Dense Breast Tissue
Dense breast tissue is common and normal. Nearly half of women age 40 and older who have a screening mammogram have dense breast tissue.
Breast density is defined by the amount of fibroglandular tissue in your breasts compared to the amount of fatty tissue. An individual’s breast density is assigned on a mammogram by the radiologist.
Dense breast tissue causes
Breast density is part of an individual’s genetic makeup, but it can also be changed by other factors, such as:
- Weight. Changes in weight can increase or decrease breast density.
- Age. Breast density often decreases with age, though some women may have dense breast tissue for their entire life.
- Hormone replacement therapy. Hormone therapies can increase breast density.
- Pregnancy or breastfeeding. Breast tissue is involved in milk production, which can increase breast density.
Dense breast tissue care
Women with dense breasts have a higher risk of breast cancer compared to women without dense breast tissue. Breast cancer is also more difficult to detect on a mammogram for women with dense breasts. Because of this, women with dense breast tissue qualify for supplemental breast cancer screening exams, such as:
- Screening breast ultrasound, either with a small handheld probe or larger automated ultrasound system such as ABUS.
- Abbreviated breast magnetic resonance imaging (MRI), a shortened breast MRI exam. This is the leading recommendation for dense breast supplemental screening. Breast MRI requires IV placement and gadolinium contrast.
- Contrast enhanced mammography (CEM), similar to standard mammogram but uses different technology and IV placement with iodine contrast.
Which supplemental screening is best?
Breast MRI is the leading supplemental screening recommendation for patients with dense breast tissue.
MRI may not be the right screening if you have:
- An implanted device
- Claustrophobia
- Gadolinium allergy
- Size or weight constraints
- Personal preference based on the out-of-pocket cost, insurance coverage concerns, location and more
If any of those apply, the next-best screening would be contrast-enhanced mammography (CEM). However, CEM is not an option if you have:
- Acute renal failure
- An iodine contrast allergy
If neither MRI nor CEM are a fit, an ultrasound would be the best option. The ABUS system would be preferred for most patients, but those with breast implants will need a handheld ultrasound.
Why choose us for dense breast tissue care
We are one of the only health systems in the region that provides specialized care for women with dense breast tissue. Our program helps women who have dense breast tissue understand their risk, what it means to have dense breast tissue and what their screening and follow-up care should look like.
If you think you have dense breast tissue and may benefit from a supplemental ultrasound screening, talk with your physician. Ask if your mammogram indicated you have dense tissue. We offer consultations with our dense breast tissue experts.
We offer a variety of appointment types. Learn more or call 913-588-1227 to schedule now.
Frequently asked questions about dense breast tissue
Breast tissue is comprised of glandular and connective tissue and fat. When the breasts have more glandular and connective tissue than fat, they are defined as dense.
When viewed on a mammogram, dense breasts have more dense breast tissue than fatty tissue. Breasts that are not dense have more areas of gray on a mammogram. Dense breast tissue is white on a mammogram. Most invasive breast cancers are also white on a mammogram, making cancer more difficult to find in patients with dense breast tissue.
Breast density is determined on a mammogram, not by physical exam.
Yes. Women with dense breasts have a higher risk of developing breast cancer compared to women without dense breasts. In very dense breasts, the breast cancer risk can be 4 to 6 times greater than fatty breast tissue.
Breast density is determined on a mammogram. Federal regulations require mammogram facilities to notify patients of their breast density. Look for this information in your mammogram report and result letter.
In addition to an annual screening mammogram, women with dense breast tissue can elect for an additional supplemental screening test such as abbreviated breast MRI, contrast-enhanced mammography or ultrasound. Breast MRI is the leading recommendation, with contrast-enhanced mammogram and ultrasound (handheld or ABUS) as alternatives. Breast MRI and contrast-enhanced mammogram require IV placement for contrast.
Yes, breast density can change over time. Many factors can influence breast density, including age, hormonal changes, weight changes, and some medicines. Breast density often decreases with age but can increase with weight loss, pregnancy, breastfeeding, and hormone replacement therapy.
Yes. Breast density is determined on a mammogram. Federal law requires mammogram facilities to report breast density.
In addition to an annual screening mammogram, women with dense breast tissue can elect for an additional supplemental screening test such as abbreviated breast MRI, contrast-enhanced mammography or ultrasound. Breast MRI is the leading recommendation, with contrast-enhanced mammogram and ultrasound (handheld or ABUS) as alternatives. Breast MRI and contrast-enhanced mammogram require IV placement for contrast.
Not all breast imaging facilities offer supplemental dense breast screening exams. At The University of Kansas Health System, we offer a wide range of screening options for women with dense breast tissue, including automated (ABUS) and handheld breast ultrasound, abbreviated (limited) breast MRI and contrast-enhanced mammography.
If you are 40 or older, you should have a screening mammogram every year. Mammogram screening may start at an earlier age for women at high risk for breast cancer. In addition to a screening mammogram, women with dense breasts should choose one additional screening test. Breast MRI is the leading recommendation with contrast-enhanced mammogram and ultrasound as alternatives.
Yes. Getting your annual mammogram is still important and recommended for women with dense breasts. Mammogram screening has been proven to improve survival from breast cancer.
Weight fluctuation does not typically make cancer more difficult to find. Significant weight loss can result in increased breast density in some patients. Dense breast tissue can make breast cancer more difficult to find on mammogram.
The Women's Cancer Center
The Women’s Cancer Center focuses solely on breast and gynecologic cancers and improving the delivery of cancer care for women.
Learn more