Screening options and recommendations for dense breasts

The topic of breast density is gaining attention lately. To date, 29 states have mandated some level of formal communication to inform women not only of their mammogram results, but also their breast density level. In the battle against breast cancer, there is a growing need and demand for patients to be educated about breast density and their potential need for additional imaging.

What is breast density?

Upon completion of your last mammogram, you may have received a letter informing you that you have dense breasts, and you may be wondering – what does this mean? Breasts are made up of fibrous or glandular tissue and are considered dense when the percentage of fatty tissue is low.

Although women with dense breasts may require additional screening, it is not abnormal. The additional concern is merited because studies have shown that dense breast tissue increases a woman’s risk of developing cancer, and may have some bearing on its reoccurrence. Also, because both dense breast tissue and cancerous cells appear white on a mammogram image, the greater the opportunity is for abnormalities to hide behind the dense tissue and go undetected.

What should I do?

If you’ve had a mammogram and been told that you have dense breasts, your doctor may order additional imaging, typically a screening ultrasound. If the result is inconclusive or your risk level warrants it, he or she may order a molecular breast image (MBI).

An ultrasound uses high-frequency sound waves to create an anatomical view of the breast tissue, which shows exactly how the tissue looks. With the help of a thin layer of gel, a transducer is moved across the breast creating the image, which is based on the reflection of the waves against the body. Ultrasound can be performed with or without the assistance of a dedicated radiologist, depending on the method, and there is no ionizing radiation exposure associated with ultrasound imaging. It’s also relatively inexpensive, by comparison, and the procedure takes approximately 15 minutes plus interpretation time.

MBI uses a radioactive tracer to detect cancer inside the breast. Once the tracer is injected, a nuclear camera takes a physiological image, which captures the interaction of tissue surrounding a cancer as opposed to a snapshot of how it looks. Any abnormal cells will attract a higher concentration of the radioactive substance and identify areas of concern. The MBI procedure typically takes approximately 40 minutes plus interpretation time, and is more expensive than an ultrasound. However, unlike the anatomic images produced by mammography or ultrasound, the physiologic imaging of MBI may offer more conclusive diagnostic confidence.

Take action!

Hearing that you have dense breast tissue may be upsetting, but don’t sit back and accept the uncertainty that comes with it. Take action. By communicating with your physician and discussing your individual need for additional testing, you’ll be doing everything possible to ease your mind. Screening for disease is the key to early detection and being an educated, responsible patient who takes your health seriously will help you live a long and healthy life.


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