How dense are your breasts? What you need to know...

Why I'm pleased about this week's news and what every woman needs to know….

May 26, 2025

two white frosted cupcakes with cherry toppings — Photo by Annie Spratt on Unsplash

How dense are your breasts? It's not a question that tends to crop up in general conversation and it’s not something you’re likely to have pondered.

However, it’s a subject that has been making the UK news this week….

It was after I'd had my second child in 2009 that I discovered I was the owner of 'dense' breasts.

A lump had formed in my left boob a few weeks after my son was born and I was swiftly referred for an ultrasound. After a week of spiralling catastrophising in which I convinced myself I was going to leave my newborn baby and his sister motherless, the ultrasound showed that the scary lump was in fact nothing more than an abscess that would need to be drained using a delightful syringe. It was then that the radiologist who had been looking over various scans informed me I had ‘dense’ breasts.

I didn't think much more about the ‘dense’ information at the time. I was high on relief, low on sleep and preoccupied with the ceaseless demands of feeding my four-week-old who couldn’t have cared less about the density of his mum’s boobs so long as they continued to squirt out a regular supply of food.

Fast forward to 2023 and having hit my 50s I was invited for a routine mammogram at my local breast clinic.

“Would I like to participate in a trial that Kings College Hospital was conducting in which I would be offered a 3D mammogram rather than the traditional 2D mammogram.”

Yes, why not. Sounds good to me.

I scribbled my consent and entered the room to have my boobs squeezed into the vice-like equipment by a smiley radiographer.

A couple of weeks later I got the news that the 3D scan had shown signs of breast cancer. However as I was about to discover this wasn’t the full picture. It was the tip of the iceberg or more literally, the tip of the tit tumour.

That 3D mammogram had initially shown a small area of concern and when I was called back for further tests the ultrasound and biopsy that followed confirmed the presence of a 16mm tumour. I was told I would be looking at a lumpectomy to remove it.

However, and much more crucially, I was also told I would need a further scan, this time an MRI, (the one where you lie motionless inside a long tube), to establish the extent of the tumour. It was explained to me that mammograms and ultrasounds could only pick up so much particularly with the dense breast situation and the type of cancer I had: lobular.

I was warned the tumour may be bigger.

And bigger it most definitely was.

MRI scan to detect breast cancer size — Photo by Accuray on Unsplash

A few days later I was back at the breast clinic where a surgeon informed me that the MRI had shown the tumour was 98 mm. A considerable leap from a marble-like 16mm.

I remember the way in which I slumped as I took in these new dimensions and lent into the wall, the side of my head resting on a pillar for support as the surgeon explained a lumpectomy was no longer an option and that I was now on the pathway for a mastectomy, nipple removal radiotherapy and possibly chemotherapy.

A couple of days later and with the tumour-size pulsating in my mind I was about to eat a satsuma when I noticed a tape measure I’d got out for some rug-purchasing mission lying on the table.

white and black ruler on brown surface — Photo by Markus Winkler on Unsplash

I felt my throat constrict as I gingerly got out the tape measure and realised my tumour was the same size as that (large) satsuma. How was it possible not to feel any kind of lump when it seemed to be taking up a considerable portion of my C-cup boob? How was it that the tumour size had barely registered on a mammogram?

It was days later that I learnt my type of cancer is strand-like rather than cluster-like (or large-satsuma-like).

I also learnt invasive lobular breast cancer (ILC) can be harder to detect than other types of breast cancer due to its unique growth pattern. The cells often grow in lines rather than forming a distinct lump, which can not only make it difficult to see on mammograms, it also means you often won’t feel a lump.

What became clear from the numerous hospital appointments that followed with specialists was that ‘dense’ breasts make excellent hiding places for cancer .**

It seemed to boil down to this: Dense breast + lobular = extra hard to detect.

Which is why I was pleased to read the news this week that there have been calls for the NHS to give women with dense breasts extra scans.

A recent study led by Cambridge University of over 9,000 women found that using different scans from traditional mammograms could treble the number of cancers detected in women with dense breasts.

The news report stated that around one in 10 women have dense breasts and a higher risk of developing breast cancer.

So how do you know if you have dense breasts?

Unfortunately it’s not just a case of self-examination or giving them a good squeeze to find out. The only way you will know if your breast density is low, moderate or high is to have a mammogram in the first place.

So my advice for anyone is go to your mammograms when invited. And even more importantly, don’t always expect to feel a lump as a warning sign of anything suspicious. I didn’t.

No lump DOES NOT necessarily mean no cancer.

I am really pleased it’s been recognised there needs to be more scans for women with dense breasts.

Now it’s the small matter of actually making those scans happen.

What makes breasts ‘dense’? And why is cancer harder to spot on mammograms?

** I found this helpful link that explains what exactly makes ‘dense breasts’ and why it is harder to see on mammograms.

It says: “The breasts are made up of dense breast tissue and fatty breast tissue. Dense breast tissue includes the milk glands, milk ducts and supportive tissue in the breast. Fatty tissue is made of fat cells. A person with dense breast tissue has more dense tissue than fatty tissue.”

“On a mammogram image, the fatty breast tissue is transparent. It's easy to see through to look for anything concerning. However, the dense breast tissue looks solid white on the mammogram image. It's hard to see through. Breast cancer, which also looks solid white on a mammogram, could be missed.”

female doctor standing near woman patient doing breast cancer screening — Photo by National Cancer Institute on Unsplash

Moving forward: worth knowing

If you have been diagnosed with lobular breast cancer do check this link provided by Lobular Breast Cancer UK - it explains how you have good grounds to request an annual MRI scan (rather than a mammogram) for the exact reasons explained in this post and it provides a template letter you can send to the hospital treating you. I did this and following a recent meeting with a consultant it was decided I would have an MRI scan for extra screening even though a recent mammogram came back clear.

I got the results the MRI this week. All clear. I’ve had fun this weekend letting off steam with lots of dancing at The WideAwake music festival in South East London’s Brockwell Park although as anyone who’s had breast cancer knows, it’s a long and winding journey. Scans (and daily Tamoxifen meds) will be part of my life for at least the next four years.

https://lobularbreastcancer.org.uk/monitoring/

Are you someone going through annual monitoring following your breast cancer diagnosis? And how are you finding the annual mammograms? If you had a lobular diagnosis have you requested to have MRIs instead? I would love to hear from you.

T WITH TESS by Tess Lamacraft

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