If you’ve been told you have dense breast tissue, you’re not alone. Breast density is a common finding after a mammogram, but for many patients, it comes with questions: What does it mean? Is it dangerous? How does it affect my breast cancer screening?
OhioHealth radiologist, Bang Huynh, MD, breaks it all down. Here’s what you need to know about breast density, cancer risk and how to make informed choices for your health.
What does it mean to have dense breast tissue?
Breasts are comprised of three main types of tissue — fatty tissue, connective tissue and glandular tissue. Some people have more fatty tissue and others have more glandular tissue. The more glandular tissue you have, the denser your breast tissue is considered to be.
The density of your breast tissue can only be identified by imaging, so you and your providers will likely not know your breast density prior to your first mammogram.
“Dense tissue is a normal thing and it’s very, very common. I would say at least 40-50% of mammograms we look at in the normal population have what we would consider dense breast tissue,” says Dr. Huynh.
On a mammogram, your providers are looking for things that stand out as abnormal. “The way I think about this is: Looking at fatty tissue is like looking through a clear window and things on the other side of this window are easier to see,” says Dr. Huynh. “The more connective or glandular tissue a person has, the opaquer that window becomes, and the harder it is to see something on the other side.”
Tumors and other abnormalities can have a similar density to glandular tissue, making them harder to identify in mammograms. This doesn’t mean mammograms aren’t valuable — they’re still the primary tool for breast cancer screening. But for women with dense breasts and additional risk factors, supplemental imaging might help improve early detection.
Are you at higher risk for cancer if you have dense breast tissue?
There are many variables that can contribute to someone’s risk of breast cancer, and it is true that denser breast tissue is one of the variables that can increase the risk of breast cancer along with many others, such as age, genetics and lifestyle. No single factor contributes to overall risk on its own.
“If a patient has no other risk factors besides dense breasts, based on the current recommendations, it’s probably not enough to warrant extra imaging or concern outside of getting annual mammograms,” assures Dr. Huynh. If someone has additional risk factors like a family history of breast cancer or other genetic risks, then it’s worth finding out if the overall risk warrants additional steps outside of the typical mammogram.
“If you find out you have dense breasts, doing a risk assessment is a great next step. It helps determine whether you’re average or high risk,” says Dr. Huynh.
Supplemental screening options
For patients with dense breast tissue, providers may use 3D mammography (also known as tomosynthesis), which provides more detailed information. At OhioHealth, 3D mammography is a standard practice even for those without known dense breast tissue.
“3D or tomosynthesis mammography lets us look through the breast as if it were broken down into multiple slices — like slices of a loaf of bread instead of looking at the whole loaf as one thing,” says Dr. Huynh.
Other options may include an ultrasound or breast MRI, particularly for patients at higher risk. “These tools are not for everyone, but they’re valuable in specific cases,” Dr. Huynh explains.
At OhioHealth, supplemental screening is tailored to each person.
If we can’t see something clearly on a screening mammogram, or if we notice something suspicious, we’ll call the patient back for additional imaging,” says Dr. Huynh. This may include diagnostic mammography and/or targeted ultrasound. If necessary, a biopsy could follow. “The goal is never to cause fear — it’s to be thorough,” he reassures. “Early detection saves lives, and these follow-ups are part of the normal process.”
Lifestyle tips and risk reduction
While you can’t change your breast density, you can take steps to reduce your overall breast cancer risk. Maintaining a healthy weight, limiting alcohol, exercising regularly and avoiding tobacco all make a difference.
“If you have dense breasts, that’s just one part of your risk profile,” says Dr. Huynh. “There are so many things you can do to support your health.”
One of the misconceptions Dr. Huynh encounters is that people sometimes stop getting mammograms after they learn they have dense breast tissue, since it makes cancer harder to detect. “Don’t stop getting mammograms because you have dense breasts,” emphasizes Dr. Huynh. Screening still starts with mammography and supplemental screening is available when appropriate so that early detection is possible for all women.
If you’ve recently had a mammogram or are due for one, talk with your provider about breast density and whether supplemental screening might be right for you. It’s one small question that could prove lifesaving.
To learn more about cancer screenings or to schedule your next mammogram, click here.
