Girls, listen up.

Do you have dense breasts? Do you know how to tell if you have them? And do you know the health implications they bring?

If you’re an Asian female, chances are you have dense breasts. Asian women historically have denser breasts than other demographic populations.

Breast density isn’t based on how your breasts feel. It’s not related at all to breast size or firmness. You can’t tell by feeling or looking at them. Rather, breast density can only be determined via a mammogram.

Women with dense breasts may have a slightly higher risk of breast cancer compared to women with less dense breasts. According to cancer.gov, women with dense breasts are at increased risk of breast cancer, and high breast density is a cause of false-negative results on a standard screening mammography.

A report by breastcancer.org says that research has shown that dense breasts can be six times more likely to develop cancer.

But what exactly are dense breasts?

Breasts are essentially the same in men and women, until they hit puberty. With sexual maturity in women comes the breast tissues growing in size and amount. Unlike popular belief, breasts aren’t exclusively composed of fat. They’re actually made from both fatty and nonfatty tissues. Nonfatty tissues are the milk glands, milk ducts and other types of supportive, fibrous tissue.

Having dense breasts means having more nonfatty tissue than fatty tissue.

Complications

And that’s where things get complicated.

Dense breasts can make it harder for mammograms to detect breast cancer. On mammograms, fatty tissues look dark, while dense breast tissues look white. Unfortunately, tumors appear white on mammograms as well, making it hard for doctors to distinguish tumors from dense breast tissue. Breast cancers (that appear white) are easier to see on a mammogram when they’re surrounded by fatty tissue (which looks dark).

Cancer also appears to develop in areas where the breast is dense, suggesting a causative relationship, although the exact connection is unknown. In a report by healthline.com, research also suggests that women with dense breasts have more ducts and lobes, increasing their risk because cancer often arises in these places.

The National Cancer Institute in the United States reports that about 20 percent of cancers are missed in a mammography. That percentage can approach 40-50 percent in women with dense breasts.

According to Mayo Clinic, you are more likely to have dense breasts if you are younger. Women in their 40s and 50s are most likely to have dense breast tissue, though some women may have dense breast tissue at any age. Premenopausal women are more likely to have dense breasts, as well as women who take combination hormone therapy to relieve signs and symptoms of menopause.

Supplemental screening

Mayo Clinic recommends supplemental breast screening such as a 3D mammogram, breast magnetic resonance imaging (MRI), breast ultrasound and molecular breast imaging (MBI).

3D mammogram detects an additional one to two cancers per 1,000 women. Breast MRI is estimated to detect 18 or more additional cancers per 1,000 women, although it is also likely to find areas of concern that aren’t cancer. Breast ultrasound finds an additional three to four cancers per 1,000 women and is also likely to find areas of concern that aren’t cancer. MBI, available at a few medical centers, detects an additional seven cancers per 1,000 women and it’s less likely to find areas of concern that aren’t cancer.

October is breast cancer awareness month. Go see your doctor if you haven’t already.