If a mammography report indicates the patient has heterogeneously dense or extremely dense tissue but is otherwise categorized as “negative” or “benign” what should be considered next?

Dense breasts are “normal.” In fact, 40% of women over age 40 have dense breasts. But dense breast tissue can hide cancer on a mammogram and can reduce the effectiveness of mammography screening. So a “normal,” “negative,” or “benign” mammogram result does not reliably exclude cancer in women with dense breasts. This is why, sometimes, a woman with dense breasts may have cancer detected soon after a “normal,” “negative,” or “benign” mammogram. This is known as an “interval cancer.” To find cancer in a woman with dense breasts, additional screening should be considered. See flow chart: Who Needs More Screening? (or, in Europe, European Screening Decision Support Tool).