Breast Density Resource Guide

In 2015, the IMS Policy Forum adopted Substitute PRS 15-2-08, which directed that IMS would work with other stakeholders, including patient advocacy groups, to promote evidence-based information for patients regarding breast density and cancer risk and the limitations of mammography. This resource page is the result of that work.

Patient Resources

Regardless of breast density, it is important for all women over the age of 40 to talk to their physician about getting an annual mammogram. Mammography remains the single best method for the detection of breast cancer.

Screening Recommendations 

Women ages 40 and older should receive an annual mammogram.

Statement on Dense Breast Tissue

Women with dense breasts have a modestly increased risk of breast cancer and experience reduced sensitivity of mammography to detect breast cancer. However, evidence is lacking to advocate for additional testing until there are clinically validated data that indicate improved screening outcomes. Currently, screening mammography remains the most useful tool for breast cancer detection and has consistently demonstrated a reduction in breast cancer mortality. The American College of Obstetricians and Gynecologists does not recommend routine use of alternative or adjunctive tests to screening mammography in women with dense breasts who are asymptomatic and have no additional risk factors.


The American College of Obstetricians and Gynecologists is a professional association of physicians specializing in obstetrics and gynecology in the United States. It is a 501(c)(3) organization with a membership of approximately 58,000 obstetrician-gynecologists and women's health care professionals. It was founded in 1951. 

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Physician Resources

The American College of Radiology (ACR) recognizes that breast density has an impact on mammographic screening. The ACR’s BI-RADS lexicon describes four categories of breast parenchymal density and instructs radiologists to include this density information in the medical report to the referring physician.

Mayo Clinic

Reference: Mayo Clinic Article: Breast Density and Breast Cancer Risk: A Practical Review, 2014

  1. Discuss the mammographic breast density description on the mammogram report with your patient, if available, and inform her that up to 50% of women have dense breasts (D3 or D4).
  2. Consider sharing details of magnitude of risk of breast cancer associated with dense breasts. Explain that though there is a higher chance of missing a cancer on a mammogram in a woman with dense breasts than in a woman without dense breasts, mammography is still valuable and the test of choice for breast cancer screening for women ages 40 and older.
  3. Encourage her to be breast self-aware and to seek prompt medical attention if she detects a breast change, even if she has had a recent screening mammogram showing no abnormalities.
  4. If she is otherwise at average risk, explain that high breast density alone does not automatically necessitate risk-reducing medications (eg, tamoxifen, raloxifene, and exemestane) or additional imaging.

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