Breast Density and Your Mammogram Report

Regular mammograms are the best way to find breast cancer early. But if your mammogram report said that you have dense breast tissue, you may be wondering what that means. 

What is dense breast tissue?

Breasts are made up of lobules, ducts, and fatty and fibrous connective tissue.

  • Lobules produce milk and are often called “glandular tissue.”
  • Ducts are the tiny tubes that carry milk from the lobules to the nipple.
  • Fibrous tissue and fat give breasts their size and shape and hold the other tissues in place.

Your breasts will be seen as dense if you have a lot of fibrous or glandular tissue and not much fat in the breasts. Some women have more dense breast tissue than others. For most women, breasts become less dense with age. But in some women, there’s little change. Breast density is very common, and is not abnormal.

illustration showing the structure of the breast including location of the ducts, areola, nipple, collecting ducts, fatty connective tissue and lobules

How do I know if I have dense breasts?

Breast density is seen only on mammograms. Some women think that because their breasts are firm, they are dense. But breast density isn’t based on how your breasts feel. It’s not related to breast size or firmness.

Radiologists are the doctors who “read” x-rays like mammograms. They check your mammogram for abnormal areas, and also look at breast density. There are 4 categories of breast density. They go from almost all fatty tissue to extremely dense tissue with very little fat. The radiologist decides which of the 4 categories best describes how dense your breasts are.

Breast density categories

Breasts are almost all fatty tissue.

There are scattered areas of dense glandular and fibrous tissue.

More of the breast is made of dense glandular and fibrous tissue. This can make it hard to see small tumors in or around the dense tissue.

Breasts are extremely dense, which makes it hard to see tumors in the tissue. 

Some mammogram reports sent to women mention breast density. Your health care provider can also tell you if your mammogram shows that you have “dense breasts.”

Why is breast density important?

Women who have dense breast tissue have a slightly higher risk of breast cancer compared to women with less dense breast tissue. It’s unclear at this time why dense breast tissue is linked to breast cancer risk.

We do know that dense breast tissue makes it harder for radiologists to see cancer. On mammograms, dense breast tissue looks white. Breast masses or tumors also look white, so the dense tissue can hide tumors. In contrast, fatty tissue looks almost black. On a black background it’s easier to see a tumor that looks white. So, mammograms can be less accurate in women with dense breasts.

If I have dense breasts, do I still need a mammogram?

Yes. Most breast cancers can be seen on a mammogram even in women who have dense breast tissue. So, it’s still important to get regular mammograms. Mammograms can help save women’s lives.

Even if you have a normal mammogram report, you should know how your breasts normally look and feel. Anytime there’s a change, you should report it to a health care provider right away.

Should I have any other tests if I have dense breast tissue?

At this time, experts do not agree what other tests, if any, should be done in addition to mammograms in women with dense breasts.

Studies have shown that breast ultrasound and magnetic resonance imaging (MRI) can help find some breast cancers that can’t be seen on mammograms. But MRI and ultrasound both show more findings that are not cancer. This can lead to more tests and unnecessary biopsies. And the cost of ultrasound and MRI may not be covered by insurance.

Talk to your health care provider about whether you should have other tests.

What should I do if I have dense breast tissue?

If your mammogram report says that you have dense breast tissue, talk with your provider about what this means for you. Be sure that your doctor or nurse knows your medical history and whether there’s anything in your history that increases your risk for getting breast cancer.

Any woman who’s already in a high-risk group (based on gene mutations, a strong family history of breast cancer, or other factors) should have an MRI along with her yearly mammogram. For more information on breast cancer risk factors and whether you’re in a higher-risk group for breast cancer, please call your American Cancer Society at 1-800-227-2345.

For cancer information, day-to-day help, and emotional support, visit the American Cancer Society website at www.cancer.org or call us at 1-800-227-2345. We’re here when you need us – 24 hours a day, 7 days a week. 

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Last Medical Review: June 1, 2016 Last Revised: August 18, 2016

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