Whether or not you are notified about breast density after your mammogram, you can ask the doctor who ordered your imaging for a copy of your full report. Read it over and look for information about breast density.
The report also may include the letter rating from A through D, with a result of C or D meaning you have dense breasts. Breast density is thought to be inherited in part, although the amount of dense breast tissue you have can change over time. Breast density can decrease as you go through menopause. Mammograms don't always reveal cancers that may be present in dense breasts. Small cancers can be hidden by dense tissue, since both appear white on a mammogram.
The more density there is, the harder it is for a radiologist to see an abnormality. Know your breast density and make it part of a conversation with your doctor about your annual screening plan. Newer technology known as digital breast tomosynthesis DBT , sometimes called three-dimensional 3D mammography, appears to be more accurate than traditional 2D mammography for women with heterogeneously dense breasts.
Like traditional mammography, 3D mammography takes two views of each breast, but then creates images of thin slices of the breast tissue for the radiologist to read.
These slices are somewhat like a CT scan result, showing slivers of the breast with the overlying tissue peeled away. This can allow the radiologist to see lesions hidden within the tissue and better characterize their appearance. Check to see if your imaging center offers 3D mammography, and if not, ask your doctor if you can switch to one that does. If not, be sure to keep up to date with your traditional 2D mammograms.
Some doctors also may recommend supplemental screening if you have heterogeneously dense tissue, especially if you have other breast cancer risk factors. In the United States, not all insurance companies cover supplemental screening; it depends on the laws in your state. For example, here in Pennsylvania where Breastcancer. For women with heterogeneously dense breast tissue, supplemental screening will be covered if they have one other high-risk factor for developing breast cancer.
The law will not go into effect until sometime in Other states require insurance coverage for supplemental screening for all women with dense breasts while others limit it to certain groups and certain types of testing. You and your doctor should discuss your individual situation, including the amount of dense breast tissue you have and whether you have other breast cancer risk factors.
You also should discuss the cost of supplemental screening, what options are available in your area, and whether those tests would be covered by your insurance. Supplemental screening for dense breasts has pros and cons. The main benefit is that adding a second imaging test to your mammogram makes it more likely that your doctor will be able to detect an early breast cancer.
It also may give you some peace of mind that you are doing more to find breast cancer early. The main risk of supplemental screening is the need to have additional testing and biopsies that may turn out to be unnecessary.
Imaging studies often identify areas of concern that turn out not to be cancer known as false positives , leading many women to experience more callbacks, more imaging, and biopsies. The biopsy itself can cause some level of anxiety, as can waiting to see what the results reveal. Researchers are still trying to figure out whether the benefits of supplemental screening for all women with dense breasts would outweigh the risks of doing unnecessary biopsies. Over time, radiologists will be able to compare your images to see if there are any concerning changes.
Unlike mammography, which is fully covered by insurance, supplemental imaging often counts toward your deductible and is usually subject to a copay, so you may face some out-of-pocket costs.
Talk to your doctor about your level of risk and which test s make the most sense for you. Ultrasound: Ultrasound is the most widely available supplemental screening option for women with dense breasts. It uses high-frequency sound waves to create images of breast tissue.
The images are created as the waves pass through and are reflected by the tissue. The traditional approach is hand-held ultrasound, in which a technologist or breast imager runs the transducer the device that produces the soundwaves over the breasts.
A newer technology is automated breast ultrasound AUS , which uses an automated scanner to produce a 3D image of the whole breast. Some imaging centers now offer AUS for women with dense breasts.
Harvey — unlike handheld ultrasound images, which give information in real time but where there may or may not be saved images of a specific area for comparison.
Having dense breast tissue will not affect your daily life. However, it increases the chance that breast cancer may go undetected by a mammogram, since dense breast tissue can mask a potential cancer.
It also increases your risk of breast cancer, though we aren't certain why yet. Most medical organizations recommend women with an average risk of breast cancer consider regular mammogram testing beginning at age 40 and consider repeating the screening annually. Women with dense breasts, but no other risk factors for breast cancer, are considered to have a higher risk of breast cancer than average.
Dense breast tissue makes it more difficult to interpret a mammogram, since cancer and dense breast tissue both appear white on a mammogram. Very dense breasts may increase the risk that cancer won't be detected on a mammogram.
Despite concerns about detecting cancer in dense breasts, mammograms are still effective screening tools. The most common type of mammogram — digital mammogram — saves images of your breasts as digital files instead of film and allows for more detailed analysis.
This is more effective at finding cancer in dense breast tissue than older film mammogram technology. Additional tests carry additional risks and benefits, though MRI and molecular breast imaging have demonstrated superior cancer detection in women with dense breasts. You and your doctor may consider additional or supplemental testing based on your other risk factors and your personal preferences.
Every test has pros and cons. Talk with your primary care provider about your breast cancer risk factors. Together you can decide whether additional screening tests are right for you.
Richard Ellis, M. Request an Appointment Patient Online Services. Plainview Red Wing Sherburn St. James St. Peter Waseca Waterville Wells Zumbrota. Iowa Decorah Lake Mills. View map. Posted By. Dense breasts: What do our patients need to be told and why? Annals of Surgical Oncology.
Breast cancer screening and options for supplemental screening in the dense breast adult. Rochester, Minn. Lee CI, et al. Risk-based breast cancer screening: Implications of breast density. The Medical Clinics of North America. D'Orsi CJ, et al. Reston, Va. Accessed Feb. Nattinger AB, et al. Breast cancer screening and prevention.
Annals of Internal Medicine. Trentham-Dietz A, et al. Tailoring breast cancer screening intervals by breast density and risk for women aged 50 years or older: Collaborative modeling of screening outcomes.
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