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5 Things to Know if You Have Dense Breast Tissue

Nearly half of women over 40 who have mammograms are found to have dense breasts. If you’re one of them, you might be wondering what exactly that means—and how it impacts your risk for breast cancer. Here’s what you should know.

1. There’s nothing unusual about dense breasts. Breasts are made up of glandular, connective, and fat tissue. Dense breasts simply have more glandular and connective tissue, and less fat tissue. “All categories of breast density are completely normal,” said Catherine Tuite, MD, a breast radiologist at Fox Chase Cancer Center.  

2. Having dense breasts can affect your breast cancer risk. Experts don’t fully understand why, but women with dense breast tissue are slightly more likely to develop breast cancer. Still, “it’s only one factor among many that may increase your lifetime risk of the disease,” Tuite said.  

It can also be harder to spot cancer when looking at dense breast tissue on a mammogram image. Fatty tissue shows up as black, while dense tissue shows up as white. Masses or tumors can appear white as well, so they’re not always easy to see in dense breasts, Tuite explained.

3 You can have dense breasts and not know it—until you have a mammogram. Dense breasts don’t have a certain size or shape. And breasts that feel firm aren’t necessarily dense. In fact, the only way to determine breast density is with a mammogram. In Pennsylvania, state law requires that your health care provider inform you about your breast density level in your mammogram report because of the slight increase in breast cancer risk for women with dense breast tissue.

4. Your doctor may recommend additional screening if you have dense breasts. Regular breast cancer screenings are the most reliable way to find breast cancer early. But because masses in dense breasts can be difficult to detect on mammograms alone, your healthcare provider might recommend more detailed screenings. These can include:

  • Breast ultrasounds and magnetic resonance imaging (MRI).
  • Molecular breast imaging (MBI). This is a special type of nuclear imaging test. “It shows us metabolic activity in breast tissue that could reflect breast cancer,” Tuite said. MBI isn’t widely available, but it’s offered at Fox Chase.

Experts haven't yet reached a conclusion on the value of additional screening only for women who have dense breasts. Additional screenings can be helpful, but they could also lead to false positives. That could subject women to even more testing, not to mention unnecessary stress.

The American Cancer Society recommends talking with your doctor to determine what’s best for you. If you have other factors that put you at higher risk for breast cancer—such as gene mutations or a family history of the disease—more screenings might make sense. If you don’t, you may decide to stick with regular mammograms. “Overall, it’s something that each woman with dense breasts needs to make her own decision about after an informed discussion with her doctor,” Tuite said.

5. You should know your breast density. But don’t let it scare you. Being aware of your breast density can help you better make decisions about screening options, including how often and where to be screened. Just remember to keep the big picture in mind. “Dense breasts may increase your breast cancer risk,” Tuite said. “But, again, it’s just one factor and we don’t know if having dense breasts increases the risk for every individual.

Learn more about breast screening at Fox Chase.