Dense breasts and mammograms: what comes next?

Getting your yearly mammogram is a great step for your health. But there is one more important thing to check—do you have dense breast tissue? More than 40% of women do, and it can make it harder to spot cancer on a mammogram.

Dense breasts have more glands and tissue and less fat. On a mammogram, dense areas and cancer both appear white, which can hide signs of cancer. Your mammogram report will say if your breasts are "heterogeneously dense" (mostly dense) or "extremely dense" (almost no fat). If you are not sure, ask your doctor or check your report online.

Why this matters: Regular mammograms can miss up to 30–40% of cancers in dense breasts. That is why some women need extra tests like an MRI, breast ultrasound, or a special type of mammogram that uses contrast dye. These tests can help find cancer that a regular mammogram might miss.

Not all doctors automatically suggest these extra tests, and not all insurance plans cover them. Some tests, like MRI, can be expensive, but quicker and cheaper options are becoming available. A 3D mammogram is also better than the standard version and may be covered by insurance.

In the end, the decision to get extra screening depends on your personal risk factors (like family history) and your comfort level. Extra tests can be stressful or costly—but catching cancer early can save your life.

Talk to your doctor and learn your options. The more you know, the better choices you can make.