FDA Mandates All Mammogram Reports Address Breast Density

In early September, the U.S. Food and Drug Administration began mandating that all mammogram reports must include a summary of breast density. Patients are now advised whether their breasts consist mostly of fatty tissue, or of fibrous glandular and connective tissue, which depicts density.

The Women’s Center at the Washington Hospital Healthcare System (WHHS) has provided breast density information on its mammogram reports for several years, according to William Dugoni, MD, medical director. The Hospital was at the forefront in recognizing that breast density can obscure a mammogram and make it harder to interpret.

What Does Breast Density Mean?

Breast density refers to the different types of tissue seen on a mammogram. Dense breast tissue has relatively high amounts of glandular tissue and fibrous connective tissue and relatively low amounts of fatty breast tissue, according to the National Cancer Institute at the National Institutes of Health.

Why Is This Important Information?

Having dense breasts puts a person slightly more at risk for breast cancer. It can also be harder to distinguish a cancerous tumor from normal results on a mammogram, and something could be questioned or missed, Dr. Dugoni explained. In these cases, a patient may be called back for further testing to get more information.

Dense breast tissue and abnormal breast changes, such as calcifications and tumors, can both appear as white spots on a mammogram, making it hard to define

suspicious areas. Fatty tissue appears as a darkened area.

“Looking at a mammogram of a woman with dense breasts is like looking through a snowstorm in Boston,” Dr. Dugoni said, making it harder to distinguish between a tumor and normal tissue. In addition, he pointed out that dense breast tissue can be slightly more at risk for developing cancer than a fatty breast.

The team at the Women’s Center is especially skilled in reading mammograms. The center’s radiologists are certified by the American Board of Radiology, and are experts in distinguishing a tumor verses

dense breast tissue. The center uses the most advanced technology, including 3D tomography, which assures the most accurate mammograms. 3D imaging, in use since 2020, is beneficial for dense breasts because it can more easily discern overlapping tissues than a traditional mammogram.

“It’s important to have a center of excellence for women’s health and breast issues,” said Dr. Dugoni, noting that WHHS was the first in Northern California to have such a center. “We have nationally accredited doctors. Women don’t have to travel to get the state-of-theart health care that we provide here.”

“Having this information can empower a person to take charge of their breast health,” he continued. “With knowledge, comes power.” Patients can request a further study, such as an MRI, and put the information in context if they have a family history of breast cancer.

There are four grades of breast density, from least at-risk for cancer to most:

1. Fatty breast tissue

2. Scattered fibroglandular density

3. Heterogeneously

4. Extremely dense

Dr. Dugoni recommended that when a patient receives a grading of 2,3 or 4, they to talk to their doctor and discuss options. “Genetics are what cause fatty or dense breasts,” he noted. As a woman ages, dense tissue can be replaced with fat. He emphasized, “Dense breasts are low on the risk factor list. There are many other risk factors that are much more significant.”

Schedule Your Mammogram

Soon, mammograms will be available six days per week, including Saturday appointments. Once a physician order is received, patients should call 510.818.7410 to schedule this important screening.

For more information on the Women’s Center at Washington Hospital, visit whhs.com/WomensCenter.