Healthcare professionals know that dense breast tissue makes breast cancer screening more difficult. It also increases the risk of breast cancer (Source: Dense breast tissue: What it means to have dense breasts - Mayo Clinic).
Dense breast tissue refers to the way breast tissue looks on a mammogram. It’s a very common finding. It doesn’t mean there’s something wrong (Source: Dense breast tissue: What it means to have dense breasts - Mayo Clinic).
The breasts are made up of dense breast tissue and fatty breast tissue. Dense breast tissue includes the milk glands, milk ducts and supportive tissue in the breast. Fatty tissue is made of fat cells. A person with dense breast tissue has more dense tissue than fatty tissue (Source: Dense breast tissue: What it means to have dense breasts - Mayo Clinic).
On a mammogram image, the fatty breast tissue is transparent. It’s easy to see through to look for anything concerning. The dense breast tissue looks solid white on the mammogram image. It’s hard to see through. Breast cancer, which also looks solid white on a mammogram, could be missed (Source: Dense breast tissue: What it means to have dense breasts - Mayo Clinic).
The only way to know if you have dense breast tissue is to have a mammogram. A mammogram is an X-ray of the breast tissue (Source: Dense breast tissue: What it means to have dense breasts - Mayo Clinic).
The healthcare professional who looks at your mammogram images decides whether you have dense breast tissue. This health professional is typically a radiologist. Radiologists are doctors with special training to interpret the images from an exam. The radiologist compares the amount of fatty tissue to dense tissue. Then the radiologist decides the level of breast density. Sometimes a computer program figures out the level of density in the images and the radiologist checks to make sure that it’s correct (Source: Dense breast tissue: What it means to have dense breasts - Mayo Clinic).
What are the four categories of breast density?
Levels of density are described using the American College of Radiology’s Breast Imaging Reporting and Data System, which is sometimes shortened to BI-RADS. The levels of density are often included in a mammogram report using letters. The levels of density are:
A: Almost entirely fatty** means that the breasts are almost entirely made up of fatty tissue. There is very little dense breast tissue.
B: Scattered areas of fibroglandular density**means the breasts are mostly made up of fatty tissue. But there are some scattered areas of dense breast tissue.
C: Heterogeneously dense** means that most of the breast tissue is dense breast tissue. But there are some areas of fatty tissue.
D: Extremely dense** means that nearly all of the breast tissue is dense breast tissue. There is very little fatty tissue.
In general, you’re considered to have dense breasts if your mammogram report says you have heterogeneously dense or extremely dense breasts. About half of people having screening mammograms have dense breasts (Source: Dense breast tissue: What it means to have dense breasts - Mayo Clinic).
Dense breast tissue is a common finding. It doesn’t mean there’s something wrong. But having dense breasts can affect you in two ways (Source: Dense breast tissue: What it means to have dense breasts - Mayo Clinic).
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Increases the chance that breast cancer might be missed on a mammogram.** Dense breast tissue is harder to see through on a mammogram image. Having dense breasts may increase the chance that something concerning isn’t detected on a mammogram.
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Increases the risk of breast cancer.** If you have dense breasts, your risk of breast cancer is modestly higher than someone who doesn’t have dense breasts. The level of risk is thought to be similar to the risk of breast cancer in someone who has a relative who had the disease. On its own, having dense breast tissue doesn’t give you a high risk of breast cancer. Also, having dense breasts does not increase the risk of dying of breast cancer.
In general, healthcare professionals recommend that women with an average risk of breast cancer begin screening with mammograms at age 40. For most, the screening should be repeated every year (Source: Dense breast tissue: What it means to have dense breasts - Mayo Clinic).
Having dense breasts can make it harder to detect cancer on a mammogram. But mammograms are still effective for breast cancer screening if you have dense breasts. Mammograms have been proved to reduce the risk of dying of breast cancer (Source: Dense breast tissue: What it means to have dense breasts - Mayo Clinic).
Newer mammogram technology gives healthcare professionals more detailed views of breast tissue. This may help improve the chances that cancer will be detected. For instance, nearly all mammogram machines in the United States make digital pictures instead of film pictures. Digital pictures let health professionals zoom in to take a close look at anything concerning (Source: Dense breast tissue: What it means to have dense breasts - Mayo Clinic).
Additionally, most healthcare facilities in the United States offer 3D mammograms. A 3D mammogram uses computers to combine X-ray pictures of the breast into a 3D image. The 3D images allow healthcare professionals to see past areas of density to look for anything concerning in the breast tissue (Source: Dense breast tissue: What it means to have dense breasts - Mayo Clinic).
Still, because there is an increased risk of breast cancer in dense breasts, you and your healthcare team might consider other tests (Source: Dense breast tissue: What it means to have dense breasts - Mayo Clinic).
Studies have shown that breast ultrasound and possibly magnetic resonance imaging (MRI) can also help find some breast cancers that can’t be seen on mammograms (Source: Dense Breast Tissue | Breast Density and Mammogram Reports | American Cancer Society). The cost of an ultrasound or MRI may not be covered by insurance (Source: Dense Breast Tissue | Breast Density and Mammogram Reports | American Cancer Society).
A Federal bill, the Find It Early Act, introduced by Reps. DeLauro (D), Fitzpatrick (R), and Sens. Klobuchar (D), Marshall (R), would ensure all health insurance plans cover screening and diagnostic breast imaging with no out-of-pockets costs for women with dense breasts or at higher risk for breast cancer. DenseBreast-info.org was invited to participate at the press conference on Capitol Hill. This bipartisan legislation would help address insurance barriers to breast cancer screening and lead to the earlier detection of breast cancer in women with dense breasts or at increased risk (Source: Find It Early Act | DenseBreast-info, Inc.).
These are my draft comments on this policy issue. I will be updating this information as I can.
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