What is dense breast tissue?

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Dense breast tissue is a mammogram finding, not a disease: breasts are made of glandular and fibrous tissue - which shows white on the mammogram - and fat, which shows dark. Dense means more of the white tissue, and it is common: about half of women over 40 have dense breasts, especially younger women, per NCI. It matters for two reasons. Cancers also show white, so dense tissue can hide tumors on a mammogram - the looking-for-snow-in-a-snowstorm problem. And density itself is a modest independent risk factor for breast cancer.

Why you are hearing about it now: most US states require mammogram reports to notify women of dense tissue, and the notification letter unsettles a lot of people who had never heard the term. What to do with it: keep having mammograms - they still find most cancers in dense breasts - and discuss supplemental screening: ultrasound or MRI finds some cancers mammography misses in dense tissue, with the trade-off of more false alarms. The decision weighs your other risk factors - family history, genetics - rather than density alone.

Density often decreases with age, and it cannot be felt on self-exam - it is purely an imaging finding. A new lump in a dense breast is still a now-not-later symptom, because density is exactly the setting where mammograms miss things.

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