The scary truth about dense breast tissue

When I was diagnosed with breast cancer, I quickly learned that women’s breasts are made up of a mixture of dense tissue and fatty tissue.

Woman doing breast self-exam

Some women have more “dense” tissue than “fatty” tissue, and a high proportion of glandular, or connective, dense breast tissue may prevent X-rays from detecting abnormalities such as tumors.

Having dense breast tissue is not a disease, it is just the way I was born. I was first told that I had dense breast tissue a few years ago by the radiologist who reviewed my mammogram. I had no idea at the time that my extremely dense breast tissue put me at a much higher risk of developing breast cancer than women with fatty breasts. Why? Their non-dense breast tissue allows for the easier penetration of X-rays.

Dense breast tissue is more prevalent in younger women, although it does also occur in about 25 percent of older or post-menopausal women.

How to determine breast tissue type

So how do you know if you have dense breast tissue? Dr. Claire Colombo, director of women’s imaging at SimonMed in Scottsdale, Arizona, tells her patients that if they don’t know, they need to ask. However, a doctor cannot tell what kind of breast tissue you have just by conducting a breast exam.

Rather, a radiologist makes this determination after the annual mammogram. Dr. Colombo personally writes in her reports whether a woman has dense, average (half-dense, half-fatty) or fatty tissue. This report then goes to the woman’s regular doctor. He or she should then tell the patient if they have dense breast tissue. Patients should know what the density of their breasts is. If you do not know, be proactive and ask.

The hard facts about dense breasts

  • Forty percent of women have dense breast tissue.
  • Breast density is one of the reasons that mammograms often do not detect tumors.
  • Every other tumor is missed by mammograms in women with dense breast tissue.
  • Breast density is a well-known predictor of breast cancer.
  • There is a greater risk for a woman with dense breast tissue to develop cancer than having two close relatives who have had breast cancer.

Breast cancer detection in dense breasts

Dr. Colombo says, “Mammograms are very good. They see calcium, and ultrasounds cannot see calcium. But if you do have dense breasts, you would really benefit from having ultrasounds when you have your mammogram.”

Know that you may need to add ultrasound appointments to your yearly mammogram routine. If you’re not convinced, read my personal story about how an ultrasound saved my life.

So, what do you do if you do have dense breast tissue?

Ask your doctor if you need to have additional screening such as an ultrasound or a breast MRI. I personally prefer to space my mammograms and my ultrasounds six months apart so I am getting checked every six months.

Your insurance may not cover your mammogram and additional screenings, so talk to your doctor about how he or she may help ensure coverage. Many companies offer special rates during Breast Cancer Awareness Month for breast screenings.

Because the risk of women with dense breast tissue developing breast cancer is much higher than for those with fatty tissue, make sure that, at a minimum, you don’t skip your annual mammogram. Every three minutes a woman in the United States is diagnosed with breast cancer. The facts are frightening, so knowing your breast density could save your life.

How to help raise awareness

Dr. Nancy Cappello started the advocacy campaign Are You Dense? to educate women about dense breast tissue. Dr. Cappello has helped pass laws in several states that require radiologists to inform women whether they have dense breast tissue after their annual mammogram.

Bills are pending in several states and in Congress. The opponents of these bills believe that this information could unnecessarily raise health care costs and scare many women. Personally, I would rather be informed of a health care risk than be uninformed. There is no need to panic, but there is a need to take action.

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