Breast Cancer Screening for Women With Dense Breasts

Today, the American Cancer Society recommends that women at average breast cancer risk can begin annual mammograms as early as age 40. This allows you to detect breast cancer in its earliest stages. If you have dense breast tissue, your health provider may recommend additional screenings each year.

“Mammography continues to be the gold standard for the detection of breast cancer,” said Dr. Evan J. Wolff, a board-certified radiologist at Beaufort Memorial who is fellowship-trained in breast radiology. “However, it doesn’t work equally well in all women, particularly those with dense breast tissue.”

What Does Having Dense Breasts Mean?

Dense breast tissue means there is more fibroglandular tissue (ducts and lobules for milk production) than fatty tissue. Breast density is not something you can feel; it isn’t related to the size of your breasts or your age. Dense breast tissue can only be determined on your mammogram.

After the childbearing years, some women hold on to the fibroglandular tissue while other women do not. Much of this is genetic.

Read More: 5 Questions About Mammograms Answered

Why Does Breast Density Matter?

Like tumors, dense breast tissue appears white on a mammogram. Because dense breast tissue and tumors are the same color, dense tissue can hide tumors during traditional mammograms. Additionally, dense breasts put you at higher risk of developing breast cancer.

To improve care for women with dense breasts, all breasts receive a density score. This score is provided along with your mammogram report. It is so important that the state of South Carolina requires all women who undergo a mammogram to receive a grade. By knowing your breasts’ density, you better understand your personal risk of cancer and can take extra precaution.

Your breast density receives one of the following grades:

• A — Almost entirely fatty (not very dense)
• B — Scattered fibroglandular densities (primarily fat with some scattered areas of dense tissue)
• C — Heterogeneously dense (mostly dense breast tissue with some fatty tissue)
• D — Extremely dense breast tissue

“If you receive a C or D, you have dense breasts. Proper screening and staying in touch with your healthcare provider can help detect breast cancer in its earliest stages,” Dr. Wolff said. “Work with your women’s breast health expert to monitor your breast health and breast cancer risk factors.”

Read More: For Women, Health Care Is Self-Care

Why Get Both a Screening Ultrasound And Mammogram?

For some women, even a 3D mammogram cannot detect disease through dense breast tissue. In these instances, your healthcare provider may recommend a breast ultrasound.

With a traditional breast ultrasound, an imaging services professional moves a small, handheld instrument across your breasts. The device uses sound waves to create images of the interior of your breasts. According to the American Cancer Society, ultrasound helps provide clarity in dense breast tissue. Ultrasound is also helpful when a mammogram uncovers a suspicious area, as ultrasound can differentiate between benign cysts and tumors that may be cancerous.

Beaufort Memorial offers an ultrasound technology that images both breasts at once. Known as automated breast ultrasound (ABUS) screening, this advanced approach captures hundreds of images in a short amount of time. Any areas of concern can then undergo further testing.

Like all breast imaging technology, ABUS protects your physical health, reducing mental stress and the need for unnecessary follow-up care.

These screenings provide a clearer view of the breast, improving breast cancer detection and reducing the number of false positives that lead to unnecessary biopsies.

We recommend women begin annual mammograms at age 40, regardless of breast density. Schedule your mammogram today by calling 843-522-5015. If you have no insurance or a high-deductible plan, you may save money on your screening by purchasing a voucher through MDsave.

Updated: September 2025