Breast Density: Higher Risk & New Screening Options

We teach you how breast density is a risk factor for developing cancer and share new tools and technologies to better screen women with dense breasts.

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Questions for your Physicians or Breast Surgeon:

1. Do I have significantly dense breasts on my mammogram?
2. Shouldn’t I have a 3D mammogram?
3. What is my mammogram “BI-RADS density score?”
4. Should I see a breast surgeon to discuss this?

What is mammographic breast density?

Breast density is a term used to describe how much breast tissue is made up of glands and supportive tissue. Dense breasts have more of this “thicker” tissue, which appears white on mammograms. Mammograms in women with very dense breasts can be more challenging to interpret by breast radiologists. Up to 40 percent of women have significantly dense breasts.
Why does breast density matter?

We have learned over time that women with dense breasts have a higher risk of developing breast cancer in their lifetime. Studies have yet to narrow down exactly how much of an increased risk, but the best “calculator” is the BCSC Calculator outlined in detail below.

Dense breasts also make it more difficult for radiologists to see a small breast cancer because these growths can be overshadowed by the dense or white appearing tissue on a mammogram.

So dense breasts pose a “double-whammy” of increased risk and decreased ability to find breast cancers on mammograms. The take-home message for those with dense breasts is to get regular mammograms, and ask for 3D mammograms if they are available to you. This best applies to those who have high BI-RADS Density scores of 3 and 4 (see below).

What is my “BI-RADS” Density Score on my mammogram report?

This scoring system is the radiologist’s estimate of breast density. The BI-RADS scores for low density are 1 and 2. High density are 3 and 4. The images below are examples of low to high density from left to right. The “terms” used to describe density in the figure below correspond to the BI-RADS scores 1 – 4.
LOWER DENSITY terms used on every mammogram report:
BI-RADS 1 or “A” or “Almost Entirely Fatty Tissue”
BI-RADS 2 or “B” or “Scattered Fibroglandular Tissue”

HIGHER DENSITY terms used on every mammogram report:
BI-RADS 3 or “C” or “Heterogeneously Dense”
BI-RADS 4 or “D” or “Extremely Dense”
Should I see a breast surgeon for density?

Seeing a breast surgeon is not generally necessary just for dense breasts. However, if you have multiple other “high risk” factors, or are at risk for carrying the BRCA mutation, ask for a breast surgeon consultation.

Calculate your risk for breast cancer

The new, online Breast Cancer Surveillance Consortium (BCSC) Risk Calculator (link on our website) calculates your 5-year and 10-year risk of developing invasive breast cancer. It is the only “risk calculator” that includes breast density as a risk factor. It is designed for physicians, but you are free to use it also. We suggest you take a printout of “your calculated risk” to your physician to engage them in a discussion about your personal risk for developing breast cancer. Share this calculator with your physician in case they aren’t aware of this new tool.

To calculate your breast cancer risk online you will need a copy of your most recent mammogram report from your physician to complete the questions. Most radiologists will list a “BI-RADS” breast density score (1,2,3, or 4) or a description of the level of density as described above. Enter this “level” into the calculator in addition to the other information that is requested. The Breast Cancer Surveillance Consortium (BCSC) is a group of organizations that work together to advance breast cancer research.

Automated Whole Breast Ultrasound (ABUS)

Whole breast ultrasound was designed to screen women with dense breasts to improve the chance of finding a cancer that might be missed by mammography. It is not a replacement for mammograms. Mammograms are still essential to screen women with dense breasts. This type of ultrasound is designed to be used in addition to annual mammograms. When ABUS is added to mammographic screening, breast cancer detection can be improved by up to 50 percent.

The GE Healthcare Invenia ABUS system is the first FDA-approved device and is becoming more widely available in the community. Click (here) to find a facility near you that offers this ABUS service. More information about breast density and ABUS by GE Healthcare is located (here).

[colleendooley]

Sadly for me even the 3D mammo did not pick up my cancer. My primary Dr even ordered an ultrasound because we were concerned about a growing lump. The Radiologist told his Tech to send me on my way as all was good! The Radiologist denied my ultrasound order, did not even come & talk to me at any point, even when i asked the Tech, "What about the Lump?"
You HAVE to be your own Advocate! That hospital made me feel like i was crazy.
I'm still livid over that debacle.

