Altered breast density between two mammograms

Mammographic screening detects early breast cancers and thereby reduces potential mortality. However, its sensitivity is inversely related to breast density 1

Altered density between two mammograms can arise in a number of situations:

Affecting both breasts:
  • interval commencement/cessation of hormone replacement therapy: there is increased breast density visible on mammography when patients are on hormone replacement therapy. The changes reverse on cessation of therapy.
  • lactation: in practice ultrasound is the imaging modality of choice during lactation as the patients are young and the increased density of the breast during lactation makes mammographic imaging difficult.  
  • worsening/resolution of congestive cardiac failure
  • worsening/resolution of fluid overload from other causes 
  • substantial weight loss/weight gain: Significant changes in the body mass index have a profound impact on the density of breasts on mammography. 
  • interval precipitation of SVC syndrome
  • idiopathic granulomatous lobular mastitis (IGLM)
  • medications: e.g. Danazol decreases density
  • vitamin D and calcium intake in pre-menopausal women: decreases density
  • increasing age: Involution of the breast implies that the ratio gland: fat decreases thereby decreasing density on mammogram. 
Affecting one breast:
  • radiation therapy: this is an important etiology for increased breast density which is seen only on the irradiated breast. The changes continue even after the radiation has been stopped. 
  • lymphatic blockage
  • malignancy: e.g. invasive lobular carcinoma especially if affecting part of the breast

See also

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Article Information

rID: 14765
System: Breast
Section: Gamuts
Tags: cases, refs
Synonyms or Alternate Spellings:
  • Causes of altered density between two mammograms
  • Different densities between two interval mammograms
  • Change in breast density between two mammograms

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