Feeling a change in breast tissue often raises concerns about a lump. Dense breast tissue is a common characteristic that can sometimes cause confusion. This article clarifies what dense breast tissue is, how it can feel, and addresses common concerns about lumps.
Understanding Dense Breast Tissue
Breast tissue consists of fibrous, glandular, and fatty components. Dense breast tissue means breasts have a higher proportion of fibrous and glandular tissue and less fatty tissue. This is a common finding, affecting about half of women undergoing mammograms.
Breast density is determined only by a mammogram. It cannot be identified by touch during self-examinations or clinical breast exams. This characteristic is a normal variation in breast composition, not an abnormality or disease.
Radiologists classify breast density into four categories using the Breast Imaging Reporting and Data System (BI-RADS). Breasts are considered dense if they fall into the “heterogeneously dense” or “extremely dense” categories.
The Sensation of Density
Dense breast tissue can feel lumpy or uneven when touched. This is because fibrous and glandular tissue is firmer and more irregular than softer fatty tissue. This general lumpiness differs from a solitary, new, or specific lump that might be concerning.
The texture of dense breasts may be described as rope-like or granular. This sensation can also fluctuate with hormonal changes, such as the menstrual cycle. This generalized unevenness is a characteristic of dense tissue and does not represent a cancerous growth. However, this natural texture can make it challenging to differentiate between typical breast architecture and a new, potentially concerning lump.
Implications for Breast Cancer Detection
Dense breast tissue impacts breast cancer detection, especially with mammography. On a mammogram, dense tissue appears white. This is challenging because cancerous masses and tumors also appear white.
This similar appearance can obscure potential tumors, making them harder for radiologists to identify. Mammography may therefore have reduced sensitivity in detecting cancer in individuals with dense breasts. While dense breast tissue is also associated with a slightly increased risk of breast cancer, the primary concern related to density is its effect on mammogram interpretation.
When to Seek Medical Attention
It is important to seek medical attention for any new or concerning breast changes, even if you know you have dense breasts. A healthcare professional should evaluate any new lump, thickening, or area that feels different from the surrounding tissue or the other breast. Changes in breast size or shape, skin dimpling, nipple inversion, or nipple discharge also warrant prompt medical assessment.
Even if a recent mammogram was normal, any new finding should be reported to a doctor. For individuals with dense breasts, additional diagnostic tools may be recommended to supplement mammography. These can include 3D mammography (tomosynthesis), which provides multiple images for a clearer view through dense tissue.
Breast ultrasound is another common tool, using sound waves to differentiate between fluid-filled cysts and solid masses, and it is not affected by breast density. Magnetic Resonance Imaging (MRI) may also be used, particularly for those with a higher risk of breast cancer, as it offers highly detailed images of breast tissue. A healthcare professional can determine the most appropriate diagnostic pathway based on individual risk factors and breast characteristics.