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What does it mean to have ‘dense’ breasts and how does it affect mammogram findings?

Posted on May. 13, 2019 ( comments)

A new law in Washington state requires radiologists to notify women of their breast density in mammogram findings. The FDA is currently proposing rules nationwide for a similar notification.

Approximately half of all women have dense breasts, a risk factor for breast cancer. The only way to know your breast density is through a mammogram.

Before the law went into effect, radiologists shared this information with doctors, but weren't required to share it directly with patients.

“The law provides women with more information about their bodies,” says Kristi Martin, MultiCare’s imaging provider liaison.

This will help women make more informed choices about their health care, she adds.

What are ‘dense’ breasts, anyway?

Having dense breasts means you have more glandular and fibrous tissue compared to fatty tissue, Martin says. Breast size does not play a factor.

Unfortunately, dense breasts can make abnormalities and tumors more difficult to detect with mammography on its own, Martin says.

Since it’s not possible to know breast density just by looking in the mirror — only a mammogram can show you — it’s best to talk to your medical provider about your breast density and other cancer risk factors such as family history.

From there, you can decide whether a mammogram makes the most sense, and when.

The American Cancer Society no longer recommends clinical breast exams for average-risk women of all ages. Starting at age 40, women should discuss mammography with their doctor, taking their specific health history and risk factors into account.

“Patients should discuss their health concerns or questions with their doctor to decide on a plan that meets their specific health needs,” Martin says.

Women ages 45-54 should get mammograms every year, according to the American Cancer Society. At age 55, women can choose to get a mammogram every two years or continue yearly screening.

Types of mammograms

A mammogram is a low-dose X-ray that can detect breast cancer. Using two plates to compress the breast, images are taken from two different angles.

A newer type of mammography, 3D mammography (also called breast tomosynthesis), may allow doctors to see breast tissue more clearly and reduce the chance for the patient to need additional exams. The breast is compressed, as in a traditional mammogram, but many low-dose X-rays are taken to create a three-dimensional picture.

At MultiCare and in general, 3D mammograms are the standard for detecting breast cancer. If you have a choice of traditional (2D) and 3D, go with 3D.

“Mammography remains the best first test to detect breast cancer in almost all cases, regardless of breast density,” says Nils Nankin, MD, a radiologist with TRA Medical Imaging.

It’s important to note that having dense breasts is only one of many risk factors for breast cancer, he says.

“Several other factors are taken into account when determining if additional testing (to supplement mammography) is appropriate, such as personal and family history of breast cancer, genetic mutations and previous history of radiation exposure,” Nankin says.

Where can I get a 3D mammogram?

MultiCare Gig Harbor Medical Park, MultiCare Auburn Health Center and MultiCare Covington Clinic offer 3D mammograms. To schedule, call MultiCare Imaging scheduling at 253-792-6220.

Breast MRIs are also offered at MultiCare Covington Clinic.

Learn more about 3D mammography
Find a location for a mammogram

About The Author

Roxanne Cooke

Roxanne Cooke tells stories in words, photos and video.

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