Key Takeaways

The Food and Drug Administration (FDA) will nowrequiremammography centers to notify patients if their mammograms show that they have dense breast tissue. The new requirement is an update to theMammography Quality Standards Act (MQSA) of 1992, which was put in place to ensure that facilities that do mammograms provide quality care.

Experts say that breast density matters because acancerous tumorin a dense breast may not show up as clearly on mammography as it would in a less dense breast. Research shows that for women with very dense breasts, screening mammograms may miss cancer up to half the time.

Under the updated rule, patients will also need to be told what it means to have dense breasts, including how this can affect the accuracy of their mammograms and their risk of getting breast cancer.

Here’s what experts want you to know about the updated guidelines and what it means if you find out you have dense breasts.

What To Expect During a Mammogram

Why Mammogram Guidelines Are Changing Now

In the United States,38 statesand the District of Columbia have passed legislation that requires mammography centers to inform patients about dense breast tissue and its consequences.

Since some states still have no requirement, there has been growing inequity regarding the information that patients in different stages get about their mammogram findings.

The FDA’s update will make the requirements more uniform and ideally help address some of these inequities.

“Until now, there has been a patchwork of different laws and requirements with 38 states plus DC requiring variable information be provided to women,”Wendie Berg, MD, PhD, a professor of radiology at the University of Pittsburgh School of Medicine, told Verywell.

The new rule means that organizations like the American Cancer Society (ACS), the American College of Radiology (ACR), the Centers for Disease Control and Prevention (CDC), and others “can work off the same script” when they’re talking to patients,Robert Smith, PhD, senior vice president of cancer screening for the ACS, told Verywell.

What Do Normal Breasts Look Like on a Mammogram?

What Your Doctor Will Tell You After a Mammogram

Having dense breasts is not uncommon or necessarily abnormal or “bad”—but it’s only been fairly recently that researchers have started to understand how breast density can complicate breast cancer risk and screening.

“A woman’s breast density category has usually been included in the report that goes to her doctor,” said Berg. “Unfortunately, many health care providers themselves lack a detailed understanding of the risks of dense breasts.”

According to the FDA, about half of women aged 40 and older have dense breasts.

Berg said that with the new guidelines, “all women will be told dense tissue can hide cancer on a mammogram and that it increases the risk of developing breast cancer.”

This information is key to making sure that patients have information about their health so they can make informed decisions about their care. To that end, the new requirement will also make sure that patients with dense breasts understand that they might need other imaging tests to look for cancer.

“All women should discuss their risk factors with their healthcare provider,” said Berg, adding that anMRIis the “gold standard” for finding early breast cancer.

People who have dense breasts and other breast risk factors like a family or personal history of breast cancer or an atypical breast biopsy, should talk with their providers about having a screening MRI or a breastultrasoundon top of their annual screening mammogram.

What Does Breast Density Mean?

According to Smith, breast density cannot be determined with a physical exam of the breasts, and “mammographic density does not correlate well with how solid or firm your breasts are.”

Humanbreastsare made up of glandular tissue, fibrous connective tissue, and fatty tissue. On a mammogram, glandular and connective tissue looks white, and fat shows up as black.

The ACR created four categories of breast density. About 80% of women fall into categories 2 and 3, 10% fall into the least dense category (1), and 10% fall into the densest category (4).

According to the National Cancer Institute, breast densitycan be notedon a patient’s report in the following ways:

What This Means For You

2 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gordon PB.The impact of dense breasts on the stage of breast cancer at diagnosis: A review and options for supplemental screening.Curr Oncol. 2022;29(5):3595-3636. doi:10.3390/curroncol29050291National Cancer Institute.Dense breasts.

2 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gordon PB.The impact of dense breasts on the stage of breast cancer at diagnosis: A review and options for supplemental screening.Curr Oncol. 2022;29(5):3595-3636. doi:10.3390/curroncol29050291National Cancer Institute.Dense breasts.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Gordon PB.The impact of dense breasts on the stage of breast cancer at diagnosis: A review and options for supplemental screening.Curr Oncol. 2022;29(5):3595-3636. doi:10.3390/curroncol29050291National Cancer Institute.Dense breasts.

Gordon PB.The impact of dense breasts on the stage of breast cancer at diagnosis: A review and options for supplemental screening.Curr Oncol. 2022;29(5):3595-3636. doi:10.3390/curroncol29050291

National Cancer Institute.Dense breasts.

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