Dense breasts make it harder to detect cancer on mammograms – NBC Los Angeles

When a woman undergoes a mammogram, the most important finding is whether there are signs of breast cancer.

The next important finding is whether her breasts are dense.

Since early September, new U.S. regulations require mammography centers to notify women about their breast density. This information is not entirely new to some women, as many states already have similar requirements.

Here's what you need to know about why breast density is important.

Are dense breasts a bad thing?

No, condensed milk is not bad. In fact, they are quite common. Approximately 40% of women over 40 have dense breasts.

Women of all shapes and sizes can have dense breasts. It has nothing to do with chest tightness. And that only matters in the world of breast cancer screening, said Dr. Ethan Cohen of MD Anderson Cancer Center in Houston.

With the new rules, “there's going to be a lot of questions for a lot of doctors, a lot of Google searches, and that's fine. But we want to make sure people don't panic.” Cohen said.

How is breast density determined?

Doctors who examine mammograms have a system for classifying breast density.

There are four categories. The least dense category means that the breast is almost entirely fatty tissue. The densest category means that the breast is mostly glandular and fibrous tissue.

Breasts are considered dense in two of four categories: “non-uniformly dense” or “very dense.” The other two categories are considered less dense.

Dr. Brian Donchos of the Seattle-based Fred Hutchinson Cancer Center said mammograms are “somewhat subjective,” so the classification may differ depending on the doctor who reads the mammogram.

Why am I told I have dense breasts?

There are two reasons. For one, dense breasts make it harder to see cancer on X-ray images (mammography).

“Dense tissue looks white on a mammogram, and cancer looks white on a mammogram,” says Wendy Berg, Ph.D., of the University of Pittsburgh School of Medicine and chief scientific advisor for DenseBreast-info.org. “It's like trying to see a snowball in a snowstorm.”

Second, women with dense breast tissue have a slightly higher risk of developing breast cancer. This is because cancer is more likely to start in glandular or fibrous tissue.

What's reassuring is that women with dense breasts are less likely to die from breast cancer than other women.

What should I do?

If you are found to have dense breasts, you should check your family history of breast cancer and undergo additional screening with an ultrasound or MRI, says Dr. Georgia Spear of Endeavor Health/North Shore University Health System in the Chicago area. Please consult your doctor regarding whether this is the case.

Researchers are studying better ways to detect cancer in women with dense breasts. To date, there is insufficient evidence to broadly recommend additional screening. The U.S. Preventive Services Task Force called for more research in this area when it updated its breast cancer screening recommendations earlier this year.

Do I still need a mammogram?

Yes, women with dense breasts should have regular mammograms. This remains the gold standard for early detection of cancer. For average-risk women, transgender men, and nonbinary people, age 40 is the age to start mammograms.

“We don't want to replace mammography,” Spear said. “We would like to add certain other tests to add to that.”

Will my insurance cover additional tests?

For now, it depends on your insurance, but a bill has been introduced in Congress that would make insurance companies pay for additional testing for women with dense breasts.

Additional tests can cost between $250 and $1,000 out-of-pocket, which is a barrier for many women.

“All women should have equal opportunity to find cancer early and easily treat it,” Berg said. “That's the bottom line.”

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