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Dense Breasts: What You Need to Know

When you get a mammogram, you may learn something new about your body. You may have dense breasts. If you’re not familiar with that term, it’s time to learn a little more about it.

Why? Dr. Lisa Staton, medical director for BlueCare Tennessee, explains that women with dense breasts tend to be at higher risk for breast cancer. More than 5,500 women in Tennessee are diagnosed each year with invasive breast cancer. Knowing more about your own risk can help you stay on top of your health.

Understanding breast density

First, it’s important to understand what breast density actually means. Breasts contain three different type of tissue: fibrous connective tissue; glandular tissue, which is another name for the lobules that produce milk; and fatty tissue. Dense breasts don’t have a lot of fatty tissue. Instead, they contain mostly fibrous or glandular tissue.

According to the American College of Radiology, there’s a system called Breast Imaging Reporting and Data System (BI-RADS) that categorizes breast composition. So, breasts can fall into one of these four categories:

  1. Entirely fatty tissue.
  2. Scattered areas of fibroglandular tissue
  3. Heterogeneously dense. Breasts in this category may have some areas that are dense with fibrous or glandular tissue, interspersed with areas that are mostly fatty tissue.
  4. Extremely dense. There’s very little fatty tissue at all.

About four out of ten women fall into category 3: heterogeneously dense breasts. However, the last two categories often get combined into one big category described simply as “dense breasts.”

4 important facts about dense breasts

Now that you know what dense breasts are, learn more about what it means to have them.

Dense breasts are common. The National Cancer Institute reports that nearly half of women over 40 who get mammograms are found to have dense breasts.

You need a mammogram to tell for sure. You might think you have dense breasts, but you can’t tell for sure without a mammogram. “You can’t determine breast density by self-examination or even a clinical breast exam,” says Dr. Staton. “It’s something that can only be found with a mammogram or some type of imaging study.”

Dense breast tissue can hide masses. Small masses can hide in dense breast tissue, making it harder for a mammogram to pick up on them.

Other tests may be necessary. If you have dense breasts, your doctor may want to discuss other kinds of tests besides a mamogram. That could include a breast ultrasound, a breast MRI, molecular breast imaging (MBI), and breast tomosynthesis (also known as 3-D mammography). However, your specific circumstances should be considered before you decide to go with any supplemental testing. “It’s not recommended for everyone to get additional tests, and there may be additional risks from having more tests,” says Dr. Staton.

Talk to your doctor

Wondering whether you have dense breasts or not? The next time you go for a mammogram, read the report closely. It should tell you whether or not you have dense breasts. If you do have dense breasts, talk to your doctor about what that means for you. Or if you’re not certain you understand your own risks for developing breast cancer, that’s also a good reason for a conversation with your doctor.

Together, you can discuss your history and your specific risks and decide how to proceed, including whether any additional types of testing might be appropriate for you.

Jennifer Larson

Jennifer Larson

Jennifer Larson is Nashville-based writer and editor with nearly 20 years of experience. She specializes in health care and family issues.

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WellTuned does not offer medical advice. Any personal health questions should be addressed to your doctor.

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