Looking beyond the mammogram to assess mammographic density: A narrative review

MD – the white areas on a mammogram (also known as breast density), has long been recognised as an indicator of breast cancer (BC) risk and mammographic masking. Recent legislation in 32 American states has mandated the inclusion of mammography density information in reports for women in the higher two MD quartiles, and it is a growing consideration world-wide. While the mammogram is currently the only means of estimating MD, it suffers from a number of limitations. These are related to the accumulation of low dose ionising radiation used in mammography that limits its repeated use, particularly in young women, women with previous radiation exposure, those having undergone prior surgery, or those with radio-sensitising gene mutations. This review compares and contrasts the variety of emerging technologies that can provide a quantitative and true volumetric analysis of breast density, without the use of ionising radiation.