Delivering caring, personalized, quality healthcare to women in an environment that is supportive, education-focused and compassionate.


Eat Well – Janos Wilder’s Lentil Rice Salad

Why is it that the food tastes so much better when you eat at a restaurant? What is the special magic that chefs use to get the food to taste so wonderful? And can it really be healthy AND tasty?

Chef Janos Wilder, Tucson’s James Beard award-winning chef, reveals the secrets to one of his tasty and healthy dishes in this demonstration video. Chef Wilder and our Tucson Medical Center Wellness team have collaborated to create a program that helps even the most reluctant cook to create meals that are delightfully sumptuous and healthy to boot. From demonstration lunch and learn sessions with Chef Janos at The Carriage House, Chef Janos-inspired dishes on TMC patient and public menus, to easy to follow recipes and videos with Chef Janos we’ve got you covered. Check out this tasty and easy to prepare Lentil Rice Salad.  Click here to download the Lentil Rice Salad Recipe Card

Lentil Rice Salad

Yield: 4 cups


¾ Cup Toasted blanched slivered almonds
1 Cup Green lentils, cooked, available at Trader Joe’s
½ Cup Uncle Ben’s long grain rice
1 Cup Chicken broth or substitute water if needed
1 Cup Grated, peeled carrots
¼ Cup Finely diced red onion
¼ Cup Finely chopped parsley
¼ Cup Crumbled feta cheese

Lemon Mustard Vinaigrette


½ Cup Olive oil
5 Tbs Lemon juice
2 Tbs Whole-grain mustard
Salt and pepper to taste


  1. Cook rice in chicken stock or water 20 minutes until rice tender and all liquid absorbed.
  2. While rice is cooking whisk Lemon Mustard Vinaigrette ingredients together.
  3. When rice is done cool it on a sheet pan.
  4. Toss cooled rice and lentils with toasted almonds, carrots, onions, parsley and enough dressing to liberally coat the ingredients. Reserve remaining dressing for a simple green salad or other use.
  5. Sprinkle with feta cheese.

For more recipes, videos and information about The Carriage House partnership check out the Tucson Medical Center website.

Call the Midwife – Shelley McGrew, CNM

For more than 34 years, even before the opening of Tucson Birth Center in 1982, midwives have been helping women deliver their babies at Tucson Medical Center. Today, we continue to partner with the midwives of the Tucson Birth Center and El Rio Congress to provide the only option in Tucson for women to give birth with the support of a midwife with admitting privileges in the hospital setting.  

We celebrate National Midwifery Week with a focus on midwives and the powerful role and impact they have in the evolution of our services for women and the community. Each day we will meet one of the El Rio amazing midwives serving our community.

shelley mcgrew midwife tucson

Meet Shelley McGrew, Certified Nurse Midwife

Shelley was born at TMC and grew up in Oracle, AZ. She lived and began her work with pregnant and birthing women in NYC from 1986-1999, returning back to AZ and have been here since.

“I have been a CNM for two years. I became a massage therapist specializing in perinatal massage in 1990, then became a labor doula and childbirth educator for many years. In 1997 I became an RN and worked for many years as a labor & delivery nurse before finally realizing my dream and becoming a midwife at age 50.”

Why did you choose midwifery?

“Midwifery is about being with women through their lifecycle – supporting normalcy with evidence-based care – providing education and resources so they can be empowered in their own health. What could be better?!”

What do you love about being a midwife?

“Empowering women – supporting them as they discover their own strengths. From contraception to childbearing to menopause.”

What impact do you see of having midwives involved in hospital birth?

“Midwives contribute to TMC being in the top 10 hospitals in the nation with the lowest cesarean rates. Being part of the amazing team of nurses and doctors at TMC allows us to provide midwifery care to women with diverse backgrounds and needs.”

What would you like to see in the future?

“I’d like to see even more physical and policy support for natural and low intervention hospital births.”

Is a midwife is the right choice for me?

“Do you have any health issues that need OB or perinatologist care? Are you planning a vaginal birth?  What type of birth experience are you hoping for?”

At both the Birth Center and in TMC for Women’s remodeled rooms there is a focus on environment, what and how do you feel this aids women in birthing?

