Whether you have dense breast tissue or not, your insurer may cover a 3D mammogram. It’s worth checking.

Published: May 27, 2019 | Updated: March 10, 2023

Dense breast tissue can make it hard to find cancers on mammograms because dense tissue and cancers both look white on a mammogram. By comparison, fatty tissue looks dark.

In Kentucky, physicians are required to tell women if they have dense breast tissue. Whether a woman needs to consider additional screening options depends on her personal risk for breast cancer.

One option is a 3D mammogram, also called tomosynthesis mammography. A 3D mammogram involves the same breast compression as a traditional 2D mammogram. It just takes a few seconds longer.

THE DIFFERENCE BETWEEN 3D AND 2D MAMMOGRAMS

A traditional mammogram takes pictures from two different angles. A 3D mammogram takes more pictures, from many different angles, resulting in a computer-generated, three-dimensional picture. Radiologists can examine the images layer by layer.

“There have been studies that show 3D mammography increases the cancer detection rate and produces a lower rate of false positives. Studies also show that women of all breast densities benefit from the incorporation of tomosynthesis, though for different reasons,” said Shannon O. Steed, M.D., a radiologist for Norton Healthcare.

A false positive occurs when a possible abnormality is seen, but no cancer is present.

A 2D mammogram finds about two to seven cancers for every 1,000 women screened. 3D mammography detects an additional one or two cancers per 1,000 women screened.

According to Dr. Steed, insurance companies may pay the charges for 3D mammograms, regardless of a woman’s breast density; women should check with their insurer.

Read More: What it means to have dense breasts

3D mammography can help reduce the number of times women need to come back for additional imaging that confirms they don’t have cancer. Since 3D imaging reduces the number of callbacks, that can mean less anxiety for the patient, according to Dr. Steed.

DO YOU HAVE DENSE BREAST TISSUE?

Based on a mammogram, radiologists determine if the breast density falls into one of four groups:

• Almost entirely fatty
• Scattered areas of fibroglandular density
• Heterogeneously dense
• Extremely dense

If you fall into the last two categories, you are considered to have “dense” breast tissue. Two out of five women have dense breast tissue.

If you don’t know if you have dense breast tissue, ask your health care provider for a copy of the report sent from the facility the last time you had a mammogram. When you have a mammogram, you will be informed if you have dense breasts.

Having dense breasts slightly increases your chance of developing breast cancer.

Postmenopausal obesity also increases the risk, and those women typically do not have dense breast tissue on a mammogram, according to Dr. Steed.

Overall, women in the U.S. have a 1 in 8 chance of being diagnosed with breast cancer at some time during their lives.