Breast Cancer Awareness Month: Dense Breasts, 3D Mammograms, and When to Add Ultrasound
Last updated on September 30, 2025
October is Breast Cancer Awareness Month, a reminder for women in Montgomery County to take proactive steps for their health. For many, that means scheduling an annual mammogram. But if you’ve ever received a letter saying you have “dense breasts,” you may be unsure what it means or whether you need additional imaging.
As a primary care physician and menopause specialist in Horsham, I help women navigate these questions every day. From understanding breast density to choosing the right type of imaging, my goal is to make screening more personalized, more effective, and less stressful.
This guide will help you understand what dense breast tissue means, how 3D mammography has become the current standard of care, and when ultrasound or MRI may be appropriate for a more complete picture of your breast health.
What Does It Mean to Have Dense Breasts?
Breast density describes the amount of fibrous and glandular tissue compared to fatty tissue in your breasts. Dense tissue appears white on a mammogram, the same color as many early cancers, which can make it more challenging for radiologists to detect subtle findings.
Nearly half of women over 40 have dense breasts. In Pennsylvania, you’ll receive a letter after your mammogram letting you know if your tissue is dense. While this letter can sound alarming, dense breast tissue is not unusual or abnormal. It simply means you and your physician may need to use additional imaging to ensure the most accurate results.
2D vs. 3D Mammography: Why 3D Is the New Standard
Traditional 2D mammograms have long been the foundation of breast cancer screening. They take two flat images of the breast, but because breast tissue can overlap, small cancers may be hidden.
Today, 3D mammography (also known as tomosynthesis) has become the current standard of care for breast cancer screening. This advanced technology takes multiple low-dose images from different angles, creating a detailed, layered view of the breast. It allows radiologists to examine tissue one thin “slice” at a time, reducing the problem of overlapping tissue.
Research consistently shows that 3D mammography:
Detects more cancers at earlier stages
Reduces unnecessary callbacks for false positives
Improves accuracy, especially in women with dense breasts
For women in Montgomery County, I strongly recommend requesting a 3D mammogram whenever possible. It’s the most advanced and reliable foundational screening tool available today.
When to Add Ultrasound or MRI
Even with 3D mammography as the foundation of screening, some women benefit from additional imaging. The right combination depends on your risk factors, breast density, and personal health history.
Ultrasound is often recommended when breast density makes mammogram results less clear. It utilizes sound waves to differentiate between fluid-filled cysts and solid masses, serving as a valuable complement to mammography.
MRI provides highly detailed imaging and is typically reserved for women at higher risk—such as those with a strong family history, prior abnormal findings, or genetic predisposition.
At Premier Medicine and Wellness, I utilize a Breast Cancer Risk Assessment to help determine the best approach for you. This assessment takes into account your breast density, family history, and overall health profile to guide whether ultrasound or MRI should be added.
Addressing Common Concerns
Fear of False Positives
Getting called back after a mammogram can cause understandable anxiety. However, it’s important to know that most callbacks are precautionary and do not indicate cancer. 3D mammography significantly reduces the likelihood of false positives, meaning fewer repeat tests and less worry.
Scheduling and Result Delays
Another concern I hear from patients is the time it takes to schedule imaging or get results. At Premier Medicine and Wellness, I coordinate concierge imaging orders with trusted local partners for 3D mammography in Montgomery County. Results are reviewed promptly, often within the same week, so you’re not left waiting and wondering.
Preparing for Your Screening
A little preparation goes a long way in making your mammogram efficient and informative. Before your appointment, bring:
Prior mammogram and imaging records, especially if done elsewhere
Details about your family history of breast or ovarian cancer
Any previous biopsy or pathology reports
A list of your current medications and supplements
Questions you want to discuss about your breast health
Having this information helps create a clear, personalized plan and ensures that your imaging results can be compared accurately over time.
How Premier Medicine and Wellness Supports Your Breast Health
At Premier Medicine and Wellness, our breast cancer screening is tailored to you. As part of the Ms.Medicine network, we take a comprehensive, evidence-based approach to preventive care. My process includes:
A detailed Breast Cancer Risk Assessment
Concierge imaging orders for 3D mammography and ultrasound
Referrals to top imaging centers in Montgomery County
Rapid review of results and next-step planning
Clear communication so you never feel left in the dark
With 3D mammography as the standard of care and personalized risk assessment guiding your choices, we can detect issues earlier and reduce unnecessary stress along the way.
Download the Ms.Medicine Breast Health Guide
Take your knowledge a step further with the Ms.Medicine Guide to Breast Health.
This free resource helps you understand breast changes, screening options, and risk factors across every stage of life.
(PDF available through Ms.Medicine’s official website.)
Take the Next Step This Breast Cancer Awareness Month
If you are between 40 and 74, this is the ideal time to revisit your breast cancer screening plan. Whether you are due for a mammogram, have questions about a dense breast letter, or want to know if an ultrasound or an MRI is right for you, I can help.
Call Premier Medicine and Wellness in Horsham today at 267-207-3100 or visit www.jenniferkostacosmd.com to schedule your Breast Cancer Risk Assessment. Together, we’ll create a plan that meets your needs, supports early detection, and provides you with peace of mind.