“A peaceful environment helps women relax, feel safe and have privacy which facilitates the birth process. I appreciate TMC’s policy of allowing women to have who they choose with them at their birth without external constraints – this autonomy is important and is culturally sensitive.”

 What gives you the greatest joy in your work?

“The look of joy & accomplishment when a woman meets her baby. I also love it when the dads cry.”

Lowering the chances of having a c-section

How do you decide where to have your baby?

The type of care you receive in hospital can vary widely based not only on location of the hospital, but within a city between different hospitals dependent on their practices. A recent Consumer Reports article suggested that the biggest c-section rate was in fact the place you choose to give birth.

So where do we stand?

Tucson Medical Center scored higher than most other hospitals in the nation on a number of maternal health metrics measured by the Leapfrog Group* in three key areas:

  1. More than 60 percent of hospitals report a rate of C-sections that’s higher than the target rate. In addition to the concerns about impacts on the baby, C-sections carry risk of infection and blood clots, and many women experience longer recoveries. The target rate of 23.9 percent was based on goals of Healthy People 2020, a federal program that sets evidence-based benchmarks for improving the health of Americans. TMC’s C-section rate is significantly better than the target rate, at 16.9 percent.
  2. Although nearly 80 percent of hospitals don’t have adequate experience with high-risk deliveries, TMC meets the standard set by Leapfrog. Babies weighing less than 3 pounds, 4 ounces are more likely to survive, according to Leapfrog, if a hospital has an experienced newborn intensive care unit onsite.  TMC has professionals available 24 hours a day, 365 days a year, who specialize in high-risk pregnancy and deliveries and has a nationally renowned Newborn Intensive Care Unit.
  3. TMC is among hospitals that continue to make progress on reducing the rate of early elective deliveries. Hospitals should aim for a target of 5 percent or fewer for C-section or induction prior to 39 weeks, without medical necessity. TMC fully meets the standard, with a rate of 3.1 percent.

We asked Debra Derck, Manager Labor and Delivery at TMC for Women what factors play a role in our low primary caesarean section rates.

Why our c-section rates are low

1.  24-hour Perinatology

We have 24 hour perinatology available for any concerns and therefore are able to wait and potentially resolve a situation before having to resort to a C-Section.

2.  Partnerships with Midwife Practices

We have 2 midwife practices that deliver patients at our hospital and promote position changes and laboring down during second stage of labor.

3.  Elective Inductions ONLY after 39 weeks

Elective inductions are performed only after the patient reaches 39 completed weeks of pregnancy.

4.  In-house dedicated anesthesia & neonatology

We have resources that are available 24/7 – Along with 24/7 perinatology, there is in house neonatology, and in house anesthesia dedicated to labor and delivery.  This allows us the ability to respond quickly to any adverse events.

5.  Peanut Balls

We currently use peanut balls to assist patients who have received epidurals to help with laboring down once a patient reaches second stage (complete dilation) to assist in rotation and descent of the baby instead of immediately pushing to prevent patient fatigue.  Patients are then able to wait to push until they feel the urge to push.

What can I do to help reduce the risk of c-section?

Prior to birth

While the hospital you deliver at maybe a significant factor, you can also help reduce the chances of c-section by preparing for the birth. Remember to take a child birth class. We offer many options to fit many different schedules.

But what if I’ve already had a c-section and want to try to have a vaginal birth?

C-sections can be necessary, and may prevent a future vaginal birth in the future, but for many women they can have a vaginal birth following a c-section. We recommend you talk to your obstetrician about this option and take a childbirth class specifically designed for VBAC. 

*Consumer Reports listed Tucson Medical Center as one of nineteen large hospitals in the nation who are not only meeting the target of less than 24 percent of first time low risk pregnancies resulting in c-section, but beating it.

The Leapfrog Group is a national nonprofit organization driving a movement for leaps forward in the quality and safety of American health care. They collect and transparently report hospital performance, so that we can all find the highest-value care and make informed decisions. When it comes to maternal health they review the following criteria:

Make sure sore nipples don’t put an end to breastfeeding your child

Sore, painful or even cracked nipples are a common reason why a new mother may stop nursing her child. With the right kind of help and support you can often avoid or remedy problems. Our IBCLC lactation consultants weigh in on with tips to help you.

