What It Means If You Have Dense Breast Tissue

Mammography is an important tool to screen for breast cancer, but dense breast tissue can hide cancer from view. Dense breast tissue has a larger percentage of fibroglandular tissue relative to fat. It appears white on a mammogram, as do tumors, making it harder to detect abnormalities. However, mammography is still considered an important screening tool, even for women with dense breasts.

If you were notified after your mammogram that you have dense breast tissue, a recommendation for additional screening options to improve the accuracy of your breast health assessment may be suggested.

Lehigh Valley Health Network (LVHN) offers an advanced 3D imaging technology called ABUS (Automated Breast Ultrasound System). The system is a supplemental screening technology approved by the Food and Drug Administration that is specifically designed to aid in the detection of breast cancer in dense breast tissue, according to maker Invenia, a unit of GE Healthcare.

“Our network has long used ultrasound as a diagnostic tool beyond standard X-ray mammography when we see something that’s concerning or we want to problem-solve,” says Priya Sareen, MD, Chief, Section of Mammography, LVHN, with Medical Imaging of Lehigh Valley. “But most imaging was not 3D. ABUS provides large amounts of data that don’t just give us more information about a finding that we’ve already made, but can actually generate the finding.”

ABUS is a specialized imaging technique that uses high-frequency sound waves to create detailed 3D images of the breast tissue. Unlike a traditional ultrasound, which requires a technician to manually capture images, ABUS is automated and scans the entire breast in a consistent manner, reducing variability in results.

While ABUS is an excellent tool for women with dense breasts, it’s important to note that it doesn’t replace mammography. Mammograms remain the gold standard for breast cancer screening, as they can detect microcalcifications, tiny deposits of calcium in the breast tissue that may indicate early signs of cancer, which ABUS cannot always capture.

ABUS is particularly recommended for women who:

• Have dense breast tissue (typically categorized as heterogeneously dense or extremely dense on a mammogram).
• Are at a higher risk for breast cancer due to family history or genetic factors.
• Want a more thorough screening option, especially if mammogram results are unclear or inconclusive.

According to Dr. Sareen, dense breast tissue is an independent risk factor for breast cancer, making ABUS an important diagnostic tool. “Collecting more data in multiplanar images can help us tell whether we’re seeing real cancer or an artifact of a dense breast. It potentially helps us detect breast cancer even earlier, and that’s always the goal when we know that the earlier we detect it, the better the outcomes.”

By combining ABUS with traditional mammography, women with dense breasts can benefit from more comprehensive breast cancer screening, potentially catching cancer earlier and improving outcomes. If you’re unsure about your breast density or what screening methods are best for you, talk to your health care clinician about incorporating ABUS into your breast cancer screening plan. In many cases, it’s used as part of a personalized screening plan based on your individual risk factors and breast density.

While there have been recent changes requiring insurance carriers to provide coverage for supplemental screening including ABUS, it is always best to confirm coverage with your own insurance provider.