News + Insights  |  October 8, 2016  |  Kerry E. Chandler, MD

Why Do We Send a Brochure About Breast Density With Your Mammogram Results?

After a screening mammogram, we understand that our patients simply want to know their mammogram results. Many patients are surprised when their mammography report is accompanied by information about breast density.

Documenting Your Breast Density

As of January 1, 2014, a North Carolina statute requires that we inform every woman of her individual breast density in her mammogram results report.

Breast density has four distinct categories:

  • Fatty breast density
  • Scattered breast density
  • Heterogeneous breast density
  • Dense breast density

Having fatty breast density or scattered breast density makes it easier for the radiologist to recognize abnormalities in the breast tissue, the denser the tissue becomes the more difficult it is to identify subtle changes that could represent an abnormality.

Almost 50% of all women who have a screening mammogram are classified as having either “heterogeneously dense” or “extremely dense” breasts. That means one out of every two patients will receive a letter stating they have “dense breast tissue.” Having dense breasts is actually more common than most women realize.

What Does It Mean To Have Dense Breast Tissue?

Breast density is a term to describe how much fibroglandular tissue is in a woman’s breasts versus how much fatty tissue is in the breast.

When reviewing a screening mammogram, we say a woman has “dense breasts” if more than half of her breast tissue made up of  fibroglandular tissue and less than half of her breasts is made up fatty tissue.. Fibroglandular  tissue appears “white” on a mammogram while fatty tissue appears more “dark or dark gray.”

When we look for a cancer on a mammogram, we are looking for a developing “white” density. This type of tissue typically shows up “white.” For women with dense breast, their background density also appears “white” on the mammogram.

That’s why a developing “white” density that a radiologist would expect with a developing breast cancer can be much harder to see on the “already white” background of a patient with dense breast. It is like trying to see a “polar bear” in a snowstorm.

Facts about Breast Density

  • Having “heterogeneously dense breasts” does not put you at at significantly increased risk for breast cancer. Having” extremely dense” breast tissue may have a minimal increased risk for breast cancer.
  • As breast density increases, the sensitivity often associated with a mammogram is often reduced.
  • The recommendations for screening mammography are exactly the same for women with dense breasts as for the rest of the population.
  • A 3D mammogram is a useful tool for more clearly determining the difference between dense breast tissue and cancers.
  • Any woman who is already in a high-risk group for getting breast cancer and finds out that she has dense breasts, should be considered for a breast MRI, along with her yearly mammogram based on her” lifetime risk” for developing breast cancer. If a person with dense breasts has a 20% lifetime risk of developing breast cancer (based on various risk models that can be discussed with her doctor) she is a candidate for additional MRI breast screening.

If your mammogram results letter states that you have heterogeneous breast density or dense breast density, we encourage you to know more about your breast health. In fact, understanding your breast density is important if you’re trying to decide whether to have a traditional or 3D mammogram. Our video on breast density may help you understand why 3D mammography is particularly beneficial for patients with dense breasts.

If you have questions about your breast density, we encourage you to talk with your healthcare provider and consider having a 3D screening mammogram. Wake Radiology is the Triangle leader in 3D mammography with 10 units in multiple offices throughout the Triangle. You can schedule a mammogram appointment by calling 919-232-4700 or by requesting an appointment online.

Source: American Cancer Society

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