Dense Breasts Explained: How 3D Mammograms Improve Detection
Dense breast tissue can make mammogram results harder to interpret—but 3D mammography is changing that. In this guide, Dr. Loree Koza explains what breast density means, when to consider ultrasound or MRI, and how personalized screening improves outcomes for women across Boulder County.
Last updated on September 30, 2025
October is Breast Cancer Awareness Month, a time to pause and prioritize your own health. For many women across Boulder County, that means scheduling an annual mammogram. But if your results mention dense breast tissue, it can leave you wondering what that means and whether you need additional testing.
As a family and women’s health physician in Lafayette, I believe preventive care only works when you understand it. Understanding how breast density impacts screening, and how tools like 3D mammography and ultrasound fit into the process, can help you make informed, confident choices about your care.
Understanding Breast Density
Breast density refers to the ratio of fibrous and glandular tissue compared with fat. On a mammogram, both dense tissue and potential cancers appear white, which can make early changes harder to detect.
About half of women over 40 have dense breasts. Colorado requires radiologists to inform patients of this finding, but the letter you receive doesn’t always explain what to do next. Dense breasts aren’t dangerous on their own, but they can make standard imaging less clear, which is why the type of mammogram you choose matters.
3D Mammography: The Current Standard of Care
For years, 2D mammograms were the standard for screening. While helpful, they sometimes compress overlapping tissue into a single flat image, making subtle abnormalities difficult to see.
3D mammography (tomosynthesis) has changed that and is now the standard of care for breast cancer screening. It captures multiple low-dose images from different angles, creating a three-dimensional view that allows radiologists to study thin “slices” of tissue.
Why it matters:
Cancers are detected earlier and with greater accuracy.
Fewer false positives and callbacks for additional imaging.
Provides significantly improved clarity for women with dense breast tissue.
If you live in Lafayette or the surrounding communities, ask your imaging center whether 3D mammography is available; it’s worth the extra precision.
When to Add Ultrasound or MRI
Even with 3D mammography, some women benefit from additional imaging based on personal and family history.
Ultrasound uses sound waves to see through dense areas and helps distinguish harmless cysts from solid lumps.
MRI offers the most detailed imaging and is usually reserved for women at higher risk, such as those with strong family histories, prior abnormal findings, or genetic mutations.
At Manifest Health Concierge Medicine, I utilize a comprehensive Breast Cancer Risk Assessment to determine which tools are most suitable for each patient. We consider your age, family background, lifestyle factors, and breast density to create a personalized screening plan tailored to you—not a one-size-fits-all checklist.
Common Concerns About Screening
“I’m anxious about getting a callback.”
That’s completely understandable. A callback simply means your radiologist wants a closer look, not that something is wrong. Using 3D mammography can dramatically reduce the likelihood of false alarms and the stress that comes with them.
“It takes forever to get results.”
Waiting is the hardest part. Through my concierge practice, I coordinate personalized imaging referrals for women across Lafayette, Louisville, and Boulder, and I review results quickly—often within the same week—so you have answers without the anxiety of a long wait.
What to Bring to Your Appointment
A few small steps can make your screening more useful:
Prior mammogram or imaging reports (especially if done elsewhere)
Details about your family history of breast, ovarian, or prostate cancer
Any biopsy or pathology results
A list of medications and supplements
Questions about symptoms, hormone therapy, or breast changes
Coming prepared ensures your care team has the complete picture.
How Manifest Health Supports Women’s Breast Health
At Manifest Health, prevention isn’t rushed. It’s intentional and personalized. As part of the Ms.Medicine network, our practice takes a whole-person approach to breast cancer prevention and early detection.
Our process includes:
Breast Cancer Risk Assessments during annual visits
Concierge imaging coordination for 3D mammography and ultrasound
Referrals to trusted radiology partners across the Front Range
Prompt result review and next-step planning
Clear, compassionate communication at every stage
When women have time to ask questions and get clear answers, screening becomes empowering—not overwhelming.
Download the Ms.Medicine Breast Health Guide
Build your understanding with the Ms.Medicine Guide to Breast Health.
This free, evidence-based resource guides you through breast changes, density, and screening options at every stage of life.
(Free PDF available through Ms.Medicine’s official website.)
Take the Next Step Toward Preventive Confidence
If you’re between 40 and 74, this is the perfect time to review your breast cancer screening plan. Whether you’re due for a mammogram, recently received a dense breast notification, or want a personalized prevention strategy, I’m here to help.
Call Manifest Health Concierge Medicine at 720-439-4002 or visit www.manifesthealthcm.com to schedule your Breast Cancer Risk Assessment. Together, we’ll create a plan that suits your body, life, and peace of mind.
