Breast Cancer

Dr. Kirti Kulkarni, breast radiologist, University of Chicago Medicine, works on the front lines of breast cancer screening, detection, and screening.  

“My typical day starts with reading mammograms. When I interpret a mammogram, number one, I talk about breast density in my report. That’s the first thing that strikes me, and I want the patient to be aware of it,” she said.

Her goal is to find cancer, and she knows that dense breasts pose a challenge.

“It’s hard for me as a radiologist to interpret that exam because the glandular tissue is white and cancer can also be white, and sometimes, it’s hard to differentiate one from the other,” she said.

While she recommends additional breast cancer screening for women with dense breasts, that doesn’t mean patients should skip the mammogram. 

“Mammograms help me understand what your breast density is, it helps me find the location of the cancer, and, if there is any. And it also helps me see those fine calcifications,” she said.

“Breast density is not something that you can palpate or the doctor can palpate and tell the breast density. It is only determined on a mammogram, and it is actually a mathematical calculation,” she stated.

Dr. Kulkarni and her colleagues look at the ratio of glandular tissue to fat in the breast to determine density, measured as A, B, C, or D.

Here are the breast density guidelines:

A: Almost fatty: Breast tissue mainly composed of fatty tissue and less than 25% glandular tissue 

B: Scattered fibroglandular density: Breast contains between 25% and 50% glandular tissue

C: Heterogeneously dense: Breast contains 50% to 75% glandular tissue

D: Extremely dense: Breast contains more than 75% glandular tissue

Once doctors determine a patient’s density, they are able to recommend the appropriate additional screening from a variety of available options such as automated whole breast ultrasound or breast MRI.

Dr. Kulkarni chose the field of breast radiology to make a change in patient’s lives, and when she met Leslie Ferris Yerger, Executive Director, My Density Matters, the doctor did not hesitate to sign on as a medical advisor. “We hit it off right away, and we knew we were both passionate about this field and educating patients. I’m immensely inspired by Leslie and her team for all the efforts they put into this movement,” she said.

In addition to educating the general public about breast density through her work with My Density Matters, Dr. Kulkarni is also dedicated to teaching medical students, residents, and fellows and collaborating with colleagues on patient care, research, and new technology. She values the work underway to make breast cancer detection less expensive and faster via MRI and liquid biopsies.  As for treatment, she predicts progress for patients on multiple levels. “Targeted chemotherapy is getting more effective and comes with less side effects, which means patients are more willing to go along with the protocol,” she explained.

My Density Matters is here to answer your questions and make sure you are informed and empowered to take control of your breast cancer screening. Check Your Chart™ and learn more about reading your mammogram report and sign up for the My Density Matters newsletter to stay up-to-date about the latest recommendations.

Meet other members of the My Density Matters Medical Advisory Board.