Why It Matters If You Have “dense” Breast Tissue
The Food and Drug Administration (FDA) has announced that new regulations require mammographs to notify patients of their breast density . Thirty-eight states (and the District of Columbia) already have some kind of notification requirement, but this will make messaging consistent across the country and deliver those notifications to states where they are not currently required.
What is “dense” breast tissue?
The breast contains fat, glandular tissue and connective tissue. On a mammogram, fat appears as dark areas, while other tissue types tend to appear as white areas.
This is important because tumors and calcifications also appear in white, meaning that a mammogram is easier to read in a person whose breast tissue is less dense. The National Cancer Institute has images of four different categories of breast density. Breasts that are “fat” or have only “scattered” areas of denser tissue appear darker. Breasts that are “inhomogeneously dense” or “extremely dense” have more white areas. If you are told that you have dense breast tissue, you fall into one of these last two categories.
Who has dense breast tissue?
Dense breast tissue is common; The FDA estimates that “nearly half” of women over 40 have dense breasts. You may have firmer breasts if you have used hormone therapy to treat menopause or if you have a lower body mass index.
Older people or those who have had children are less likely to have dense breasts. But your chances of having dense breasts are also probably inherited; some people just have denser tissue than others.
Is it bad to have dense breast tissue?
Thick fabric is fine on its own, but there are two reasons why it’s important to know if you have it or not. First, mammography is less likely to detect early signs of cancer because it is difficult to distinguish normal, dense tissue from tumors or calcifications.
Second, breast cancer appears to be slightly more common in people with dense breasts. We’re not sure why. However, having dense breasts does not seem to increase the chance of dying from breast cancer.
What happens if I am told that I have dense breast tissue?
This is the tricky part. We don’t have enough evidence yet to say whether people with dense breast tissue should have more or different types of screening, or whether they can continue their regular screening schedule and not have additional tests.
Ultimately, it’s up to you and your doctor to decide, experts say. The U.S. Preventive Services Task Force declined to make a recommendation , saying “the available evidence is insufficient” to properly weigh the harms and benefits of breast ultrasound, MRI, or another technology called digital breast tomosynthesis, in people with dense breasts.
The benefits of additional imaging may be earlier detection of cancer, and the disadvantages may be that you will be sent for biopsies or additional procedures that you do not need. Insurance doesn’t always cover extra imaging if you’re doing it because of a tight chest.
Whether or not you decide to have additional screenings will depend on factors such as your risk of developing breast cancer and your personal preferences – some people choose to err on the side of caution, while others may be more determined to avoid unnecessary procedures. Your doctor can help you understand your risk and tell you about the pros and cons of additional screening.