Your breasts may not feel different if they are dense. Also, breast density is not related to firmness or size. You can only tell if someone has dense breast tissue on a mammogram.[1]

Breasts are known as dense if you have more fibrous and glandular tissue than fatty tissue as seen on a mammogram.

It’s normal if you have high breast density. Dense breasts are common, especially at a younger age. However, for some women, the density doesn’t reduce with age.

Why is it important for you to know your breast density?

Women with dense breast tissue are more prone to breast cancer.[2]

Breast cancer in women with dense breasts was about 22% more than in women with non-dense breasts as measured by a Norwegian study that examined 3,07,015 digital screening records of over 1,00,000 women.[3]

Starting an annual mammography screening routine at age 30 may benefit the women with dense breasts as found by another large US study of more than 5 million mammograms.[4]

It’s unclear to medical science at this time why dense breasts present more breast cancer risk. Probably because dense breast tissue has more cells that can grow abnormally to become cancer cells.

Dense breasts earlier used to pose another risk with the older technology mammograms by making it harder for doctors to detect cancer hiding underneath dense tissue in some cases. But now the latest 3D mammography machines are designed to provide higher quality images from multiple angles and improve breast cancer detection in dense breast tissue.[5]

How can I find out my breast density?

If you are above 30 years of age and do not know your breast density, you may want to get a mammogram done to find out about it.

If you are already screening yourself every year as a healthy routine for early detection of breast cancer, your mammography report may already have your breast density mentioned.

There are four categories of breast density ranging from almost all fatty tissue to very dense tissue with very little fat. Your radiologist will explain your category with the help of your mammogram report.

If you have never done mammography before, you may visit a mammography center near you and test yourself. You don’t need a doctor’s prescription to get a mammogram done. It’s a quick outpatient imaging test. The latest 3D mammography exam makes the experience much more comfortable and captures high-quality images quickly at much lower dose of radiation than the accepted guidelines.

If I have dense breasts, do I need any other tests in addition to screening mammograms?

No. More tests in addition to mammogram have not proven beneficial for women with dense breast tissue as of now. Although adding breast ultrasound and MRI may sometimes help, they can also highlight more findings that look like but are not cancer. This can lead to more tests, unnecessary biopsies,[6] more anxiety, and more expenses.

Besides dense breasts, if you also have other breast cancer risks such as personal history, family history etc., you may please want to speak to your doctor for specific advice.

What should I do if I have dense breasts?

That’s a very good question. Here are five key recommendations for your consideration.

1. Never miss your annual mammography schedule: No one can prevent breast cancer. Early detection is the best protection. Early diagnosis of breast cancer dramatically improves the chances of complete cure, and disease-free survival with 93% or higher survival rates in the first five years.^[7] Mammography remains the gold standard[8] for early detection of breast cancer- as concluded by a University of California headed expert panel that reviewed 18 different detection systems. Hence do not miss your annual screening mammograms above the age of 30 if you have dense breasts.⁴

2. Do not depend on self-breast-exam: Most medical organizations across the world do not recommend self-breast-examination[9] because it does not help early detection. It takes two to five years of growth[10] for the breast cancer to be felt even by trained hands of a doctor. By then, it is already at least 2 cms in size and has probably spread to the armpit. Whereas mammograms can detect breast cancer very early. Hence whether you have any symptoms or not, yearly mammography is recommended by the Breast Imaging Society of India (BISI)[11], the American College of Radiology (ACR)[12], and several other global authorities.

3. Even if you don’t have a family history of breast cancer, you need screening: Only 5%-10% of breast cancer cases are associated with a family history[13]. The vast majority of breast cancers occur due to unknown causes and factors such as environment, lifestyle, obesity, etc. Hence, even if you have no family history of breast or any other cancer, please do subscribe to an annual mammography schedule.

4. Even if your last year’s mammogram was normal, you need a mammogram this year: Mammograms do not provide immunity against breast cancer. The past mammograms neither predict nor assure that you will be cancer-free in the future. Also, interval cancers, meaning cancers occurring between two consecutive annual screening mammograms, can suddenly emerge. Hence the medical experts recommend prompt annual mammograms so that cancers can be detected when they are very small in size and very much confined to the breast alone.

5. Annual screening mammograms can substantially reduce your stress & medical expenses: Just like car insurance that you buy every year with a small premium to protect yourself against a potentially large expense due to an accident that may never occur; spending a small amount on mammography every year may help you save 30% to over 100% of the treatment costs of breast cancer compared to the women who present with advanced-stage breast cancers[14].

Early detection may also qualify you for less invasive treatment options. For example, in early breast cancers, chemotherapy may be completely avoided thereby saving you the costs incurred and its side effects.

Most importantly, a small yearly investment in screening mammography may save immense stress to your loved ones which is a priceless benefit if you agree.

So, what can you do today?

If you are above 30 years of age, please find your breast density with a mammogram. If you have dense breasts, subscribe to an annual screening plan with 3D mammography today.

If you have neither dense breasts nor other high risks such as personal or family history, begin your annual screening mammography at age 40.

Annual Screening Mammography is a simple ritual that can save your life!

1. https://www.webmd.com/breast-cancer/news/20180626/study-confirms-denser-breasts-are-more-prone-to-cancer accessed on 9 April 2022.
2. Boyd NF, Guo H, Martin LJ, et al. Mammographic Density and the Risk and Detection of Breast Cancer. New England Journal of Medicine. 2007;356(3):227-236. doi:10.1056/nejmoa062790
3. Moshina N, Sebuødegård S, Lee CI, et al. Automated Volumetric Analysis of Mammographic Density in a Screening Setting: Worse Outcomes for Women with Dense Breasts. Radiology. 2018;288(2):343-352. doi:10.1148/radiol.2018172972
4. Lee CS, Ashih H, Sengupta D, Sickles EA, Zuley M, Pisano E. Risk-Based Screening Mammography for Women Aged. Journal of the American College of Radiology. 2020;17(3):368-376. doi:10.1016/j.jacr.2019.08.033
5. https://www.mayoclinic.org/tests-procedures/3d-mammogram/about/pac-20438708 accessed on 9 April 2022
6. https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/mammograms/breast-density-and-your-mammogram-report.html accessed on 9 April 2022
7. https://www.carolmilgardbreastcenter.org/early-detection Accessed on 9 April 2022
8. https://www.webmd.com/breast-cancer/features/mammography-still-gold-standard-for-breast-cancer accessed on 9 April 2022
9. https://www.mayoclinic.org/tests-procedures/breast-exam/about/pac-20393237 accessed on 9 April 2022
10. https://oregon.providence.org/forms-and-information/a/ask-an-expert-breast-cancer-growth-rate/ accessed on 9 April 2022
11. https://www.bisi.co.in/guidelines/mammography/ Accessed on 9 April 2022
12. https://www.acraccreditation.org/Mammography-Saves-Lives/Guidelines Accessed on 9 April 2022
13. Liu L, Hao X, Song Z, Zhi X, Zhang S, Zhang J. Correlation between family history and characteristics of breast cancer. Scientific Reports. 2021;11(1). doi:10.1038/s41598-021-85899-8
14. Feig S. Comparison of costs and benefits of breast cancer screening with mammography, ultrasonography, and MRI. Obstet Gynecol Clin North Am. 2011 Mar;38(1):179-96, ix. doi: 10.1016/j.ogc.2011.02.009. PMID: 21419333. https://pubmed.ncbi.nlm.nih.gov/21419333/