Do You Have Dense Breasts?

Roughly 50 percent of all women have dense breast tissue. Are you one of them?
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I was fortunate enough to be able to nurse my daughter for nearly 14 months. As my milk supply went down while weaning her, I noticed a change in my breasts — one that was uncomfortable and made them feel different than before. In a fit of panic, I made an appointment with my local doctor’s office for an examination, after which I was told I had dense breasts. While my nursing discomfort had nothing to do with this discovery, I was glad to know about it.

Since October is devoted to breast cancer awareness, it’s also a good time to discuss the fact that in the case of breast tissue, one size does not fit all. The way in which a professional breast examination is done for a woman who has dense breast tissue varies greatly from how it's done for a woman who has fatty breast tissue.

A Different Approach to Detection

Dense breast tissue is not at all abnormal, according to Wake Radiology, which has locations across the Triangle. Roughly 50 percent of women have either heterogeneously dense or extremely dense breast tissue. If you’ve never given thought to your breast density before, a mammogram reading can help determine it. Radiologists use the Breast Imaging Reporting and Data System, or BI-RADS, to classify breast density into four categories:

  • Breasts are almost entirely fatty.
  • There are scattered areas of fibroglandular density.
  • Breasts are heterogeneously dense, which may obscure small masses.
  • Breasts are extremely dense, which lowers the sensitivity of mammography.

Women who have dense breast tissue fall into the latter two categories. Dense breast tissue is comprised of less fat and more connective tissue, which appears in white masses on a mammogram. Cancerous tumors also appear as white masses; thus, tumors are often hidden or masked by dense breast tissue.

“When a radiologist reviews a screening mammogram, she looks for a developing ‘white’ density,” says Dr. Kerry Chandler, M.D., of Wake Radiology. “Cancerous tissue typically presents white. For women who have dense breasts, their normal background density also appears white on the mammogram. That’s why identifying a developing white density that radiologists typically expect with a developing breast cancer can be more difficult to detect on a dense breast patient. It is like trying to see a polar bear in a snowstorm.”

As a woman ages, her breasts usually become more fatty. However, two-thirds of premenopausal women and one-fourth of postmenopausal women have dense breast tissue, according to Wake Radiology. Additionally, as the density of the breast increases, the risk of breast cancer also increases. This is why mammograms are recommended more frequently to women as they age and experience menopause.

Don’t Fear the Mammogram

If you’ve resisted getting a mammogram due to medical fears or concerns about discomfort, you’re not alone. Women often report that they do not get mammograms because they worry that the procedure will hurt, or are scared of what the results may be. However, mammograms provide the best method for early detection and prevention.

Fortunately, advanced technology, such as mammography with computer-aided detection (CAD), assists with improved and more accurate detection of breast cancer in its earliest stages — when it has the best chance of being cured. In addition to mammography with CAD, a number of other tools exist to help radiologists and doctors find abnormalities within breast tissue, ranging from handheld ultrasound exams to MRI technologies.

If you think you might have dense breasts, a radiologist and doctor can help confirm this by distinguishing fatty verses dense tissue. Make time in your schedule for this important checkup.

Lauren Ramirez of Lexington is a new mom, former teacher and current higher education professional.


Categories: Health