Getting a Clear Diagnosis of Breast Health From a Murky Picture

It's often harder to distinguish healthy breast tissue from possible cancer in women with dense breast tissue, so those women - and the radiologists who read their mammograms - must be particularly vigilant, says a UT Southwestern breast care expert. “Normal dense breast tissue is challenging because malignant tumors may have a similar mammographic appearance,or the dense tissue may hide a malignancy,” says Phil Evans, M.D., Director of the Center for Breast Care and Clinical Professor of Radiology. 

Breast density refers to the amount of fat and tissue in the breast as seen on a mammogram. A dense breast has more tissue than fat. About 40 percent of all women in the U.S. have dense or extremely dense breasts, as classified by the American College of Radiology. Some states, including Texas, require that patients be informed of their breast density during mammography. This information helps women and their doctors discuss screening tests that are best for them.

There are four categories of mammographic density, and the radiologist assigns each mammogram to one of the categories. “Your doctor should be able to tell you whether you have dense breasts based on your mammogram report,” Dr. Evans says. Mammograms aren’t the only tool in the arsenal for detecting breast cancer in women with dense breast tissue, according to Dr. Evans. More breast cancers could be found in women at high risk of developing breast cancer if they were screened with digital mammography and a supplemental screening exam such as tomosynthesis, ultrasound, or MRI (Magnetic Resonance Imaging), he says. All are available at UT Southwestern.

Are You Up To Date?

The American Cancer Society recommends that all women, including those with dense breast tissue, have a clinical breast exam at least every three years starting at age 20 and a mammogram every year starting at age 40.

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