breast tissue refers to the composition of your breasts, which is determined through a mammogram. The breast is made up of two main types of tissue: dense tissue and fatty tissue. The dense tissue includes milk glands, milk ducts, and supportive tissue, while fatty tissue is composed of fat cells. When someone is said to have dense breasts, it means that their breasts have more dense tissue than fatty tissue.
Dense breast tissue is a common finding, and it is not an abnormal condition. In fact, about half of all women who undergo mammograms have dense breasts. However, dense tissue appears as solid white on mammogram images, making it difficult to detect abnormalities like tumors, which also appear white. This similarity in appearance can sometimes make it harder to identify potential cancers on mammograms.
How is dense breast tissue diagnosed?
The only way to determine if you have dense breast tissue is through a mammogram. Mammograms are specialized X-rays of the breast tissue, and they allow radiologists to assess the composition of the breast. A radiologist will review the mammogram images and evaluate the amount of dense versus fatty tissue in your breasts.
Breast density is classified into four categories according to the American College of Radiology’s Breast Imaging Reporting and Data System (BI-RADS):
- Almost entirely fatty: The breasts are primarily made up of fatty tissue, with very little dense tissue present.
- Scattered areas of fibroglandular density: Most of the breast is fatty tissue, but there are some areas of dense tissue.
- Heterogeneously dense: Most of the breast tissue is dense, but there are still some areas of fatty tissue.
- Extremely dense: Nearly all of the breast tissue is dense, with very little fatty tissue.
If your mammogram falls into categories C or D, you are considered to have dense breasts.
Why is breast density important?
- Impact on mammogram accuracy: Dense tissue makes it harder for radiologists to spot abnormalities on a mammogram. Because both dense tissue and tumors appear white, it’s easier for cancer to be missed in women with dense breasts.
- Increased breast cancer risk: Having dense breasts modestly increases your risk of developing breast cancer. While dense breast tissue alone does not mean you have a high risk, it raises the likelihood compared to someone with less dense breasts.
Despite these challenges, mammograms remain an important tool for detecting breast cancer. Advanced mammogram technology, such as digital mammograms and 3D mammograms, is helping improve accuracy by providing clearer, more detailed images.
Additional breast cancer screening options
For women with dense breast tissue, a mammogram may not be enough to detect all abnormalities. Depending on your risk factors and personal preferences, your healthcare provider may recommend additional screening methods. These include:
- 3D mammogram (breast tomosynthesis): A 3D mammogram uses X-rays to take multiple images of the breast from different angles, which are then combined into a three-dimensional image. This technique can help radiologists see beyond the dense tissue, improving the chances of detecting any areas of concern.
- Breast MRI: A breast MRI uses a combination of radio waves and a magnetic field to create detailed images of the breast. This method is often recommended for women at high risk of breast cancer, particularly those with extremely dense breast tissue.
- Breast ultrasound: Ultrasound uses sound waves to create images of structures within the breast. It is used to examine areas of concern identified during a mammogram. Ultrasound can differentiate between solid masses and fluid-filled cysts.
- Contrast-enhanced digital mammogram: This method involves the use of contrast material that highlights potential areas of concern on the mammogram. The contrast is injected into a vein, allowing radiologists to see more detail in the breast tissue.
- Molecular breast imaging (MBI): MBI involves injecting a radioactive tracer into the body, which is absorbed by breast tissue. A special camera detects areas where the tracer is concentrated, which could indicate the presence of cancer.
How often should you get screened?
For women with dense breasts, regular breast cancer screening is crucial. Generally, women at an average risk for breast cancer should start getting mammograms at age 40, and screening should be repeated every year. However, your healthcare provider may recommend additional or earlier screenings if you have dense breasts and other risk factors.
Understanding your breast density is an important part of managing your breast health. While having dense breast tissue can make cancer detection more challenging and slightly increase your risk, there are advanced screening options available to ensure thorough monitoring. Staying proactive about your health by scheduling regular mammograms and discussing additional screening options with your healthcare provider is essential for early detection. If you have any questions, do not hesitate to contact us.
