Do You Have Dense Breasts? You’re Not Alone.

Debra Demeulenaere, Mammography Technologist at Aspen Valley Hospital’s Breast Center, answers your questions on what every woman needs to know about dense breasts.

Deb has been with Aspen Valley Hospital for over 45 years. She has performed mammography for three generations of women, some in the same family.

Are dense breasts common?

Yes, they are. In fact, 40 percent of women have dense breasts. Your breasts are a network of milk ducts, milk glands, fatty tissue and supportive tissue that holds everything together. Supportive tissue is dense and shows up as white on mammograms. Fatty tissue is not dense and shows up as transparent, or black on mammograms. There are four categories of breast tissue: fatty tissue, where most of the tissue is composed of non-dense fat; and three categories of dense tissue, including scattered fibroglandular densities, heterogeneously dense and extremely dense tissues.

Our fellowship-trained breast radiologists determine which category you fall into based on the ratio of dense to non-dense tissue. Your breasts are considered dense if you have a lot of fibrous and glandular tissue and not much fat. Dense breast tissue appears as solid white areas on mammograms, which makes it difficult to see through. Now that you are 40 you should contact your primary provider and schedule your first mammogram.

Are there greater breast health issues in women with dense breasts?

Dense breast tissue is linked with an increased risk of developing breast cancer, four to five times greater than that of women with fatty breast tissue. Experts recommend annual screening mammography for women starting at age 40. Some women with elevated risk may benefit from screening earlier. With elevated risk and breast density, some women may benefit from supplemental screening with screening breast ultrasound and screening MRI, all done at the Hospital.

How does this affect breast self-examination?

Dense breasts can be very difficult to self-examine because the lumpy, fibrous and fatty tissue is all mixed together. That said, you should become very familiar with your breast tissue and perform self-examinations regularly. You may notice something sooner rather than later that can be treated.

Are mammograms effective in detecting cancer in dense breasts?

Every imaging test has a bit of gray area, and dense breast tissue is harder to interpret because it appears white on the mammogram. The more dense your breast tissue, the more difficult to see what is going on. This means an increased likelihood of cancer going undetected. A combination of mammography and ultrasound creates better imaging – more information for our fellowship-trained breast radiologists to interpret and diagnose. The technologies complement one another because they each detect what the other can’t.

What, if anything, do I need to do differently to take care of my breasts?

If you are 40 or over, ask your primary care physician to order a mammogram for you. At the Hospital, breast radiologists read our mammograms. Upon reading your mammogram and evaluating your family history, they may recommend a breast MRI for further evaluation.

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