What is Breast Density?

The “Preoperative” work up is where you learn about your patient and is the most important step. During this part of your journey, you will learn what breast density is, how to find out if you have dense breasts and what different imaging modalities are available for screening of breast cancer.

Breast density is a term used by radiologists that compares the amount of breast glandular and connective tissue seen on a mammogram to the area of fat.

Therefore, you can only find out if you have dense breast tissue by getting a mammogram and reading the entire report.

It will list if you have fatty breasts, scattered densities, heterogeneously dense or extremely dense breast tissue.

Breasts are made up of glandular tissue, connective tissue and fat. Glandular tissues consist of milk ducts and lobules. Connective tissue is what holds the breast tissue in place.

  • Glandular and connective tissue appear white on mammography and fatty tissue appears dark on imaging.

  • Why this is of concern is because abnormal findings such as cancer also appear white on mammography.

  • Therefore, the more dense tissue in your breasts the harder it will be to detect cancer on mammography.

  • It is like trying to find a snow ball in a pile of snow. It all blends in!

Example Diagnostic Mammogram

Breast Density Categories

If you have dense breasts…

  • You need imaging in addition to your mammogram to adequately screen your breast for breast cancer.

  • The most common supplemental imaging options for women with dense breast tissue are Whole Breast Automated Breast Ultrasounds (ABUS) or Magnetic Resonance Imaging (MRI).

  • What imaging you may need is determined according to your individual risks assessment for breast cancer development.

  • Talk to your physician about calculating your lifetime risk of breast cancer development via the Tyrer-Cuzick Model Calculator and discuss what supplemental imaging is needed for you.

What are the available breast cancer screening modalities?

  • 2D Mammogram

    CONVENTIONAL DIGITAL MAMMOGRAPHY

    A 2D mammogram is an imaging test that takes two X-rays of the breast-one from the side and one from above.

    Image Example

  • 3D Mammogram

    DBT – DIGITAL BREAST TOMOSYNTHESIS

    A 3D mammogram is an imaging test that combines multiple breast X-rays to create a three-dimensional picture of the breast. multiple images are taken of the breast from different angles.

    Image Example

  • Hand Held Ultrasound

    HAND HELD ULTRASOUND

    An ultrasound is an imaging method that uses sound waves to produce images of structures within your breast. A hand held ultrasound looks at a targeted area.

    A hand held ultrasound is ordered in addition to a mammogram if there is a specific area of concern on the breast.

    Image Example

  • SoftVue

    3D WHOLE BREAST ULTRASOUND TOMOGRAPHY

    SoftVue™ is a new approach for imaging the entire breast utilizing sound and water, which make the solution safe and gentle. Utilizing Triple Acoustic Detection, or TriAD technology, that captures reflection echoes as well as sound speed and attenuation transmission signals, SoftVue improves dense breast screening and detects up to 20% more breast cancers with higher accuracy when combined with mammography.

    Image Example

  • ABUS- Invenia

    AUTOMATIC BREAST ULTRASOUND

    An ABUS- Automated Breast Ultrasound image is of the whole breast that is performed by a machine.

    The Invenia ABUS 2.0 is a comfortable, nonionizing alternative to other supplemental screening options for women with dense breast tissue. When used in addition to mammography, Invenia ABUS 2.0 can improve breast cancer detection.

    Image Example

  • Breast MRI

    MAGNETIC RESONANCE IMAGNIG

    MRI uses a magnetic field and computer-generated radio waves to create detailed images of the organs and tissues in your body.

    A contrast agent is injected into the vein in the arm. MRI is ideally performed from day 7-10 of the menstrual cycle. The exam typically takes 40 minutes.

    A shorter technique called the “Abbreviated” MRI can be performed for screening at some center which uses few imaging and takes about 10 minutes.

    MRI finds an additional 17 in 1000 cancers in conjunction with mammogram.

    Image Example

  • MBI

    Molecular Breast Imaging

    MBI uses a radioactive tracer that “lights up” any areas of cancer inside the breast. This tracer is injected into the body through a vein in the arm. Breast cancer cells tend to take up the radioactive substance much more than normal cells do. A special camera called a nuclear medicine scanner then scans the breast, looking for any areas where the radioactive substance is concentrated.

    Molecular Breast Imaging (MBI), can detect three times as many cancers in women who have dense breast patterns on their mammograms.

    Image example

  • CESM

    CONTRAST ENHANCED SPECTRAL MAMMOGRAPHY

    CESM is an advanced technique that uses iodinated intravenous contrast in combination with standard digital mammogram.

    CESM shows the same cancer detection rate as MRI.

    Image Example
Make It

Comparison of imaging modalities available