In dense breasts, how does density affect screening?

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Dense breast tissue creates a masking effect on mammograms. Because fibroglandular tissue appears white just like many cancers, lesions can be hidden within the white background, lowering the test’s sensitivity and making cancers harder to spot during routine screening. This is why adjunct imaging—such as ultrasound or MRI—is often used to improve detection when breasts are dense, especially if there are signs or clinical concern, or in higher-risk individuals. Breast density is also a risk factor for developing cancer, but for screening purposes the key point is the reduced sensitivity and the potential need for additional imaging. The other options don’t fit because density does not increase sensitivity, it does not eliminate the need for adjunct imaging, and it does affect detection.