Why and when breastfeeding results in sore nipples

When breastfeeding you may feel strong sensations as your baby begins to nurse, but pain when breastfeeding isn’t okay. Often nipples become sore within 3-7 days of the start of breastfeeding, usually because your baby isn’t positioned or latched quite right.

Arizona Department of Health Services offers a 24-hour Breastfeeding Hotline 1-800-833-4642.You may have seen a lactation consultant in the hospital or birth center and talked about latch, but a few sleep deprived days into motherhood and it’s easy to forget and important to check in and review if you are having some difficulty. If one or both nipples begin to crack or bleed seek help as soon as possible. The lactation consultant can help you correctly position baby.

If your baby doesn’t seem settled after a feed, or your nipples are flattened or white these maybe signs that baby isn’t latching effectively.


What can you do at home to prevent and treat sore nipples?

  • Check Latch on and positioning with an IBCLC.
  • Nurse on the side that is least sore side first, if possible.
  • Apply warm, moist compresses to your nipples after feedings, this is comforting and removes residue of milk and bacteria before applying ointments.
  • Try hand expressing a little breastmilk and applying to your nipples to soothe the nipples and reduce the chances of infection (human milk has antibacterial properties.)
  • Try keeping nipples covered with a medical grade (100% pure) modified lanolin ointment or hydrogel dressing to encourage cracks to heal without scabbing or crusting. Gently blot off nipple with warm compress before applying any ointments.
  • If your breasts are overfull, hand express to soften areola prior to feeding baby.
  • Call Breastfeeding Support Program ( 324-5730) for other tips on nipple healing.
  • If pumping make sure you are using the right size flange and pressure. Pumping should not be painful.
  • Don’t do the following

  • Don’t apply moist tea bags to the nipples. This folk remedy has shown to have an astringent effect that may promote drying and cracking.
  • Don’t use a hair dryer on sore nipples. This promotes drying and further cracking.
  • Don’t stop breastfeeding
  • Resources at TMC for Women

    TMC offers outpatient breastfeeding support services, whether you deliver at TMC or not. 1. Free weekly breastfeeding support group for new moms. Hosted weekly by a certified lactation consultant. Classes are held every Monday from 10-11:30 a.m. in the Canyon Room.
    2. Outpatient consultations with an IBCLC-certified nurse (by appointment only)
    For more information on any of these services, please call 324-5730

    Tucson Medical Center has the unique status of being the only hospital in Southern Arizona to receive the International Board Certified Lactation Consultant Care Recognition Award for its stellar support programs for nursing moms. Tucson Medical Center strives to promote healthy families in all ways possible. With what we know about breast milk and immunity, we encourage mothers to breast feed. The lactation consultants of TMC for Women provide exceptional support in establishing a satisfying, sustainable nursing relationship whenever possible.

    Who is going to be by your side when you give birth?

    Beyond the midwife or physician, and other medical staff, having someone you know really well and can feel relaxed and comfortable with during childbirth can provide immeasurable support. They can hold your hand, massage your shoulders (although you may find you don’t want to be touched at all), help move you into positions you may have practiced in childbirth classes and remind you to breathe during contractions. But who to chose?

    Once upon a time a birth companion was not allowed to be present in the delivery room. Today, medical emergencies excluded, you can choose your partner, a family member, a friend or perhaps a doula, a professional support for women in childbirth.

    birth partner, spouse, friend, family, doula

    1. Your partner

      Today most partners are present at their child’s birth and for many it is a defining moment for them and their relationship with their children and the mother of their child. However, you or your partner may feel that an additional support person might help.

    2. Family members or friends

      Whether it’s your mom, your aunt, your sister or a close friend you need to know them well enough to know that you can be completely relaxed and comfortable with them and that they will respect your wishes.

    3. A Doula

      A doula is a trained professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth. Doulas are not medical professionals. Some doulas provide emotional and practical support during the postpartum period.

