The term refers to two categories of how breast tissue look on mammograms, either “heterogeneously dense” or “extremely dense.” It is critical to know if you have dense breasts because mammography IS NOT as effective a screening tool for breast cancer in you. Guess how many women are affected, not getting optimally screened? Approximately 43% to 46% of women aged 40 and older have dense breasts.
There is an alternative form of breast imaging called molecular breast imaging (MBI) which is extremely effective at screening for cancer in dense breasts. Unfortunately, this alternative IS NOT routinely offered by many primary care doctors, insurance plans, employers, or health systems. It has simply not been disseminated as standard of care yet, despite a robust evidence base. (It has better evidence than breast ultrasound, which is the more commonly offered alternative screening imaging modality, probably because of history and ease of access).
Breast density is not related to weight or breast size. You can have dense breasts whether they are small or large, and at whatever body weight. It can run in families, so you can ask relatives if you’ve never had a mammogram. So if you or someone you know has dense breasts, get help evaluating personal risk for breast cancer and know your options. Here is a list of centers that offer MBMolecular Breast Imaging US Directory
Prevalence of Mammographically Dense Breasts in the United States. Sprague BL, Gangnon RE, Burt V, et al. Journal of the National Cancer Institute. 2014;106(10):dju255. doi:10.1093/jnci/dju255
Trends in Clinical Breast Density Assessment From the Breast Cancer Surveillance Consortium. Sprague BL, Kerlikowske K, Bowles EJA, et al. Journal of the National Cancer Institute. 2019;111(6):629-632. doi:10.1093/jnci/djy210
Hruska CB, Corion C, De Geus-Oei LF, et al. SNMMI Procedure Standard/EANM Practice Guideline for Molecular Breast Imaging with Dedicated y-Cameras. J Nucl Med Technol. 2022; 50 (2) 103-110
Rhodes DJ, Hruska CB, Phillips SW, Whaley DH, O’Connor MK. Dedicated dual-head gamma imaging for breast cancer screening in women with mammographically dense breasts. Radiology 2011; 258:106-118
Rhodes DJ, Hruska CB, Conners AL, et al. JOURNAL CLUB: Molecular breast imaging at reduced radiation dose for supplemental screening in mammographically dense breasts. AJR Am J Roentgenol 2015; 204:241-251
Shermis RB, Wilson KD, Doyle MT, et al. Supplemental breast cancer screening with molecular breast imaging for women with dense breast tissue. AJR Am J Roentgenol 2016:1-8
Hruska CB, Hunt K, Miller P, et al. Molecular Breast Imaging for Women with Dense Breasts: Results Update from the Density MATTERS Trial. Presented at Radiologic Society of North America Annual Meeting, November 27, 2023, Chicago, IL
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Image(s) courtesy of Mayo Clinic
