Whether you’re preparing for your first mammogram or are a seasoned expert, there can be some nerves and worry before your appointment. As you get ready, it’s helpful to remember key points, like skipping the deodorant- you’re doing an amazing thing for your health!
There is one term you’ll hear that is incredibly important to fully understand: breast density. Understanding your breast density is key to your breast health, and it’s not talked about enough. Read on to learn how it can impact your health.
What is breast density?
Breasts are mostly made up of fat cells. In between those fat cells are fibroglandular cells. These glandular cells are part of the breasts’ ability to make milk. Some people have more of these cells, and some have fewer. If you have a higher amount of fibroglandular tissue, your breast tissue is more “dense.” Having dense breasts is normal, and is more common in younger women.
Why does it matter?
On a mammogram screening, fat cells in the breast look dark. Cancer cells look white. Unfortunately, dense glandular tissue also looks white. This can make it harder to spot cancer. Some experts compare it to looking for a snowball in a blizzard. People with dense breasts are also more likely to develop certain breast cancers.
If you have dense breasts, it can also make it harder to feel a lump when it’s small. Cancers in dense tissue may also grow more rapidly. Skin changes, nipple changes, nipple leakage or pain may be the first noticeable symptoms of a problem in people with dense breasts.
How do I know if I have dense breasts?
Mammogram screening can determine whether you have dense breasts or not. It is federal law to be told whether you have dense breasts after your mammogram. Usually, 4 categories are used. These are called BI-RADS categories and are labeled A, B, C and D. Categories A and B are not dense, while C and D are dense, with D being the most dense. Your provider or facility should be very clear about whether you have dense breasts or not when you get your mammogram results.
Why do I have dense breasts?
Having dense breasts is normal for many folks. Younger women, those with a lower BMI, and anyone taking combination hormone therapy after menopause are all more likely to have dense breasts. Dense breasts can also be normal for anyone at any age.
There may be racial differences as well: Asian women are more likely to have dense breasts than the general population. Black women are also more likely to have dense breasts.
What can I do if I have dense breasts?
It can be worrisome to know that higher breast density can come with some higher risks, but it is also important to feel empowered: knowing more about your health and your body can help you know what your options are.
While you can’t usually control your breast density, if you do take medication that increases your breast density or have a personal history of breast cancer, there may be medication choices you can make moving forward to reduce your risk. You may also be able to make some lifestyle choices to lower breast cancer risk.
For most folks with dense breasts, start by learning your BI-RADS category and talking with your provider about the best screening options based on your other risks for breast cancer. Additional screening with ultrasound and MRI is available for those with dense breasts and other risk factors. If you aren’t sure if you’re being heard or getting the screening you need with dense breasts, online tools like the Tyrer-Cuzick are very helpful to check out. Ovia is here for you as you learn to advocate for yourself and your health.
Reviewed by the Ovia Health Clinical Team
Sources
- Boyd NF, Guo H, Martin LJ, Sun L, Stone J, Fishell E, Jong RA, Hislop G, Chiarelli A, Minkin S, Yaffe MJ. Mammographic density and the risk and detection of breast cancer. N Engl J Med. 2007 Jan 18;356(3):227-36. doi: 10.1056/NEJMoa062790. PMID: 17229950.
- American Academy of Breast Surgeons, 2019 Position Statement on Screening Mammography https://www.breastsurgeons.org/docs/statements/asbrs-screening-mammography.pdf
- Rosenberg LU, Magnusson C, Lindström E, Wedrén S, Hall P, Dickman PW. Menopausal hormone therapy and other breast cancer risk factors in relation to the risk of different histological subtypes of breast cancer: a case-control study. Breast Cancer Res. 2006;8(1):R11. doi: 10.1186/bcr1378. Epub 2006 Feb 17. PMID: 16507159; PMCID: PMC1413980.
- Nie K, Su MY, Chau MK, Chan S, Nguyen H, Tseng T, Huang Y, McLaren CE, Nalcioglu O, Chen JH. Age- and race-dependence of the fibroglandular breast density analyzed on 3D MRI. Med Phys. 2010 Jun;37(6):2770-6. doi: 10.1118/1.3426317. PMID: 20632587; PMCID: PMC2885945.
