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Breast Density Testing in Rochester, NY

What is Breast Density?

If you have questions about breast density, you are not alone. Breast density is determined by your mammogram. Each time you have a mammogram, your radiologist reviews your breast density for two reasons: dense breasts have a higher chance of developing breast cancer, and it is more difficult to find breast cancer in dense breast tissue compared with fatty tissue.

As of September 10, 2024, an FDA national standard requires that every woman in the United States, regardless of what state she lives in, be told in her mammogram results letter whether her breast tissue is “dense” or “not dense.” This replaced a patchwork of state laws (New York’s among them) with one consistent, nationwide standard. Your detailed report will also include one of four density categories:

A. Almost entirely fatty

B. Scattered areas of fibroglandular density

C. Heterogeneously dense

D. Extremely dense

brest images

You Just Received a 'Dense' Notification. What Does That Mean?

If your mammogram results letter told you that you have dense breast tissue, take a breath — this is common, and it does not mean something is wrong. About half of women over age 40 have dense breasts, and dense tissue is a normal variation, not a diagnosis.

Here’s what it does mean, and what to do next:

  • Dense tissue can make mammograms harder to read. Dense tissue and tumors can both appear white on a mammogram, which can occasionally hide a small cancer.
  • Dense tissue is also linked to a modestly higher risk of developing breast cancer, separate from the detection issue above.
  • You have options for follow-up. Many women with dense breasts benefit from an additional screening test, such as ultrasound or MRI, alongside their regular mammogram. Whether this is right for you depends on your density category, family history, and other personal risk factors.
  • The next step is a conversation, not a decision you have to make alone. Talk with your referring healthcare provider, or reach out to our office, about whether supplemental screening makes sense for you.

If you and your provider decide a screening ultrasound is appropriate, EWBC offers this service at all seven of our locations.

In July 2025, the FDA also approved a minor wording update allowing more precise phrasing for reports involving only one breast; this does not change what the density notification means for patients. The new law requires patients with heterogeneously dense and extremely dense tissue to be informed as they may be candidates for additional screening tools such as ultrasound or MRI (patients with family history and other risk factors may qualify). The denser the tissue, the more difficult it can be for a radiologist to interpret.

All breasts contain a mix of fibroglandular tissue and fat. The more fibroglandular tissue relative to fat, the denser the breast. Dense breasts are common and completely normal — according to current FDA and American College of Radiology figures, about half of women over age 40 have dense breast tissue nationally. Dense breasts are more common before menopause, and density generally decreases with age; your own density can also change from year to year. Among patients seen at EWBC specifically, we see a similar pattern, with dense tissue identified in roughly 43% of women of all ages who come in for a routine mammogram.

If we find you have a dense pattern (Heterogeneously dense OR Extremely dense), your result letter will recommend that you talk to your referring healthcare provider about your breast cancer risk and discuss whether you may benefit from additional testing. If you and your primary care physician wish to have a screening ultrasound because your breast tissue is dense, EWBC can provide that service at any of our seven locations. Patients may be responsible for payment, depending on insurance coverage.

Women with breast density of “heterogeneously dense” or “extremely dense” have been shown to be at increased risk for breast cancer by several studies on breast density published over the last 20 years. The degree of risk is controversial as studies have reported drastically different results. Nevertheless, we believe there is a considerable risk for these women, even without any other risk factors (such as a family history of breast cancer). The risk is based on the masking of breast cancer (the inability to identify an abnormality that may be a malignancy) in dense breast tissue and the inherently higher risk of cancer for women with this type of tissue.

The percentage of women we care for yearly with this type of breast density is approximately 43% of women of all ages who have a routine mammogram. In January 2013, New York State adopted the law of informing patients and their practitioners of breast density. Since 2013, we have seen a trend of women with this type of breast tissue returning for a screening breast ultrasound after notification was given to them by our staff and our radiologists.

In the women that do return, we are discovering mammographically non-visible cancers at three per 1000 women, which is comparable to published studies performed on screening ultrasound in average-risk women. Therefore, we believe screening ultrasound is a reasonable, accessible tool for breast cancer detection in addition to the screening mammogram.

Mammogram Minute: Are You Dense? Who Needs an Ultrasound?