Heterogeneously Dense or Fatty: Know Your Breast Tissue
Last updated 03/23/2023
The density of your breast has become an important subject these days. Breast density can be a risk factor for breast cancer. Heterogeneously dense or fatty?
To understand this fact will assist with keeping your breasts healthy. Most importantly, this determines which type of mammogram you should have. Likewise, you will be told of any other imaging you require in addition to your examine.
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5 Myths Connected to Breast Cancer
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What Are Dense Breast?
It has zero to do with how the breasts look or feel. But everything about how they show on your mammogram. They contain fat and tissue to provide their shape.
In addition, glands and ducts that produce milk. Fat materializes dark on a mammogram. However, everything else seems white.
The amount of density in your breast is determined by your radiologist. According to what is observed on the X-ray, they assign your breasts to one of four categories.
Are Dense Breast Common?
According to the National Cancer Institute almost half of women aged 40 and older who have mammograms are classified under dense breasts.
Because of your hormones breasts transform as you age. You could have dense breast before having children or preceding menopause. After having children or going through menopause, the breasts tend to be fatty. Certainly, it's essential with these factors to stay up to date with your breast density.
Factors Contributing to Dense Breast
Dense breast tissue has been shown to run in families. Being aware of your family history can guide you with keeping proactive with your health.
Low Body Mass Index
Going through weight loss can increase the amount of dense versus fatty tissue in your breasts. Thou losing weight is good to prevent type II Diabetes and have a healthy heart. However, this is still an area to research along with how the diet affects breast density.
If you are on hormonal therapy, you should be especially diligent having your mammograms. As a result, taking these hormones can cause dense breast tissue to increase or remain the same.
3 Types of Breast Tissue
Your breast tissue contains different mixtures or varieties in the amount of fatty and fibroglandular substance. Breast tissue may either be proclaimed non-dense (more fatty) or dense (less fatty with more fibroglandular tissue).
Fibrous tissue is responsible for keeping other structures in place. In addition, it can also be exclaimed supportive or connective tissue. This common tissue of the body is made of elastic and collagen fibers.
Glandular tissue includes a complex network of formation to carry milk to the nipple. It consists of the breast lobes and breast ducts. Combining fibrous and glandular tissue becomes fibroglandular tissue.
Fatty tissue contains fat cells responsible for providing breast with their size and shape. So, it acts as filler between the fibrous tissue, lobes and ducts.
Heterogeneously Dense or Fatty?
Going for your mammogram is the only way to identify whether you have dense or fatty breast tissue. That is to say you can’t tell your breast density by how they feel their size or firmness. Further, it is only seen on a mammogram.
This carries the importance of having a mammogram to detect which tissue type you are. In addition, if you are at risk for breast cancer. Most importantly, it is recommended if you are of screening age.
The radiologist will check for abnormal areas. Your breast density will also be determined by comparing the fatty tissue to dense tissue. In other words, this describes the images on your mammogram. In conclusion, the Breast Imaging Reporting and Data System (BI-RADS) are utilized.
Breast Imaging Reporting and Data System
Density levels are recorded in mammograms using letters A-D.
A: Almost Entirely Fatty
A: Almost entirely fatty meaning the breast are almost composed with fat. This is usually found in 10% of women.
B: Scattered areas of fibroglandular density meaning some scattered areas are seen. Still, most of the breast tissue is non-dense. Often found in about 40% of women.
C: Heterogeneously Dense
C: Heterogeneously dense meaning there are some areas of non-dense tissue, still most of the breast tissue is dense. Typically, found in about 40% of women.
D: Extremely Dense
D: Extremely dense meaning the breast tissue is nearly all dense. In short, found in about 10% of women.
Breast Density Explanation
The first two categories (A&B) are referred to as low density, non-dense or fatty breast. While women in the second two (C&D) are referred to as high density or dense breasts. About half those 40 and older have dense and this can change over time.
Depending on your area, you can receive a letter notifying you if you have dense breast. In some states in the US, it’s actually a law. The recipient then understands the accuracy of her mammogram is less than those with a lower density.
With some cases, the letter can contain supplemental imaging choices along with the mammogram, as a breast ultrasound or MRI. As a result, delivering more options to receive a better detection for cancer in woman who have dense breast.