[dbalexan]

1:18 What is density?
2:48 Screening challenges
4:36 3D Mammograms
5:46 Whole breast ultrasound

[jasminetran]

I have very dense breast and 3D mammogram never detected lumps on my breast. In the past 10 years i found myself 3 lumps on my left breast were benign, and this time i found a lump on right breast and is cancer 😢IDC. I don’t believed in the mammogram anymore. My surgery is tomorrow, i choose lumpectomy.

[littlebluefish]

60 with a BIRADS score of 4. Been doing 3D mammograms for a few years now. It DID NOT catch my breast cancer. Trying to get an ultrasound in conjunction with the mammo takes an act of God with the insurance company. I got my first ultrasound after I found my lump. The cancer surgeon said that had I not found my lump, the 3D mammo would not have picked it up. Keep in mind if you have dense breasts, there is a large margin of error even with 3D mammography.

[berthaescobar]

What A Great And Very Professional Lesson About Breast Tissue Density. Thank So Much Dr. John

[gbaddeley]

👏🏻👏🏻👏🏻👏🏻 ✨ Great explanation! I have very dense breast tissue and the 3D mammogram was able to find a IDC (1cm). Now I’m waiting for the biopsy results. Thank you for this channel!

[patriciabush]

At 75 I still have dense brests. Get a 3D mammogram every year.

[dinastrong]

I have very dense breast I been having breast pain for a week now, my mammogram is not due until October however I do have an appointment with my Gynecologist on Monday I will definitely inform her of this pain, I even examined my breast, and it feels like something is there, I’m a little scare but I know I’m be alright I hope and Pray it’s not anything.

[maplenook]

QT is the best option! Now available in California and worth the trip. No radiation and can see through density.

[Apple-mlrz]

Wow thank you for this detailed video. I just found out I have breast density.

[fangochango]

Tamoxifen (Selective Estrogen Receptor Modulator) has been shown to reduce breast cancer density. Consider talking about it to your physician.

[bonniparker]

I will have to ask about my score (If I recall, they said it was a 3 or 4 - will verify this afternoon at my appointment). I have been told I need an MRI as they cannot see well enough to determine from a mammogram whether or not I have abnormalities. Then yesterday I spoke to a lady representing the (Ciano) oncology place that Baptist runs (Gulf Breeze, Florida). She said that they are planning to do some kind of blood draw to see if I have any genetic markers for cancer.

Well . . . my grandmother had breast cancer, and like the power house she was, she kicked its butt. Lol. I have known that I have high breast density since I was 38. I am now almost 52. I am really concerned at this time. However . . . I am using this situation to praise God, knowing that no matter what happens, He's got me. But I can't lie - this is scary. I did find out that my insurance will put fakies in should I need to have the procedure nobody wants.

My biggest issue is that I keep crying, not knowing. As you saw above, I am very much leaning on God. This is great - but I am human, so even though I know He is always here for me, I still fear my future. If anyone has advice, I would surely love that. Thanks.

[heartbrokenamerican]

I have heterogeneously dense breasts, my doctor has me have a mammogram and breast ultrasound every year. I’m always so nervous at this appointment every year

[linnmacdonald]

I did my 3D for the 2nd year in a row for a side by side comparison, and just had my ultrasound! Waiting for my ultrasound results in a few days.

[hluvv]

Am 46, Just found out both breast is very dense my doctor said it’s nothing to worry about, now the radiologist is making it mandatory for me to have mammogram yearly.I scored 1

[kakisage]

I’m 6o and density level 4. I won’t have mammograms anymore but just MRI

[cherryleneneal]

I just had a mammogram
done thank you for explaining all I needed to know. Now I can make my decision on what to do
I will talk with my Dr @ the letter I received today. DR you were the greatest!! I appreciate you so very much!!! 🙏🙏 are for you
have a blessed day as you would a rainbow 🌈✨day
Be safe..

[heathercenteno]

They said I had dense breast but told me don’t worry about it my aunt passed away of breast cancer

[mangersavoir]

There are ratings of density? How come the doctor didn't tell me?

[FullTimePatient]

Well it said extremely dense breast cancer..but I have a lump i can see and a groove so if it's cancer.. it's there
. Sunday scan will tell me..