Mammograms are the best way to get an early diagnosis for breast cancer. In some cases, however, they may not provide full clarity for those with dense breasts: a category that includes around 43% of women in the U.S. between the ages of 40 and 74.
Fortunately, there are many screening options to partner with traditional mammograms for accurate diagnosis.
Why Do Dense Breasts Affect Mammograms?
All breasts (whether male or female) are made up of multiple different tissues. Dense breasts are different in that they have a larger amount of fibrous and glandular tissue — both of which appear as white on traditional mammograms. The challenge is that cancerous tumors also appear the same way, making it difficult for doctors to recognize the difference between what is benign or cancerous.
Standard X-ray mammograms for patients with dense breasts have a higher chance of missing a small tumor, which decreases the chance of diagnosis and effective treatment. This is why your doctor may recommend multiple screening tactics for an accurate diagnosis.
A 3D mammogram (also called breast tomosynthesis) combines multiple X-rays for a three-dimensional image. This view allows doctors to see beyond breast density, and better discern tissue from tumors.
3D mammograms have been shown to improve invasive breast cancer detection rates by 40%, and can decrease the necessity of “re-takes” by 15%.
While breast MRIs alone are not prescribed for breast cancer screening, this imaging tool can be used in tandem with mammograms to identify small breast lesions that mammograms sometimes miss.
Unlike mammograms, MRIs do not use radiation, making it safer to increase the number of screenings. If you have dense breasts your doctor may recommend a breast MRI along with an annual mammogram.
Breast ultrasounds are rarely used independently to screen for breast cancer, but may provide a second option for those with dense breasts. They are particularly useful to help identify whether an abnormality is benign, as they indicate whether a mass is filled with fluid, or more solid. A fluid mass is, in general, much less likely to be cancerous, but solid masses require further testing (possibly including a biopsy) to confirm the absence of cancerous cells.
More Screening Options on the Horizon
Researchers are also looking into abbreviated breast MRIs, nuclear medicine tests, and other options for breast imaging.
- Abbreviated breast MRIs take fewer pictures than regular breast MRIs and are less time-consuming.
- Nuclear medicine tests involve the injection of a small amount of radioactive material, which adheres to cancer cells. A specific camera can then identify where this material is located in the breast.
- Contrast-enhanced spectral mammography (CESM) is also currently being researched for effectiveness. CESM combines the contrast used in MRIs with traditional mammogram techniques. It’s possible this test may provide an even clearer and more accurate picture of breast tissue.
While these up-and-coming screening options are not currently confirmed to increase cancer detection, they may become an option for those with dense breasts in years to come.
At Heartland Imaging, we are specialists in breast cancer screenings. We will provide you with a comfortable, informative, and accurate screening experience so that you can be confident in your health. If you have dense breasts and are curious about your best screening options, request an appointment with us online, or call us at (502) 429-6500.