Breast density is determined through a mammogram: it describes the proportion of "breast tissue" (milk glands, milk ducts and supportive tissue) compared to fat in the breast.
Within an organised screening programme, after a mammography that shows that you have dense breast tissue, should you have tailored screening with an additional test?
The ECIBC's Guidelines Development Group (GDG) suggests:
- having either only digital breast tomosynthesis (DBT) or only digital mammography
- not having additional tests with DBT, automated breast ultrasound (ABUS), hand-held ultrasound (HHUS) or magnetic resonance imaging (MRI).
Who are these recommendations for?
- You are between 45 and 74
- You do not have symptoms of breast cancer
- You recently had a mammogram that did not show breast cancer
- You have dense breast tissue
What would following these recommendations mean for you?
It might be important to speak with your healthcare professional to determine if you have dense breast tissue and what it means for you. You may also wish to discuss whether you have or do not have any symptoms of breast cancer.
To decide whether it is better to have the additional screening or have only a mammogram, you may wish to speak with your healthcare professional about these tests and how you feel about:
- the chances of finding breast cancer or the chance of being called back for further tests which find that you do not have cancer
- the radiation exposure (with additional DBT)
- what happens after you have the results of the tests
- your comfort during the tests
Having additional screening with ABUS, HHUS, DBT or MRI may find slightly more breast cancers than having only a digital mammogram. However, it is unknown whether finding more breast cancers leads to finding more advanced breast cancers or preventing more deaths.
It is also uncertain whether more women who turn out not to have cancer may have to come back for more tests or unnecessary tests.
Having additional tests may also mean more visits to the screening service and would also increase a woman's exposure to radiation in the case of DBT.
There may also be side effects caused by the contrast agent that needs to be given intravenously when having MRI.
The GDG noted that the costs would be higher when additional tests are provided in addition to a mammogram in a screening programme, but this varies according to the country. Special training and equipment may also not be available in some countries and regions.