Although having dense breast tissue is common — half of all women in the United States have dense breasts — many women don’t fully understand what it means.
Essentially, our breasts are made up of two tissue types: dense tissue (glandular and fibrous) and non-dense, fatty tissue.
What does it mean to have dense breasts?
When you have more dense breast tissue than fatty tissue, it makes it more difficult to detect breast cancer because it’s harder to see through on a mammogram, making the accuracy of the screening lower.
“On your mammogram, dense breast tissue appears white and hard to see through,” says Laila Samiian, MD, a surgeon and director of the Breast Program at Baptist MD Anderson Cancer Center. “Therefore, tumors or calcifications that are cancerous can be hidden within the dense tissue and are more difficult to detect.”
According to the National Cancer Institute, women with dense breast tissue have a higher risk of breast cancer than those with more fatty tissue — and the more dense your breasts, the greater the risk.
Curious if you are one of the many women in the U.S. with dense breasts? The first step to figuring it out is to have an annual mammogram, which is recommended for women aged 40 and older. “The only way to know if you have dense breasts is to get a screening mammogram, as you cannot determine breast density on physical exam,” Dr. Samiian says.
What should you do if your breast tissue is dense?
If your breast tissue is on the denser side, understanding your risk of breast cancer can help you and your doctor decide on which treatment options would be best.
“Breast density is mostly hereditary and genetic,” adds Dr. Samiian. “Younger women tend to have dense breasts before menopause, especially during lactation and breastfeeding. After menopause, the dense glandular tissue is supposed to involute, or shrink, being replaced with fatty tissue. This is why mammography in younger women is more difficult – their breasts are denser and more difficult to see through. Older women tend to have fatty-replaced breasts which makes mammographic screening very effective and accurate. However, some women’s breasts do not involute after menopause and remain dense, especially in women who stay on hormone replacement therapy. They tend to have a high risk for developing breast cancer.”
How do you know if your risk of breast cancer is greater?
Regardless of whether or not your breast tissue is dense, several other factors can affect a woman’s individual risk for breast cancer, such as family history, lifestyle, menstrual history, and others. Dr. Samiian says you should definitely speak with your doctor about breast cancer risks.
Women with dense breasts (as well as other risk factors) may want to determine their lifetime risk percentage — consulting the High-Risk Breast Screening & Prevention Clinic at Baptist MD Anderson Cancer Center can help. For women with a family history of breast cancer, genetic counseling is also a good option.
And if you do have dense breast tissue, other breast cancer screening methods may be suggested. Screen options at Baptist Health include breast MRIs, digital 3D mammography, and whole breast ultrasound.
A new screening option for women with dense tissue
Women with dense breast tissue, as identified by a mammogram, may be eligible for an additional screening tool called Automated Breast Ultrasound System (ABUS), now available at Baptist Health’s Margaret and Robert Hill Breast Center. The noninvasive method is quick and uses high-frequency sound waves to produce enhanced images of areas that are not clearly visible on traditional mammograms.
During the ABUS screening, women lie flat on their backs while an automated ultrasound device is moved over the surface of the breast to create precise, 3D images. The images are reproducible year after year so that radiologists can observe and evaluate any subtle change in the breast.
“ABUS is not a replacement for a mammogram, but rather a complement to it,” says Dianne Johnson, MD, a diagnostic radiologist. “There are things that the ultrasound will pick up that the mammogram cannot, and there are things like calcifications (calcium deposits) that the mammogram will pick up that the ultrasound cannot.”
“Although mammograms are still the gold standard for breast cancer screening, we’re excited to be able to offer this supplemental imaging option to women with dense breasts,” Dr. Samiian adds.
Get regular screenings (and know your breast type)
The Margaret and Robert Hill Breast Center is the largest dedicated breast center in our region and excels in patient satisfaction measures. For more information, call 904.202.2222.
, but many women don't fully understand what it means.){kind=link}