Altered breast density between two mammograms

Dr Ayush Goel and Radswiki et al.

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

Article information

rID: 14765
System: Breast
Section: Gamuts
Tag: 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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