Breasts tend to become less dense as women get older (see Figure below), especially after menopause, as the glandular tissue atrophies and the breast may appear more fatty-replaced. Taking hormones for menopausal symptoms can delay the regression of dense tissue. If a patient loses a lot of weight, her breasts may appear denser due to the relative loss of fat. There is also variability in the visual assessment of breast density so that the density reported in the mammogram might be “scattered” one year and “heterogeneously dense” the next year or vice versa without any true change in breast density. In both situations, there are areas within the breast where there is some dense tissue which could mask cancer detection. In recent years, the use of automated computer-based density assessment can provide reproducible and objective quantification of breast density, avoiding inter- and intraobserver variability .
1. Destounis S, Arieno A, Morgan R, Roberts C, Chan A. Qualitative versus quantitative mammographic breast density assessment: Applications for the US and abroad. Diagnostics (Basel) 2017; 7