Frequently Asked Questions: Breast Density

Woman wondering if she has dense breasts and how to screen for cancer

What does it mean to have dense breast tissue? How do I know if I have dense breasts? Does breast density affect breast cancer risk? In this blog post, we’ll answer common questions about breast density patients ask at Bedford Breast Center.

What Is Breast Density?

Breasts are composed of glandular tissue, fatty tissue, and fibrous connective tissue. The glandular tissue (lobules and ducts) is responsible for producing breast milk and transporting it to the nipple. The amount of glandular tissue plus the fibrous connective tissue (fibroglandular tissue) is referred to as breast density. 

How Is Breast Density Categorized? 

Breast density is categorized in four categories, from least to most dense: 

  1. Fatty – The breast is almost entirely composed of fatty tissue. About 10% percent of women fall into this category.
  2. Scattered areas of fibroglandular density – There are a few areas of fibroglandular tissue. Approximately 40% of women have this type.
  3. Heterogeneously dense – There is more evenly mixed fibroglandular tissue and fatty tissue. About 40% of women fit into this category. 
  4. Extremely dense – The breast is primarily composed of fibroglandular tissue. Only 10% of women have extremely dense breasts. 

How Do I know If I Have Dense Breasts?

To determine if one has dense breasts, a radiologist will need to review the patient’s mammogram results.

Women are placed into one of the above categories of density based on their mammogram. Most women fall into the middle two categories of scattered fibroglandular density (B) and heterogeneously dense (C). Women that fall into Categories C and D are considered to have dense breasts. 

Why Does Breast Density Matter? 

Breast density is important for two primary reasons.

First, it can be more difficult for radiologists to identify cancer when looking at a mammogram with dense breasts. This is because fibroglandular (dense) tissue looks white on a mammogram. Cancer also typically appears white on a mammogram and can be harder to see against the white fibroglandular tissue. A cancer can more easily stand out against fatty tissue which appears darker on a mammogram.

Second, increased breast density is associated with a higher risk of breast cancer. 

Does Having Dense Breasts Mean I Need Additional Screening?

It is important to consider additional screening in those with dense breasts. Other screening options include breast ultrasound, breast MRI, and contrast-enhanced mammogram (CEM), which may find cancers in dense breasts that would go undetected on a traditional mammogram.

You should talk to your provider about the risks and benefits of these imaging modalities and if they are appropriate for you.

Should I Still Get Mammograms If I Have Dense Breasts? 

Yes, you should get annual screening mammograms if you have dense breasts. Mammograms can detect cancers before a lump can be felt and have been shown to reduce breast cancer deaths.

At Bedford Breast Center, we offer digital breast tomosynthesis (3D mammograms), which are better able at detecting cancers than conventional 2D mammograms, especially in dense breast tissue.

What Should I Do If I Have Dense Breasts? 

It is important to note that breast density is only one of many risk factors for breast cancer. If your mammogram report states that you have dense breasts, you should talk to your healthcare provider about your overall breast cancer risk and if you should be doing supplemental screening. 

Schedule a Consultation

If you have dense breast tissue and would like to learn more about screening recommendations or to schedule a consult with one of our breast specialists, call Bedford Breast Center in Beverly Hills at (310) 278-8590 or request a consultation using the online form.

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