Frequently Asked Questions

Breast Density

Additional Screening

Cancer Risk

Insurance Coverage

Other FAQs

FAQs: Breast Density

What is Breast Density?
Why is it important to understand breast density?

Breast density is significant for two reasons:

Cancer Detection: Dense breast tissue can make it more difficult to detect cancer on a mammogram because both dense tissue and tumors appear white, making it harder to see abnormalities.

Cancer Risk: Women with dense breasts have a higher risk of breast cancer compared to women with less dense breasts.

Understanding breast density is crucial for determining appropriate screening methods and improving early detection of breast cancer.
What are the categories of breast density?
There are four categories of breast density, as classified by the American College of Radiology’s Breast Imaging Reporting and Data System (BI-RADS):

Almost entirely fatty (Category A): The breasts are mostly made up of fatty tissue. This is the least dense category.

Scattered areas of fibroglandular density (Category B): There are some dense areas, but the majority of the breast tissue is non-dense.

Heterogeneously dense(Category C): There are many dense areas, which can obscure small masses.

Extremely dense (Category D): The breasts have a high proportion of dense tissue, which can obscure masses even more.
How does the size and/or feel of my breast relate to my breast density?
Can your breast density change over time? What about menopause?

Breast density can change over time. Some women’s breasts become less dense after menopause. Aging, having kids, and using Tamoxifen can lower density. Postmenopausal hormone replacement therapy and having a low body mass index are associated with higher density.
How do implants relate to breast density?
Is breast density genetic?
My doctors have always told me my breasts are dense but my mammogram report says they are not. Why is this?

It is very common for doctors, especially OB/Gyne’s and Primary Care Physicians, to use the terms “dense” or “fibrocystic” when examining a woman with “lumpy/bumpy” breasts. While this can make (self) examination a little more difficult, it has nothing to do with breast cancer risk or imaging density and is best avoided altogether.

FAQs: Additional Breast Cancer Screening

When do I need additional breast cancer screening?

If you have dense breasts (categories C & D), a mammogram is not enough for you. Learn more about additional screening here, and speak with your doctor about the options available to you. If you are at higher risk for developing breast cancer, your doctor may also recommend additional imaging. Work with your physician to find out what screening plan is right for you.
What if you have been told that you don’t have dense breasts and don’t need further testing?

If you have breast density category A or B, a mammogram will find cancer about 98% of the time. If you have an average risk of developing breast cancer, it is highly likely that a mammogram is enough for you. However, always work with your physician to find what screening plan is right for you.
Is 3D mammography better for people with dense breasts?
How accurate is additional breast cancer screening?

Ultrasound (handheld or automated) has proven to find 1-3 more breast cancers in women with dense breasts. Multiple studies show that advanced imaging techniques such as MRI, CEM (Contrast Enhanced Mammography), and MBI (Molecular Breast imaging) all find 9-15 more cancers than mammography alone.
What additional screening should be requested by a patient who has dense breast tissue but no medical history or perceived risk of breast cancer?

There is no consensus or standard of care beyond mammography for women with dense breasts. Most people must become knowledgeable about their options, and work with their doctor to discuss whether additional screening is necessary. Learn more about additional screening options here.
What is Thermography?

Thermography, also called thermal imaging, uses a special camera to measure the temperature of the skin on the breast’s surface. It is a non-invasive test that involves no radiation. Thermography has not been shown to be effective as a standalone test for breast cancer screening and detecting early-stage breast cancer.

Latermografía se basa en dos ideas:
Dado que las células cancerosas crecen y se multiplican muy rápidamente, el flujo sanguíneo y el metabolismo son mayores en un tumor canceroso.
• As blood flow and metabolism increase, skin temperature goes up.

IMPORTANT: The FDA warns Thermography should NO debe ser utilizada en lugar de la mamografía para detectar, diagnosticar o hacer pruebas de detección del cáncer de mama.

FAQs: Breast Cancer Risk

How do I know my risk of getting breast cancer? What is a breast cancer risk assessment?

A risk assessment consists of a series of questions aimed at determining an individual’s risk of developing breast cancer in her lifetime, and sometimes in the shorter term as well. Results are usually expressed as a percentage chance of developing breast cancer. The ACR (American College of Radiology) recommends the Tyrer-Cusick 8 breast cancer risk model found here.
What should I do if I am under 40 and don’t get mammograms yet?

The ACR (American College of Radiology) now recommends all women take a breast cancer risk assessment at the age of 25, especially Black and Ashkenazi Jewish women. Take the assessment results to discuss with your doctor about creating your personalized screening plan. A result of 20% or more lifetime risk is considered high and can warrant screening starting before the normal age of 40.
I have no family history of breast cancer, should I still be concerned?
How does birth control relate to the development of breast cancer?
What is genetic testing for breast cancer? Should I consider it?

A genetic test for breast cancer risk involves analyzing a person’s DNA to identify specific inherited mutations in genes that are associated with an increased risk of breast cancer. The most well-known genes associated with breast cancer risk are BRCA1 and BRCA2. Mutations in these genes can significantly increase the risk of developing breast and ovarian cancers.

There is no right or wrong answer about whether to get genetic testing. Some considerations include:

Family History: Individuals with a strong family history of breast or ovarian cancer, particularly at a young age, may consider genetic testing.

Personal History: Women who have been diagnosed with breast cancer, especially at a young age or with certain types of breast cancer, may benefit from testing.

Ethnic Background: Some ethnic groups, such as Ashkenazi Jewish women, have a higher prevalence of BRCA mutations and may consider testing even with a less significant family history.

It is against the law to discriminate against those with a genetic cancer risk mutation, but you can be denied life insurance.

FAQs: Insurance Coverage

Is additional breast cancer screening covered by insurance?

Sometimes. It varies by insurance coverage plan and state laws. Approximately 25 states now have a law calling for some level of additional breast cancer screening coverage. Contact your insurance company with billing codes to see if additional screening is covered per your plan in your state. See this guide when speaking to your insurance company about coverage for additional breast cancer screening.
What if my insurance company denies me additional screening?
Why isn’t additional screening automatically covered?

FAQs: Other Breast Related Topics

I’ve been doing monthly self breast examinations, is that enough?
What are ways that we can advocate for ourselves?

Be informed, know your breast density, understand that cancer and dense breast tissue both appear white on a mammogram, and be prepared to have an informed conversation with your physician about getting the additional screening you may need to find your cancer early, while still curable. Download our Bloqueos de carreteras and Why My Density Matters information.
How often should I be getting mammograms?
What are the early symptoms of breast cancer? What signs might l see?

Breast cancer can grow and spread with absolutely NO visible signs at all. However, often there can be signs that everyone should be aware of, as demonstrated by our partners at Know Your Lemons. Learn more.

Image courtesy of Know Your Lemons https://www.knowyourlemons.org/symptoms
Is breast pain anything to worry about?