What is breast density?
Breasts are made up of a mixture of fibrous and glandular tissue and fatty tissue. Your breasts are considered dense if you have a lot of fibrous or glandular tissue but not much fat. Density may decrease with age, but there is little, if any, change in most women.
How do I know if I have dense breasts?
Breast density is determined by the radiologist who reads your mammogram. There are four categories of mammographic density. The radiologist assigns each mammogram to one of the categories. Your doctor should be able to tell you whether you have dense breasts based on where you fall on the density scale. (See scale below.)
Breast density in the U.S. (See pie chart)
- 10% of women have almost entirely fatty breasts
- 10% have extremely dense breasts
- 80% are classified into one of two middle categories
How does Volpara Density make a difference?
At Southtowns Radiology, we use Volpara to more accurately categorize breast density into the four categories defined by the American College of Radiology. This computer algorithm calculates breast density automatically based on your mammogram scan. The advantage is that you will always get the most consistent picture of your breast density, with no possible variations from one doctor to the next. Knowing what category your breast density falls into helps determine what screening options are best for you.
How does 3D mammography make a difference?
3D mammography or tomosynthesis allows doctors to see masses and distortions associated with cancers and precancerous cells significantly more clearly than conventional 2D mammography. Instead of viewing all of the complexities of your breast tissue in a flat image, as with traditional 2D mammography, fine details are more visible and no longer hidden by the tissue above or below. 3D mammography is especially recommended for women with dense breasts, however multiple studies have found that it detects 41% more invasive cancers in women of all breast tissue types. Southtowns Radiology recommends that women with both dense or with fatty breast tissue consider 3D mammography for their screening exam.
Why is breast density important?
Having dense breast tissue may increase your risk of getting breast cancer. Dense breasts also make it more difficult for doctors to spot cancer on mammograms. Dense tissue appears white on a mammogram. Lumps, both benign and cancerous, also appear white. So, mammograms can be less accurate in women with dense breasts.
If I have dense breasts, do I still need a mammogram?
Yes. A mammogram is the only medical imaging screening test proven to reduce breast cancer deaths. Many cancers are seen on mammograms even if you have dense breast tissue.
Are there any tests that are better than a mammogram for dense breasts?
In breasts that are dense, cancer can be hard to see on a mammogram. Multiple studies have shown that 3D mammography can help find 41% more invasive cancers in women and are beneficial to all women with all types of breast density. Studies have also shown that ultrasound and magnetic resonance imaging (MRI) can help find breast cancers that can’t be seen on a mammogram. However, both MRI and ultrasound, show more findings that are not cancer, which can result in added testing and unnecessary biopsies. Also, the cost of ultrasound and MRI may not be covered by insurance.
What should I do if I have dense breasts? What if I don’t?
If you have dense breasts, please talk to your doctor. Together, you can decide which, if any, additional screening exams are right for you such as having a 3D mammogram. If your breasts are not dense, other factors may still place you at increased risk for breast cancer — including a family history of the disease, previous chest radiation treatment for cancer and previous breast biopsies that show you are
at high risk. Talk to your doctor and discuss your history. Even if you are at low risk, and have entirely fatty breasts, you should still get an annual mammogram starting at age 40.
For more information on deciding on additional test, visit our 3D Mammography Decision page.