Serena Williams has urged women not to let breast cancer screenings slide, revealing that her very dense breasts mean she must be 'extra thorough'. Mayo Clinic says cancer could be missed on a mammogram in dense breasts.

The tennis icon, 45, described 'a morning full of breast exams. Top on, top off, top on, top off!' in a post on X on 2 November. 'I know October is over, but breast cancer awareness should never stop,' she wrote.

She told women to 'get checked, know your body, and stay on top of your screenings'. The US Centers for Disease Control and Prevention says more than 99 per cent of women diagnosed at an early, localised stage are alive five years later.

Why Dense Breasts Matter

Dense breast tissue is made up of milk glands, milk ducts and supportive tissue. It is a very common finding and does not mean something is wrong. About half of people having screening mammograms have dense breasts.

Dense breasts are more likely in younger women, those with a lower body mass index and those taking combination hormone therapy for menopause. Density can occur at any age, however.

On a mammogram, fatty tissue appears transparent, while dense tissue looks solid white. Because cancer also looks solid white, it could be missed in dense breasts.

Dense breasts also carry a modestly higher risk of breast cancer, similar to that of someone with a relative who had the disease. On its own, however, density does not mean a high risk or raise the risk of dying from the disease.

Only a mammogram can show density, and a radiologist decides the level. Cleveland Clinic says mammogram reports include breast density by law, so women can ask a doctor what theirs means.

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Why Waiting Carries a Cost

Screening cannot prevent breast cancer but can help find it when it is easier to treat. Regular mammograms can lower the risk of dying from the disease and detect cancer before it is big enough to feel.

Screening mammograms usually take about 15 to 20 minutes and can find about 85 per cent of breast cancers. They are most helpful when radiologists can compare images over time.

Screening has risks as well, including false positives, overdiagnosis and missed cancers. Women should decide with a doctor whether screening is right for them.

When to Start Mammograms

The US Preventive Services Task Force recommends that women aged 40 to 74 at average risk have a mammogram every two years. Most doctors recommend one every year from age 40.

For average-risk women, the American Cancer Society says those aged 40 to 44 may choose yearly mammograms and those 45 to 54 should have them every year. Women aged 55 and older can switch to every other year.

High-risk women should typically have a yearly mammogram and breast MRI from about age 30. Women with a family history may also need to start before 40.

Extra Tests for Dense Breasts

Mammograms remain effective for women with dense breasts and have been proved to reduce the risk of dying of breast cancer. Newer 3D mammograms may help doctors see past areas of density.

Extra tests such as ultrasound and breast MRI may improve detection in dense breasts, but they can also cause false positives. More research is needed to know which test is best, and none has been proved to reduce the risk of dying.

Anyone who notices a new lump, nipple discharge or skin changes should contact a doctor right away. Women can also discuss with their doctor which tests suit them, based on their personal risk factors and preferences.

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Frequently Asked Questions

  • What are dense breasts?
    Dense breasts have more glandular and fibrous tissue than fatty tissue, which can make it harder to detect cancer on a mammogram.
  • Why is breast cancer screening important?
    Screening can help detect breast cancer early when it is easier to treat and can lower the risk of dying from the disease.
  • What additional tests are available for women with dense breasts?
    Women with dense breasts may consider additional tests such as 3D mammograms, ultrasound, or breast MRI to improve cancer detection.
  • When should women start getting mammograms?
    Women at average risk should start mammograms at age 40, with frequency depending on age and risk factors. High-risk women may need to start earlier.