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Breast density, measured by mammogram, is important in assessing cancer risk and detecting tumors. Radiologists assign a score of one to four, with four being the highest density. Genetics, ethnicity, and life stage affect density. Women with dense breasts may need additional mammography procedures and increased cancer screening.
Breast density is a measure of how much tissue is in the breast, as opposed to fat. A radiologist can use a mammogram of the breast to determine density. This information may be important in assessing cancer risk, as there is an association between density and breast cancer, and it is also more difficult to detect tumors on mammograms of women with dense breasts. Patients who are unsure of their breast density can ask if it has been recorded in their files and can also ask to see copies of their mammogram results and have them explained.
On an X-ray, fat shows up mostly black, highlighting structures within the breast, including clots of dense tissue that can be warning signs of breast cancer. In contrast, normal tissue is predominantly white. It can hide small specks that indicate developing breast cancers and can make it more difficult to gauge the size and precise location of a cancer when it can be identified. Digital mammography, which uses computer programs to isolate particular areas of interest, can increase the chances of finding cancer or precancerous tissue in the breast.
Radiologists can assign the patient a breast density score between one and four. A four is extremely dense, the highest score, where 75% or more of the mammogram includes dense tissue. Patients with a score of three have heterogeneous dense tissue. It’s harder to spot anomalies, but they’re not necessarily made invisible. A score of two indicates that a patient has sparse fibroglandular densities, some dense material on the mammogram, but not enough to obscure it significantly. A score of one says that the breasts are made up almost entirely of fat.
Genetics and ethnicity tend to play a role in breast density. Some women have a higher genetic likelihood of having dense tissue than others. Life stage is also important. Women’s breasts become less dense after childbirth and menopause, while young women who have not had children may have greater density.
The connection between breast density and mammography results is important, as very dense breasts can be more difficult to evaluate, especially if the woman has large breasts. Your doctor may need to take a few extra pictures to get full views of the inside of your breast or may recommend more advanced mammography procedures to reduce your chances of missing something important. Women with dense breasts may also be advised to pay special attention to cancer screening due to their increased risk of breast cancer.
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