Breast tissue is composed of dense fibroglandular tissue (milk glands and ducts, muscle and connective tissue) and non-dense fatty tissue. The more fibroglandular tissue you have, the denser your breasts are. Dense breast tissue is very common and not abnormal. However, dense breast tissue is associated with an increased risk of developing breast cancer because glandular tissue makes it harder to see small tumors and can make screening more difficult.

  • Breast density is not based on your overall body habitus.
  • Breast density is not related to your breast size or firmness.
  • Breast density can only be determined by a mammogram.
  • At Princeton Radiology we call a mammogram a SmartMamm™ because the reports include your type of breast density, along with your lifetime risk assessment of breast cancer – to help you and your doctor determine the right monitoring plan for you.
  • Some early-stage concerns are more difficult to detect on mammograms alone.
  • That’s why an additional study may be recommended.



Nearly half of all women aged 40 and older who have mammograms are found to have dense breasts (either heterogeneously or extremely dense). Women with 50 percent or higher breast density are three times more likely to be diagnosed with breast cancer than women with less than 10 percent breast density (Journal of the National Cancer Institute, Aug 2011).

Type A
Almost Entirely Fatty

*Categories of Breast Density

Type B
Scattered Areas of Fibroglandular Density

Type C
Heterogeneously Dense

Type D
Extremely Dense


Women with dense breasts can benefit from supplemental screening with one of Princeton Radiology’s Smart Breast MRIs™. Smart Breast MRI™ can detect more than twice as many breast cancers as 3-D mammography alone – and often at earlier, more treatable stages.

Smart Breast MRI™ is a non-invasive imaging exam without ionizing radiation. Patients lie in the MRI machine, while an extremely safe contrast agent is administered intravenously into the arm. The MRI machine then uses magnets and radio waves to produce detailed 3-dimensional images of the breast tissue.

On the Smart Breast MRI™, the contrast agent becomes more concentrated in areas of cancer growth, showing up as white areas against a dark background. This helps radiologists determine which areas may be of concern.


An average or high risk of breast cancer or concerns due to family history or other reasons

You’re likely to be a candidate for our Diagnostic Smart Breast MRI™. Click here to learn more about that specific exam.

No history of breast cancer, but have dense breasts and want to be proactive about my breast health

You’re likely to be a candidate for our Smart Breast MRI™. Click here to learn more about that specific exam.

Types of Smart Breast MRI™ Exams

Princeton Radiology offers both Diagnostic Smart Breast MRI and Screening Smart Breast MRI™. Most insurance plans cover Diagnostic Smart Breast MRI™ for women at increased risk of developing breast cancer, such as those with a Claus risk score of 20+ on their SmartMamm™ report, and/or an inherited conditions such as BRCA 1 or BRCA 2 genetic mutations. Get your Claus score here

If a Diagnostic Smart Breast MRI™ exam is not covered by your insurance, our Screening Smart Breast MRI™ is available for the low, self-pay fee of $375.

Diagnostic Smart Breast MRI™

  • Exam time: approx. 30 minutes
  • Recommended as a follow up to a SmartMamm™ if you have an average risk of breast cancer, but have concerns due to family history or other reasons
  • A physician’s order is required

Additional reasons to consider a Diagnostic Smart Breast MRI™ include:

  • General concerns about breast health and risk factors not resolved with a mammogram
  • Discovery of a lump/mass during a physical exam, ultrasound or mammogram
  • Concerns about the integrity of breast implants
  • Distinguishing between scar tissue and recurrent tumors
  • Staging of breast cancer to make the best treatment decisions

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Screening Smart Breast MRI™

  • Exam time: approx. 10 minutes
  • Recommended for concerned patients and their doctors when referral for diagnostic breast MRI does not meet insurance coverage requirements
  • Not covered by most insurance plans; out-of-pocket cost: $375
  • A physician’s order is required

Additional reasons to consider a Smart Breast MRI™ include:

  • Dense breasts and/or an average risk of breast cancer
  • Additional safety net that detects 15 to 18 more breast cancers per 1,000 screenings
  • Ability to reveal aggressive cancers, as it detects tumors that are vascular and can grow quickly in between annual mammograms

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Not sure about your risk of breast cancer? Click here to find out.


A small percentage of breast MRIs require additional testing. These might include a follow-up diagnostic Smart Breast MRI™, breast ultrasound, diagnostic SmartMamm™ (mammogram), or biopsy.


Yes! Even with dense breasts, mammograms are the only imaging exam proven to reduce breast cancer mortality. Mammograms also help detect changes in the pattern of your breast density, which is critical for detecting breast cancer early. We recommend that you continue with annual mammograms.