      Certification for doulas usually includes multiple workshops, readings and childbirth education, as well as requirements to attend a number of births and being evaluated by a midwife or doctor present.
      For more information about doula’s check out the DONA International Birth Doula FAQ.  You can find doulas offering services in town through DONA’s directory search. 

    What can your birth partner do?

    1. Advocate

      Make sure you talk before about what type of birth you would like and what you’d prefer to avoid so they can support you in those efforts. If you have made a birth plan, go over it together.

    2. Be there for you

      Whether it’s just chatting with you during the early stages or sitting quietly, this can be a long process.

    3. Make your environment comfortable.

      From massaging your back, to getting you water, plumping pillows, to providing support as you walk your birth partner can make your environment more comfortable.

    4. Breath with you

      It’s especially helpful if your birth partner attended childbirth classes with you, they can remind you about the relaxation and breathing techniques.

    5. Cut the umbilical cord

      Your birth partner may be able to cut the umbilical cord – you can talk to your doctor or midwife about this.

    Whoever you choose remember it’s ultimately your decision! #birthpartner #birth #pregnancy Click To Tweet

    Work and Breastfeeding -Yes You Can!

    If you’re heading back to work and planning on pumping to provide breast milk for your child here are some tips to support your pumping from our lactation consultants:

    • Get help early and often until breastfeeding is going smoothly.
    • Try to delay returning to work until six weeks after delivery, and longer, if possible, since the work of breastfeeding lessens around this time.
    • A quality breast pump that fits well around the nipples and provides various adequate pressures and variable speeds can help a mother extract her milk more efficiently.
    • Learn to “let down” to the pump: warm compresses, warm flanges (the plastic funnels that come with the pump), massage and hand expression can help your milk flow out more easily. Use visualization, scents, imagery and distraction to aid relaxation.
    • A breastfeeding mother can hand express before and after pumping sessions to collect more milk.
      Click to watch Stanford School of Medicine’s 10-minute video “How to Use Your Hands When You Pump” for ways to increase milk production without medication. (
    • Get breastfeeding off to a good start by working on problems with an International Board Certified Lactation Consultant, or IBCLC, who can help you with difficulty latching, pain or low milk supply.

    tips for working breastfeeding moms, work and breastfeeding

    Not sure you are pumping enough milk?

    It’s a common concern for mothers who are breastfeeding. Our lactation consultants suggest that you track your numbers for a week.
    • How much milk did you pump or hand express in that week?
    • How much breast milk did your baby drink while you were at work that week?
    • How many times did you move your milk (breastfeed, pump or hand express) per day during that week?

    Add in more pump sessions if you are not meeting your goal. If you need more milk, power pump once a day — pump 15 minutes on, 15 minutes off several times in a row.

    Daycare Tips:

    • Try not to have baby fed within the hour of mom returning from work.
    • Give a small snack to hold baby off until mom gets back to baby for feeding.
    • Pace bottle feeding to increase the length of bottle feeding to about 20 minutes.

    Worried about pumping while at work? Read this post about why supporting breastfeeding mothers is good for business.

    Tucson Medical Center Breastfeeding Support Program (520) 324-5730

    At TMC for Women

    TMC Breastfeeding Support Services is dedicated to helping you meet your breastfeeding goals, whether you deliver at TMC or somewhere else. We serve clients at all stages of pregnancy and breastfeeding. Our lactation consultants are all internationally board-certified hospital-based nurses who ensure that new moms receive the most up-to-date care. We are dedicated to helping you achieve breastfeeding success, before, during and after your delivery.
    TMC for Women’s Breastfeeding Support Program – Call 324-5730
    TMC for Women’s Breastfeeding Support Group – Every Monday from 10-11:30am in the Canyon Conference Room near the SouthEast entrance.


    La Leche League’s Work and Breastfeeding provides lots of great articles on the topic provides a host of information for both employers and employees
    In the Literature:
    The Milk Memos – At times hilarious, sometimes poignant and always insightful resource that started as a plea from one new mom sitting in a lactation room at IBM to whoever might be also using the lactation room.

