Getting smart about being dense can help in early cancer detection

Mammograms are one of the most effective tools in detecting breast cancer. In women with dense or nonfatty tissue, however, detection can be difficult and additional screening may be needed.

One Dallas woman’s personal battle with breast cancer was the inspiration for Henda’s Law – a state law signed into effect June 17 that requires women to be informed about their breast tissue’s density and the limitations of mammography in certain cases. Dr. Roshni Rao, assistant professor of surgery at UT Southwestern Medical Center, was Henda Salmeron’s breast surgeon whose work helped drive passage of the law.

“Breast tissue that has minimal or no fat may appear white, or dense, on a mammogram. This sometimes makes it difficult to identify cancers, which also typically appear as small white spots,” says Dr. Rao.

Radiologists use a grading system to describe the density of breast tissue based on the amount of fat (nondense) and connective (dense) tissue. Research is ongoing as to why some women have denser breast tissue but generally, as women age, their breast tissue becomes more fatty.

“Many factors contribute to a woman’s risk of breast cancer. Having dense breast tissue may be one of them, but your doctor considers other factors when evaluating your risk and tailoring your screening program,” Dr. Rao says.

Those factors may include the age at which you had your first child, family history of cancer or your age at the onset of menstruation, among others.

Starting at age 20, a yearly breast exam by a doctor is recommended. Every woman older than 40 should get screened annually. For women with dense breast tissue, digital mammograms may be better at finding cancer. Other tests – breast magnetic resonance imaging, ultrasound and breast thermography – also may be helpful, but only when added to mammogram results.

Visit to learn more about UT Southwestern’s clinical services in cancer.

October is National Breast Cancer Awareness Month.

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