What are Dense Breasts?
Dense breasts are common and can be found in almost half of women over the age of 40. Dense breast tissue is composed of milk glands, milk ducts, supportive tissue (dense breast tissue), and fatty tissue, which can make it harder to detect cancer on a mammogram.
Need a mammogram?
Women over 40 should get their mammogram screening every year. Schedule your annual mammogram today.
Women with dense breasts have a higher risk of breast cancer, making it a “double whammy” that deserves a spotlight and education, said Jennifer Harvey, M.D., chair of Imaging Sciences at the University of Rochester Medical Center and an international expert on early detection of breast cancer.
Her advice: Know your density level.
“Once you know what your risk is, you can decide whether a mammogram alone performs well for you or whether you need additional screening tests,” Harvey said.
What does dense breast tissue look like?
Dense tissue on a mammogram looks like cumulonimbus clouds (storm clouds), and it can be difficult for radiologists to see tumors. On the other hand, lower-risk tissue resembles a blue-sky day with wispy cirrus clouds, and tumors stand out more clearly, Harvey said.
There are four categories:
• Fatty tissue • Scattered tissue • Heterogeneous tissue • Dense tissue
What causes dense breasts?
Breast tissue density is often inherited. It can also be influenced by- weight (thinner women tend to have denser tissue)
- circulating hormones
- age
- whether a woman has had children
How do I know if I have dense breasts?
Breast density will appear in your mammogram results. Women who receive breast cancer screening at UR Medicine can check MyChart for density information."Those with heterogeneous or dense tissue should strongly consider having an ultrasound following a mammogram," Harvey said.
Although additional testing sometimes uncovers suspicious lesions and requires a biopsy — which can be stressful — finding breast cancer early can afford more treatment options and a better outcome, she added.
Additional Imaging for Breast Density
Research and Innovation in Rochester
Today, our research focuses on predicting who will benefit most from additional screening. Studies show that MRIs detect three times as many cancers, but MRIs are costly and time-consuming. Imaging experts are moving toward using contrast dyes during mammography for women with dense breasts when lesions are difficult to see, or in individuals who are at high risk for breast cancer who cannot undergo MRI, Harvey said.
How Contrast-Enhanced Mammography Works
Before the exam, the patient receives an iodine-based contrast injection that helps highlight areas of concern, making tumors easier for radiologists to see. The mammogram images are completed in about 10 minutes.
Currently, doctors use this technique when cancer is difficult to diagnose using standard tests or for women who have pacemakers or are not otherwise eligible for MRIs. It is believed to improve cancer detection and reduce false positives. European research shows that contrast-enhanced mammograms are equal to MRIs for finding cancer.
To advance contrast-enhanced mammography into cancer screening in the U.S., the University of Rochester Medical Center is joining a national clinical trial, known as CMIST (contrast-enhanced mammography imaging screening trial).
Goal of the trial: Discover if this method is better than or equal to 3D mammograms, which are widely used.
Who qualifies? Women with dense breasts and good kidney function (to clear the dye from the body) would qualify for the study, which will last two to three years for most patients.
The University of Rochester is one of 10 prominent institutions taking part in the trial, which is organized by the American College of Radiology.
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