    Good carbs? Bad carbs? Making good decisions – Savor the Flavor

    It’s National Nutrition Month and our TMC registered dietitians love the Savor the Flavor theme! Throughout the month Laurie and Mary are sharing tips to help you make healthier, tastier choices.

    Are “carbs” bad?

    Awwww… poor carbs. Carbohydrates (a.k.a. “carbs”) are not bad. They haven’t misbehaved or broken any rules, but they have gotten a bad rap because of the way food manufacturers and some of us consumers have abused them.

    making good choices about carbsCarbohydrate is one of the macronutrients in food, along with protein and fat, that provide energy for our bodies. Foods that are high in carbohydrates include grains, fruits and vegetables. All of these foods can be included in a healthy diet, as long as you make smart choices within each food group. That means choosing minimally processed grains, fruits and vegetables.
    For example:

    * whole grains rather than white bread, pasta, rice (and especially cookies and pastries, etc.)
    * whole fruit (whether fresh, frozen or dried) rather than juice or smoothies
    * real vegetables rather than Veggie Stix, potato chips or any snack food with nice pictures of veggies on the front of the package but no actual veggies (or only vegetable powders) listed among the ingredients.

    These good carbs provide more of the nutrients your body needs without the potentially harmful additives, such as extra fat and salt. By choosing foods that are less processed, you can also cut added sugar from your diet. Sugar is the real “bad guy” when it comes to carbohydrates, and we will cover that subject in more detail in our next post. You can also look forward to discussion of another source of carbohydrates – dairy products – in a future post.

    One thing to keep in mind, even when eating good carbs, is to watch your portion sizes. Eating too much of these foods, or any food, will give you more calories than you need, causing you to gain weight. And we can’t blame the carbs for that.

    If you’d like more information about crafting a healthy diet that meets your specific needs or a private consultation with our nutrition experts make a nutritional assessment appointment today. 

    Ouch! Mastitis – tips on prevention & treatment

    Breastfeeding is cheap, efficient, and a solid nutritious choice for you and your baby with all kinds of positive side effects for mom! But sometimes there can be a little hiccup along the way. Mastitis affects 33% of breastfeeding women, know the symptoms so you can catch and treat it as quickly as possible.

    The signs and symptoms of mastitis:

    • Fever of 101°F or greater
    • Flu-like aches and chills
    • Red, tender, hot, swollen, wedge-shaped area of the breast
    • Pain or burning while breastfeeding or all the time.
    • Breast swelling, tender or warm to the touch

    mastitisWhy do mothers develop mastitis?

    There have been limited studies of lactation mastitis, but generally researchers focus on two potential risk factors

    1. Poor breastfeeding technique – Get the latch right
      If you’re struggling with breastfeeding you’re probably fed up of people talking to you about latch! Improper latching of baby to mom’s nipple is at the root of many a new mother’s frustration. Poor technique can lead to poor drainage of a duct, insufficient emptying of the breast, milk stasis, and cracks or fissures of the nipple. These, it is hypothesized, provide an avenue for infection.
    2. Lowered immune system response
      Guess what, you’re probably sleep deprived, and maybe a little stressed out? You’re not alone. Those factors can reduce your immune system response to a duct infection.
    3. Delay in feeding, busy schedule, stress can also lead to an occurrence of mastitis

    Whatever the cause of the mastitis you need to see a medical professional. Antibiotics can help address the infection. ( Antibiotics are usually prescribed for a 10-14 day course. It is important to take the full course of antibiotics even if you start to feel better). Also coordinate with a lactation consultant to address what led up to the infection.

    What can I do to alleviate the symptoms?

    1. Continue to breastfeed on the affected side as much as you can. This can reduce the tenderness of your breast.
    2. Apply a warm compress
    3. Massage the affected part of the breast. It will help speed the healing process. Pump to help drain the breast after applying warm compresses. Rest, fluids and frequent breastfeeding will help you heal and resolve mastitis. try to reduce your stress or workload until you feel better.  Seek help from friends/family to allow you more time to rest.
    4. Wear a supportive bra. (Your bra should be well fitting, not overly tight causing creases to skin and may be best to avoid underwire bras.)
    5. Make sure your baby latches on well. (Check with the lactation consultants)
    6. Change positions every time you breastfeed.

