Dense Breast Tissue, Thinner Answers

One of my brother's best friends was just diagnosed with breast cancer at age 33. When he told me, I was taken right back to when my friend Lisa called me (on Christmas morning) to tell me she had the disease.

I've written a lot about my ATM gene mutation, and the strange, specific limbo of knowing you're at higher risk before anything's actually wrong. So when my co-founder Abby, who recently turned 40, mentioned she'd just found out at her mammogram that she has dense breasts, I knew exactly where that conversation would go next. She left with a piece of critical, potentially life-saving health information — and basically no idea what to do with it.

As of September 2024, the FDA now requires every mammography facility in the country to tell patients whether their breasts are dense. Nearly half of women over 40 have dense tissue, and it's a two-for-one problem: it raises your baseline risk and makes cancer harder to spot on a mammogram, since dense tissue and tumors both show up white on the scan. So the women who most need a clear picture are the ones most likely to get a blurry one.

What the FDA doesn't require is what happens after. No mention of a supplemental ultrasound, no explanation of what your actual risk percentage is, just a sentence, maybe a pamphlet, and the door.

When I found out about my ATM mutation, I was told I'd need regular scans for the rest of my life, full stop, with a new prescription required every single time. So I did the research myself and wrote it all down here.

Lisa didn't get the years to figure any of this out. The least the rest of us can do is not have to start from zero.