Breast Density – What You Need To Know

Breast density is in the news a lot these days – just what is all the fuss about? Let’s review the facts about breast density and your breast health: What is breast density?

• Breast density is a description of the makeup of your breast tissue and its appearance on mammography.
• Breasts contain fat (dark gray on a mammogram), varying amounts of glandular tissue (white) and supporting structures (linear white).
• Breast density may vary based on hormonal changes.

Why does breast density matter?

• The more glandular tissue, the harder your mammogram is to interpret!
• Breast cancers often appear as white, star-shaped masses or may appear as tiny flecks of white.
• It is much harder to find a small white mass or speck of white on a background of white tissue than it is on a background of dark gray.
• Further, studies have shown that for those women with the densest breast tissue, there is a slight, probably around 4% increase in the risk of breast cancer.

How do I know what my breast density is?

• Breast density is determined by your radiologist from your breast imaging.
• You cannot determine breast density from a physical breast exam- either by you or your doctor!
• Your breast density will be classified on your mammogram report as:
  • Fatty (10% of women)
  • Scattered fibroglandular tissue (40% of women) – meaning a mix with around 25-50% of the breast being glandular or white mammographically
  • Heterogeneously dense (40% of women) – meaning a mix with 50-75% of the breast glandular
  • Extremely dense (10% of women) – meaning over 75% glandular
• Breasts with density in the last two categories are considered dense.
• As breast density increases, the mammogram becomes progressively whiter.

Where do I find out my breast density?

• Many states have passed laws requiring the reports we give to you include information on your breast density.
• We have been providing information on breast density to our patients for the past few years along with the results we provide before you leave our office.
• If your facility does not provide this information to you, your doctor’s mammography report should contain a statement on breast density.

What should I do now?

• Knowledge is power. Breast density is just one factor which influences breast health.
• If you have no other risk factors for breast cancer other than being female and being over the age of 40, screening with annual mammography and careful clinical breast exams every year will likely be all you need. 3D mammography would be beneficial. Be compulsive and come for that mammogram every 12 months!
• If you are at higher risk for breast cancer due to family history of breast or ovarian cancer or from other factors like radiation to the chest, additional screening tests may be helpful.
• Consulting with your doctor or with a genetic counselor can help determine your individual risk for breast cancer.
• For those with a lifetime risk of over 20%, breast screening should consist of mammography and breast MRI every year, alternating each test every 6 months.
• If your risk is less than 20% or if you are unable to tolerate MRI, screening with breast ultrasound in addition to mammography is an alternative.

No matter your breast density, remember this: mammography saves lives. Make sure you and all those you love get the screening they need.