    Never fear, help is here

    • Nursing assistance during your TMC for Women hospital stay, offered seven days a week

    TMC offers outpatient breastfeeding support services, whether you deliver at TMC for Women or not.

    • Free weekly breastfeeding support group for new moms. Hosted weekly by a certified lactation consultant. Classes are held every Monday from 10-11:30 a.m. in the Canyon Room.
    • Outpatient consultations with an IBCLC-certified nurse (by appointment only. Call 324-5730. BCBS covered)

    For more information on any of these services, please call 324-5730

    Arizona Department of Health Services Breastfeeding 24/7 Hotline: 1-800-833-4642  Breastfeeding and Motherhood resource line for any mother or provider in Arizona


    Do you believe this Breast Cancer Treatment Myth? TMC One’s breast oncology surgeon weighs in on cancer diagnoses

    Throughout the month of October, Breast Cancer Awareness Month, we tapped into the expertise of Dr. Michele Boyce Ley, TMC One’s  board-certified breast oncology surgeon and medical director of TMC’s Breast Health Program. We’ve shared information with you including how to assess your breast cancer risk, asked her to weigh in on breast cancer myths about breast screening including mammography and self-breast exams and had her tell us what to do – and consider – if you find a lump in your breast.

    To round out this blog series, we asked her opinion on a story that was recently released by the Susan G. Komen organization titled: Debunking Five Common Myths About Breast Cancer Treatment.

    We decided to focus on the three Dr. Boyce Ley thought would be the most meaningful.

    Breast Cancer Treatment Myth #1

    I don’t have time to get a second opinion because I must begin treatment as soon as possible.

    BDP36480First – that second opinion issue. “Second opinions are important for a couple of reasons,” said Dr. Boyce Ley. “Maybe the physician you initially went to isn’t a breast specialist. Or maybe they’re just not a good fit for you. Women need to know that it’s OK to find another doctor! Don’t worry about offending your current doctor or the person who referred you to them. It’s your health. People need to feel empowered to get multiple opinions.” Dr. Boyce Ley added that second opinions are also great because perhaps the first time around, you didn’t quite understand all of the information. Or maybe one physician has a treatment option that another doctor didn’t offer you.

    Second – how soon after diagnosis should treatment start? The National Breast and Cervical Center Early Detection Program guidelines recommend starting treatment within 60 days of being diagnosed. Dr. Boyce Ley said that timeframe is readily accepted by most people – that two months is the maximum amount of time a patient should wait before starting therapy. She added that most patients in Southern Arizona begin therapy within a month of being diagnosed. “I think this is really hard for patients,” she said. “They feel like it’s an emergency, but realistically, it takes years for the cancer to grow. A couple of weeks in the life of breast cancer doesn’t change the outcome. Even a patient with an aggressive cancer will usually start therapy within a week or two.”

    Breast Cancer Treatment Myth #2

    Everyone diagnosed with breast cancer dies from breast cancer or everyone diagnosed with breast cancer survives.

    Dr. Boyce Ley stressed that breast cancer is not a death sentence. With modern treatment, an estimated 90 percent of women with early-stage breast cancer will go on to live five or more years after diagnosis without it recurring. Of course survival rates vary based on what stage the cancer is in and what kind of behavior the breast cancer has. According to the National Cancer Institute, there are about three million breast cancer survivors in the United States. However, more than 40,000 women and more than 400 men still die from breast cancer every year. The reality is that while most people will survive breast cancer, unfortunately some patients will not.

    Breast Cancer Treatment Myth #3

    Chemotherapy and radiation therapy are more harmful than helpful.

    Decades of breast cancer research have proven that chemotherapy and radiation therapy saves lives. “We know that these are two things that contribute to better survival,” said Dr. Boyce Ley. “Historically, doctors have gone from giving no chemotherapy to giving too much chemotherapy and now we’re working hard to give patients just the right amount.”

