Published: October 14, 2026
Estimated reading time: 7 minutes
If you’ve recently had a mammogram and were told you have dense breasts, you may be wondering what that means — and whether you need a different type of breast cancer screening.
Dense breast tissue is common and normal. But because dense tissue can make breast cancer harder to see on a mammogram, knowing your breast density is an important part of understanding your breast cancer risk and screening options.
Norton Healthcare uses digital breast tomosynthesis (DBT), sometimes called 3D mammography, at all its mammography and breast cancer screening locations. This technology provides radiologists with more detailed breast imaging and can make it easier to see abnormalities, particularly in women with dense breast tissue.
“Dense breasts are very common, and being told you have dense breasts does not mean that something is wrong,” said Shannon Steed, M.D., a diagnostic radiologist with Norton Healthcare. “What it does mean is that we need to be thoughtful about how we screen for breast cancer. DBT allows us to look through the breast tissue in greater detail, which can make it easier to see some abnormalities. Your breast density is one piece of information we consider along with your other risk factors when determining the best screening plan.”
It may be time to begin receiving annual breast cancer screenings. Guidelines depend on your age and other risk factors.
Breasts are made up of fatty tissue, connective tissue and milk glands and ducts. Breast density describes how much fibroglandular tissue — the connective and glandular tissue — appears on a mammogram compared with fatty breast tissue.
Breast density is determined by a radiologist and falls into one of four categories:
The last two categories are considered dense breast tissue.
Having dense breasts is common and is not a disease or abnormal condition. About half of women age 40 and older have dense breast tissue.
You cannot determine whether you have dense breasts based on how your breasts look or feel. Breast density can be determined only by looking at a mammogram.
Dense breast tissue appears white on a mammogram. Unfortunately, many breast cancers also appear white.
That means a cancer sometimes can be harder for a radiologist to see when it is surrounded by dense tissue. Dense breasts are also an independent risk factor for breast cancer, although most women with dense breasts will not develop breast cancer.
Since September 2024, federal regulations have required mammography facilities to tell patients whether their breasts are dense and to include a standardized breast-density assessment in the mammography report.
Being told you have dense breasts does not mean that something is wrong or that you have cancer. It means you and your healthcare provider have another piece of information to consider when determining your breast cancer screening plan.
DBT takes multiple X-ray images of the breast from different angles. A computer combines those images to create a series of thin image slices that a radiologist can examine individually.
A traditional 2D mammogram produces images that can overlap. With DBT, the radiologist can look through the breast tissue layer by layer. This can make small abnormalities easier to see and can reduce the effect of overlapping tissue.
DBT can be particularly useful in women with dense breasts, but it does not eliminate the challenge of dense tissue obscuring cancer.
At Norton Healthcare, DBT is now used at all mammogram and breast cancer screening locations.
The experience is similar to a traditional mammogram. Your breast is compressed in the same way, although obtaining the additional images may take a few seconds longer.
One benefit of DBT is that it can reduce the number of women who need to return for additional imaging after a screening mammogram.
With 2D mammography, overlapping breast tissue sometimes can look like an abnormality even when no cancer is present. The additional views provided by DBT can help radiologists distinguish normal tissue from potential abnormalities.
That can mean fewer callbacks for additional testing — and less of the anxiety that can come with being told that your mammogram needs another look.
DBT, however, cannot eliminate the need for additional imaging. If your mammogram shows an area that needs further evaluation, your care team may recommend additional mammographic views, an ultrasound or another test.
Although DBT can improve cancer detection and reduce callbacks compared with 2D mammography, the improvement is relatively modest in heterogeneously dense breasts and remains limited in extremely dense breasts. Dense tissue still can mask cancers, because the fundamental challenge of overlapping tissue and limited contrast remains.
A callback does not mean you have breast cancer. Most women who are called back for additional imaging do not have cancer.
Sometimes.
Having dense breasts does not automatically mean you need additional screening, but breast density can be one reason to consider supplemental screening in addition to mammography. The decision depends on your breast density, overall breast cancer risk, personal preferences and the potential benefits and limitations of additional imaging.
Supplemental screening is different from high-risk screening. Those at high risk for breast cancer may need screening MRI because of their overall risk, while some women with dense breasts may consider supplemental screening specifically because dense tissue can make cancer harder to detect on a mammogram.
Your provider may consider factors such as:
Depending on your individual risk and breast density, supplemental screening may include breast MRI or ultrasound in addition to mammography. The American College of Radiology (ACR) considers breast MRI an appropriate supplemental screening option for women with extremely dense breasts, including some women at average risk, and considers MRI or ultrasound potentially appropriate for some women with heterogeneously dense breasts.
For women at high risk of breast cancer, screening MRI may be recommended because of their overall risk, regardless of breast density.
Talk with your healthcare provider before scheduling additional screening based solely on breast density. Your provider can help you weigh the potential benefits and limitations of supplemental screening based on your breast density and overall risk.
Screening recommendations vary somewhat among medical organizations.
Norton Healthcare follows ACR and National Comprehensive Cancer Network (NCCN) breast cancer screening guidelines. For women at average risk, ACR recommends annual mammography beginning at age 40.
Women with a higher-than-average risk of breast cancer may need to begin screening earlier or have additional screening, such as breast MRI. ACR recommends that women have a breast cancer risk assessment by age 25 to identify those who may benefit from earlier or additional screening.
Your individual screening plan should be based on your overall breast cancer risk, breast density and other factors. Talk with your healthcare provider about when to begin screening and how often you should be screened.
First, remember that dense breasts are common and normal.
Use the information as an opportunity to have a conversation about your overall breast cancer risk.
If you recently received a mammogram report showing dense breast tissue: