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Heterogeneously Dense or Fatty: Know Your Breast Tissue


Last updated 09/25/2021

Are you aware whether you have dense breast tissue or not? This also determines what type of mammogram screening you should have. Most importantly it molds a huge difference heterogeneously dense or fatty.

Why all the talk about heterogeneously dense or fatty? Knowing this fact will assist with keeping healthy breast. Likewise you will become aware of any other imaging in addition to your mammogram.

If your breast are dense, work with your provider on a plan. How often should you be examined? Above all identify your risk for breast cancer.

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5 Myths Connected to Breast Cancer

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Breast Anatomy

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). In short breast anatomy includes lobules, ducts, fatty and fibrous connective tissue.


3 Types of Breast Tissue

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Fibrous Tissue

Fibrous tissue is responsible for keeping other structures in place. In addition it can also be exclaimed supportive or connective.

Glandular Tissue

Glandular tissue the part where the breast produces milk (aka lobules) and the tiny tubes carrying milk from lobules to the nipples, named ducts. In short combined; fibrous and glandular tissue referred to as fibroglandular tissue.

Fatty Tissue

Fatty tissue is responsible for providing breast with their size and shape. For instance this tissue fatty acts as filler between the fibrous tissue, lobes and ducts.

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  1. In general, you’re more          likely to have dense breast if you:

    • Are younger
    • Pregnant or breastfeeding
    • Taking hormonal replacement therapy
    • Have lower body       weight
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How Would You Know You have Heterogeneously Dense or Fatty Breast?

Going for your mammogram is the best way to detect if your breast are heterogeneously dense or fatty.  You can’t tell breast density by how the breasts feel, their size or firmness. That is to say it is only seen  on a mammogram.

This carries the importance of having a mammogram for early detection. It doesn’t matter if you have dense breasts or not, it is recommended if you are of screening age. Moreover your radiologist (doctor who reads x-rays) will check for abnormal areas as well as determine the level of your breast density.

There is a comparison from fatty tissue versus dense tissue. Breast density is a measure employed to describe the images on a mammogram. Moreover this is done using the Breast Imaging Reporting and Data System (BI-RADS).

Heterogeneously Dense or Fatty Breast Imaging

Density levels are recorded in mammograms using letters A-D.

A: Almost Entirely Fatty 

Further meaning the breast are almost made up of fat. This is usually found in 10% of women.

B: Non-Dense

Scattered areas of fibroglandular density meaning some scattered areas are seen. Still most of the breast tissue is non-dense. This is usually 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. In conclusion this is found in about 40% of women.

D: Extremely Dense

Furthermore meaning the breast tissue is nearly all dense. This is found in about 10% of women.

What the Image Reporting Means

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 breast. In conclusion half those 40 and older have dense and this can shift over time.

Letter About Dense Breast

Depending on your area, you may 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 may include supplemental imaging options along with the mammogram, as a breast ultrasound or MRI. As a result this delivers more options to receive a better detection for cancer in woman who have dense breast.

For those living in other areas where information about dense breast is not sent out follow up. You can always request  a copy of the mammogram report. Querying your doctor what kind of breast tissue you have is also a start. In addition if you wish clarification, consult your healthcare team.

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Are Dense Breast Common?


According to the National Cancer Institute almost half of women age 40 and older going for mammograms are classified under dense breasts.

Because of our hormones breasts transform as we age. More women have dense breast before having children or before 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 in a woman’s 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.

Hormonal Therapy

If you are on hormonal therapy you should be especially diligent having your mammograms. In other words taking these hormones can result with dense breast tissue either increasing or remaining the same.


Increase for Breast Cancer

Having dense breast affects your risk for breast cancer in two ways:

Breast density can form difficulty in seeing underlying  cancer on your mammogram. Thus breast density presents a risk factor for breast cancer. More importantly 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. Thus raised concerns about  what situations, when and how to offer 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 aid some breast cancers not being seen on a mammogram according to studies.

However, MRI and ultrasound both can show other detections that are not cancer. This can cause more test and biopsies that wouldn’t be necessary. In addition insurance may not pay 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 paid by your insurance as a preventive medicine screening. If you have dense breast you should be going for a special imaging of a tomosynthesis   (aka 3D mammogram).

Consult your doctor as to how often you should to be screened for breast cancer and what tests are recommended. Depending on your personal risk your doctor may suggest additional test including more screening such as ultrasounds and MRIs.

Breast Ultrasound

Breast ultrasound is a machine adopting sound waves that assemble detailed images, named sonograms, of areas inside the breast.

Magnetic Resonance Imaging

Magnetic Resonance imaging (MRI) is a type of body scan utilizing a magnet connected to a computer. Thus MRI also creates detailed images of areas inside the breast.

Considering every woman and situation is different if you have dense breast work closely with your doctor. Most importantly stay 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; carrots, squash and sweet potatoes
    • Avoid taking the birth control pill and hormonal replacement therapy
    • Drink more green tea
    • Decrease saturated fats (such as red meats, butter, ice cream, fatty cheese)
    • Decrease sugars and refined carbohydrates
    • Limit alcoholic beverages

Self-Breast Exam

Do your self-breast exam. Dense breast can sometimes feel lumpy which can form a harder time determining a mass. For example it is recommended to do your self-exam in a couple different positions:


    • Standing in your shower
    • Standing 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).   However 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. Above all your density could put you at higher risk for breast cancer.

Do your monthly self-exams. You should have an intimate relationship with your breast where you could detect any changes. As a result keep up to date with screenings and follow ups.

Do you know which breast tissue you are?



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.

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3 thoughts on “Heterogeneously Dense or Fatty: Know Your Breast Tissue”

  1. The question is: Can losing weight cause you to have heterogeneously dense breast?

    Yes, by losing a significant amount of weight you will change your body mass index, affecting the amount of fat stored in your breast. So losing weight may contribute to heterogeneously dense breast.

    Also take into account, dense breast are usually inherited and your age all play a factor.

    Due to aging our breast change becoming more dense in about 40% of women. It is important to go for your screenings and note your breast changes.

    Thank you visitor for your question.

  2. The question is: Is dense breast tissue the same as fat?

    No. The tissue is either fatty or dense. Dense means the tissue is not as fatty it has more fibroglandular tissue (muscle). The more dense as in extremely dense it has very little fat.

    Thank you for visiting.

  3. The question or statement is: meaning for fatty tissue

    Fatty tissue is not muscle it’s more fat. Non-dense means fatty tissue. Heterogeneously dense has some areas of fatty tissue but most of the breast is dense.

    Density levels are recorded in mammograms using letters A-D.

    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. This is usually found in about 40% of women.

    C: Heterogeneously dense meaning there are some areas of non-dense tissue, still most of the breast tissue is dense. This is found in about 40% of women.

    D: Extremely dense meaning the breast tissue is nearly all dense. This is found in about 10% of women.

    Thank you for visiting.


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