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Your Mammogram Report States You Have Dense Breasts. What is next?

Why additional imaging modalities, such as ultrasound and MRI, are used for women with dense breast tissue. 

Dense breasts are common (40 to 50 percent of women ages 40 and over have dense breasts) and normal, but knowing your breast density is vital to your breast health. Most states (including New York State) have laws requiring facilities to notify patients of their breast density at the time of their mammogram.   

Each time you have a mammogram, your report will indicate your density as DENSE or NOT DENSE. Dense tissue on a mammogram can make it more challenging to detect cancer and is an independent risk factor for breast cancer development, putting patients with dense tissue at a higher risk of breast cancer.   

At Elizabeth Wende Breast Care (EWBC), we exclusively use digital breast tomosynthesis — DBT (sometimes called 3-D mammography) for all patients, which is especially beneficial for those with dense breast tissue. However, depending on your breast density and other risk factors for breast cancer, your doctor may recommend additional screening with breast ultrasound or MRI (Magnetic Resonance Imaging). For example, an ultrasound may be recommended for women with dense breasts because even the better mammogram — DBT alone can be less effective at detecting abnormalities in dense breast tissue. A breast MRI may be recommended if the patient has a strong family history of breast cancer or personal history of breast cancer along with dense breast tissue. Dense breasts contain a higher proportion of glandular and fibrous tissue (breast tissue is white, and a cancerous mass may also appear white); thus, detecting small masses or tumors is more challenging on a mammogram.   

Breast ultrasound uses high-frequency sound waves rather than X-rays to produce images of the breast tissue. It gives the radiologist a different imaging method to view breast tissue and is beneficial in its ability to distinguish between solid masses and fluid-filled cysts. Ultrasound is considered a valuable complementary tool to mammography for women with dense breasts.   

MRI is a sensitive, state-of-the-art, noninvasive diagnostic tool often used with mammography and ultrasound. Breast MRI uses a powerful but harmless magnetic field and radio waves to produce detailed images of the breast and its internal structures. Like ultrasound, no radiation is used in MRI imaging. MRI is most frequently used to help physicians evaluate the extent of breast cancer, establish a treatment plan, and monitor a patient’s response to chemotherapy. This advanced technology is also a valuable screening tool for patients at elevated risk for breast cancer, whether due to strong family history, genetic mutation, personal history, or other risk factors. Adding MRI to screening mammography is recommended for patients at very high risk for breast cancer regardless of breast density.   

Additional screening tests might be helpful for patients with dense breasts. If you have questions about breast density or which screening test suits you, your healthcare provider can help. Check with your insurance company for coverage.   


Dense breasts are common and normal, as 40 to 50% of women at age 40 have dense breasts when they have their first mammogram, but knowing your breast density is vital to your breast health. The presence of dense tissue on a mammogram can make it more challenging to detect cancer since dense tissue can mask a potential abnormality and, in addition, is an independent risk factor for the development of breast cancer, making patients with dense tissue at higher risk compared to women with less dense breasts. Additional screening tests might be helpful for patients with dense breasts, such as an MRI or ultrasound. It is important to discuss with your healthcare provider which imaging tests are most appropriate for your specific situation based on your personal risk factors, such as your breast density, age, personal medical history, and family history of breast cancer. 

For more information: 
Ultrasound video
Breast MRI Video 


brest images

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