    She added that doctors these days have lots of ways to analyze a patient’s cancer to identify more clearly what treatment would benefit the patient. This allows a treatment plan to be tailored to that specific patient. “We have ways to identify which patients are going to benefit from which targeted therapies,” said Dr. Boyce Ley. “The same can be said for targeted radiation. We have the ability to target one part of the breast where the cancer is and avoid radiation damage to the heart and lungs. Those are things we didn’t have available to us 15 years ago.”

    Dr. Boyce Ley is located at TMC One, 2424 N. Wyatt Drive #100, on the TMC campus. Call (520) 324-BRST (2778) to make an appointment.

    To schedule a mammogram, call (520) 324-2075. For more information about our free mammogram program for uninsured women, call the TMC for Women Breast Center at
    (520) 324-1286 to review qualifications and schedule an appointment.

    Just how dense are your breasts? Why keeping abreast of this indicator can help save your life

    BreastDensityFlowerWhat kind of question is that?

    In recent years it’s become the kind of question that can help health care providers identify breast cancer at earlier stages allowing them to treat women earlier with better results.

    What are dense breasts?

    The size of our breasts might be the only measurement we’ve thought about when it comes to “the girls,” so what on earth are dense breasts?  The density of breasts is a measurement of fatty tissue compared with fibroglandular tissue. The more fibrogladular tissue you have the more dense your breasts. On a mammogram, this dense tissue shows up as white areas. Levels 3 and 4 in the image below are what we describing as ‘dense breasts’ where more than 50% of the tissue is fibrogladular rather than fat.

    Breast Density Categories from American College of  Radiology

    Breast Density Categories from American College of Radiology


    Why does knowing if you have dense breasts matter?

    While having dense breasts is perfectly normal, increased density of fibroglandular tissue makes it difficult to interpret a mammogram. The dense tissue can mask a growth from view. As a result there is a slightly increased risk of not catching a tumor at an easily treatable stage. In younger women, who typically have denser breasts, an aggressive breast cancer may be hidden from detection by the dense fibrogladular tissue. There is also an increased risk of developing breast cancer in tissue that is dense. For women with extremely dense breasts there is a four to six times increase in the rate of breast cancer.


    Eek! What if my breasts are dense? Am I going to get breast cancer and not know it because the mammogram was hard to interpret?

    Knowing that you have dense breasts can help your care providers determine what is the best screening approach for you. Mammograms are still the primary way breast cancers are detected, but technology is changing rapidly. Digital mammograms have improved the ability to view breast tissue, and  3-D mammograms, also known as digital breast tomosynthesis, have further improved the ability of radiologists to assess dense breasts. There are additional methods that can be applied for women with dense breasts. Read the upcoming post for more information on tomosynthesis here in Tucson.

    My breasts aren’t lumpy, I’m not worried.

    Before you start trying to manually evaluate whether your breasts are dense (we still encourage monthly self-exams) or comparing them with friends and loved ones, the only way to assess the density of the breast is through mammography. Breast density refers to the appearance of the breasts on a mammogram rather than to breast size or firmness.  Your breasts may feel firm but not appear dense on a mammogram, or feel soft and appear extremely dense on the mammogram.

    Once I have dense breasts will it always be that way? Does breast density change?

    You may find that your breast density changes from one year’s mammogram to another for a variety of reasons – breast density is related to genetics, hormone levels and age  (all things you can’t control).

    Oh no, not the ol’ mammogram!

    If you’ve been putting off getting a mammogram, know you are not alone. More than half of Arizona’s women are not up to date on having a mammogram whether they have insurance or not. Perhaps it’s time to read this post about why there is nothing to fear from a mammogram. Whether you have insurance or not, it is time to schedule an appointment. Thanks to support from TMC Foundation, Susan G. Komen of Southern Arizona and an Avon grant many uninsured women can receive a free screening mammogram at TMC for Women.

    photo 1 (7)

    You’ve got mail!

    Last year the Arizona State Legislature passed a law requiring that women whose breasts appear dense (More than 50% dense material – Levels 3 or 4 on the image above) on a mammogram be informed – typically this is done through the results letter sent to the patient – and to encourage them to talk with their health care provider to see whether additional screening is appropriate.

    More information: Beyond the Basics – It’s Mammogram Time