If this information is not sent out in your area, ask for a copy of the mammogram report. Querying your doctor what kind of breast tissue you have is also a start. And if you need clarification, consult your healthcare team.
Increase for Breast Cancer
Having dense breast affects your risk for breast cancer in two ways.
Difficulty Finding Cancer
Breast density creates difficulty to observe underlying cancer on your mammogram. Thus, it presents a risk factor for breast cancer. Cancers can be hidden in dense tissue, as well as possible tumors.
Due to difficulty of seeing a tumor or dense breast tissue on a mammogram, a small tumor could be missed. This is because breast density presents as a white area on a mammogram just like cancer. So, dense breast tissue can mask the detection of any cancer.
Meaning those having dense breast are at a higher risk to develop breast cancer compared to those without. The risk goes up with the more density in the breast. Along with raised concerns about what situations, when and how to offer more screening options.
More Screening Options
Experts are not in agreement as to what additional test should be given, if it is done. Breast ultrasound and MRI can help show some breast cancers not being seen on a mammogram according to studies.
However, MRI and ultrasound both can show other findings that are not cancer. This can cause more test and biopsies that wouldn’t be necessary. In addition, insurance may not cover these extra procedures which could raise the cost of healthcare.
Other Imaging for Dense Breast
An annual mammogram screening is recommended if over 40 years of age. This should be covered by your insurance as a preventive medicine screening. In short, having dense breast tissue you should be going for a special imaging of a tomosynthesis (aka 3D mammogram).
Consult your doctor as to your requirement to be screened for breast cancer and what tests are recommended. Depending on your personal risk your doctor could suggest additional test including more screening such as ultrasounds and MRIs.
Breast ultrasound is a machine employing sound waves that make detailed images, named sonograms, of areas inside the breast.
Magnetic Resonance Imaging
Magnetic Resonance imaging (MRI) is a form of body scan operating a magnet connected to a computer. Further, the MRI scan makes detailed images of areas inside the breast.
Considering every woman and situation is different. Likewise, if you have dense breast, you should work closely with your doctor staying up to date with your level of density.
To Diminish Dense Breast
There is currently no evidence that reducing breast density will reduce any risk for breast cancer. However, maintaining overall health is always a good choice.
- Exercise at least 30 minutes each day
- Avoid a sedentary lifestyle
- Eat healthy, plenty of cancer fighting foods are carrots, squash and sweet potatoes
- Don’t take the birth control pill and hormonal replacement therapy
- Drink more green tea
- Decrease saturated fats (such as red meats, butter, ice cream, fatty cheese)
- Reduce sugars and refined carbohydrates
- Limit alcoholic beverages
Do your self-breast exam. Dense breast can sometimes feel lumpy which can make it harder in determining a mass.
Most importantly, it is recommended to do your self-exam in a couple different positions:
- Standing in your shower
- Upright in front of your mirror
- Laying down relaxing
Certainly, any concern such as a discrete mass, a lump or any firmness should be discussed with your doctor.
Wrapping it up
The breasts hold different structures. Some are simply lumpier (fibrous). Above all, this is common but should be watched.
Knowing whether you have dense or fatty tissue determines your mammogram screenings. Diagnosing between dense versus fatty can only be seen on a mammogram. Most importantly, your density could put you at higher risk for breast cancer.
Do your monthly self-breast exams. You should have an intimate relationship with your breast where you could detect any changes. In conclusion, keep up to date with screenings and follow ups.
Do you know which breast tissue category you fall in?
Mary is the founder of All About Our Skin. Former esthetician and CPC. Enjoys researching skincare and has been studying our skin for the past fifteen years.
https://www.breastcancer.org/risk/risk-factors/dense-breasts accessed 09/2022
https://www.cdc.gov/cancer/breast/basic_info/dense-breasts.htm accessed 09/2022
https://www.webmd.com/breast-cancer/dense-breasts accessed 09/2022
https://www.medicalnewstoday.com/articles/323920#summary accessed 09/2022
https://pubmed.ncbi.nlm.nih.gov/26692524/ accessed 09/2022