By Dr. Lisa Sheppard
The answer is rather simple and yet complex. The simple first- the “denser” your breasts the harder it is for a Radiologist to “see” a cancer on your mammogram. Density is determined by your mammogram. It cannot be determined by physical exam or any other test.
When you have a mammogram one of the first observations your Radiologist makes is whether the breast tissue is dense. The Doctor will classify the overall pattern as one of four classifications: Fatty, Scattered fibroglandular tissue, heterogeneously dense, or very dense. This is noted in your mammogram report. The heterogeneously dense and dense pattern classifications make up about half of all women younger than 50 and 1/3 of women over fifty. The density of the Breast is one of the strongest predictors of the difficulty of mammography to detect cancer.
This is because cancers typically appear as small white spots on the mammogram. The mammograms in women with fatty breasts show mostly a black background, and white spots associated with small breast cancers can be apparent. In dense breasts, the background is mostly white, which makes it more difficult to detect the small breast cancer, which is mostly white. The challenge of detecting a small cancer in a dense breast has been compared to the difficulty of finding a snowman in a snowstorm.
Thus, to find cancers early, women with dense breasts need an additional annual screening evaluation, such as a breast ultrasound or MRI. Research has found women with very dense breasts also have a 4-5 times greater risk of developing breast cancer compared to women with fatty (non-dense) breasts. Unfortunately, there is nothing you can do to lower the density of your breasts.
All women should ask their Radiologist or Family Doctor for their breast density. It is smart to know your density so you can protect yourself from advanced cancer by requesting a screening Ultrasound or, in some cases, MRI. Your density information will be in your official mammography report sent to your Doctor or in the letter you receive from the PINK Breast Center.
Also now in the state of New Jersey a new paragraph has appeared in the letters the patients receive talking about breast density and your right to have the additional exam. If you have heterogeneously dense or extremely dense breasts, your doctor should send you or you should ask for an additional screening ultrasound test each year in addition to your mammogram.
If your risk is average, you should have a screening Ultrasound and a mammogram every year. Your life is too important. If you are taking the time to be screened for breast cancer make sure you are getting a complete and effective screening. Know your density. Ask your radiologist what your density is.
For more information contact – PINK Breast Center. We have 2 convenient NJ Imaging Centers at
Paterson: 680 Broadway suite 111, 07514 Phone number: 973-977-6662
Flemington: 3 Walter E Foran Blvd, Suite 312, 08822 Phone number: 908-284-2300