Is Your Mammogram Enough?

Since September 10, 2024, all patients receiving mammograms are informed their breasts are either “dense” or “not dense.” For dense patients, the letter states, “Dense tissue makes it both harder to find breast cancer on a mammogram and raises the risk of developing breast cancer. Your breast tissue is dense. In some people with dense tissue, other imaging tests in addition to a mammogram may help find cancers. Talk to your healthcare provider about breast density, risks for breast cancer, and your individual situation.”

Additional Tests After Your Mammogram

Your health provider may recommend additional testing to find cancers that may be hidden by dense breast tissue. There are 4 categories of breast density (see above). The last two categories, heterogeneously dense and extremely dense, are considered “dense” breasts. In women with dense breasts, any additional testing (like ultrasound and especially MRI) increases the likelihood that a cancer hidden on a mammogram (whether 2D or 3D) will be detected.

Is it Covered?

Insurance coverage for additional tests is being addressed at both State and Federal levels. Always check with your insurer to learn if, and to what extent, a test will be covered.

• On the state level, about 40 states and the District of Columbia have enacted laws for additional breast imaging coverage after a mammogram. The laws vary and some still require out-of-pocket costs, see DenseBreast-info.org’s “State Law Insurance Map”.
• As of January 1, 2026, new federal guidelines for Affordable Care Act qualified plans went into effect for women at average risk. They require plans to cover no-cost supplemental screening imaging and imaging to address findings on the initial screening mammogram, and pathology evaluation.
• Several types of insurance plans (like Medicare, VHA and TRICARE) are exempt from both the new federal guidelines and state insurance laws A federal bill, the Find It Early Act, would close those loopholes and ensure all health insurance plans cover supplemental screening and diagnostic breast imaging with no out-of-pocket costs for women with dense breasts or at higher risk for breast cancer.

Learn More:  

Is My Mammogram Enough?  – This resource includes important risk factors to be aware of and what additional screening should be considered based on them (includes a link to a risk model calculator).

Screening Tests After a Mammogram – Learn what these tests are and the number of additional cancers found by each after a “normal” mammogram in dense breasts.

State Law Insurance Map – Check this map for updated info on what your state law may be for breast cancer screening tests.

Updated by JoAnn Pushkin, Executive Director, DenseBreast-info.org.