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Ask an Expert: Dense Breast Tissue

Read time: 3 minutes

Dr. Phoebe Freer stands next to a mammography machine
Dr. Phoebe Freer

On September 28, 2022, Katie Couric announced that she was diagnosed with breast cancer. According to The American Cancer Society, breast cancer is the second-most common cancer for women in the United States. Couric has hosted television programs Today, 60 Minutes, and CBS News, and has used her fame to promote regular cancer screenings. She echoes Huntsman Cancer Institute's recommendation to get a yearly mammogram. But Couric, like many others, has dense breast tissue, which can make cancer harder to detect.

Huntsman Cancer Institute has seen an influx of patients wanting additional information on dense breast tissue. We asked three of our experts, Cindy Matsen, MD, breast surgical oncologist, Phoebe Freer, MD, chief of breast imaging, and Saundra Buys, MD, chief of oncology, to share their expertise.

What is dense breast tissue?

Dense breast tissue is a term that describes the breast’s appearance during a mammogram. Breasts are made of two kinds of tissues: fat and active breast tissue. When patients have dense breasts, they have more active breast tissue.

Fatty tissue appears black or gray on a mammogram, while active tissue is white. Cancer also appears white. This can make finding cancer in dense breast tissue difficult.

A side-by-side of two normal mammograms showing the difference between a dense breast (left) and a fatty breast (right).
A side-by-side of two normal mammograms showing the difference between a dense breast (left) and a fatty breast (right).

If I have lumpy breasts, does that mean I have dense breast tissue?

Breasts are meant to be lumpy. Dense breast tissue cannot be detected a physical exam.

How common is it?

There are four grades of breast density. Around 50% of women have some sort of breast density. However, within that 50%, there is a wide range of severity.

Most women who have dense breasts have heterogeneously dense breast tissue. Around 30 to 40% of women have heterogeneously dense breast tissue.

How do I know if I have dense breast tissue?

Dense breast tissue can only be found through a mammogram. In the state of Utah, providers are required to notify you if you have dense breast tissue. Once notified, you can work with your radiologist to make a screening plan based on your history and risk of developing breast cancer.

Does breast density increase my cancer risk?

Yes, dense breast tissue can increase your cancer risk. Most people with dense breast tissue are 1.2 times more likely to develop breast cancer than average.

Is there a way to prevent or reduce dense breast tissue?

There is no way to prevent dense breasts. Breast density could change with age, hormonal treatments, or menopause, but that isn’t always the case.

Are mammograms effective for people with dense breasts? 

Mammography remains the best test for early detection and diagnosis of breast cancer. People who get mammograms reduce their chance of death from breast cancer by 30%. 3D mammograms, offered at any University of Utah Health screening site, including Huntsman Cancer Insitute's Cancer Screening and Education Bus, are better than a standard 2D mammogram for people with dense breasts.

No matter what your tissue density is, if you feel a mass, talk with your doctor.

Saundra Buys, MD | Phoebe Freer, MD | Cindy Matsen, MD
Saundra Buys, MD, Phoebe Freer, MD, and Cindy Matsen, MD all contributed to this article

Cancer touches all of us.