Being Overweight Or Obese
Women who are overweight after their menopause have a higher risk of breast cancer than women who are not overweight. Men also have an increased risk of breast cancer if they are overweight or obese. For both men and women, the risk increases as more weight is gained.
Body mass index is a measure that uses your height and weight to work out whether you are a healthy weight. For most adults, an ideal is between 18.5 to 24.9. Being overweight means having a BMI of between 25 and 30. Obesity means being very overweight with a BMI of 30 or higher.
Try to keep a healthy weight by being physically active and eating a healthy, balanced diet.
Drinking alcohol increases the risk of breast cancer in women. The risk increases with each extra unit of alcohol per day. The number of units in a drink depends on the size of the drink, and the volume of alcohol.
The latest UK government guidelines advise drinking no more than 14 units of alcohol a week.
How Do Dense Breasts Affect The Detection Of Breast Cancer
Small cancerous areas may be harder to see in dense breasts. Myers says that on a mammogram, glandular tissue appears white, while fat tissue appears dark. In a scan with mostly dense tissue and therefore lots of white, it may be harder to find a small cancerous area, which also is white. It is easier to detect an abnormal change in the dense glandular tissue if it is surrounded by darker fat, rather than if it is surrounded by white gland tissue, Myers says.
How To Find Out If You Have Dense Breasts
In the United States, 37 states and Washington, D.C., require breast imaging centers to give women some level of information about breast density after their mammogram. In 2019, the U.S. Food and Drug Administration began to develop a single national reporting standard imaging centers can use to notify both the woman and her doctor about her breast density. However, this hasnât yet been implemented. 4
Federal law requires that all women receive a letter notifying them about the results of their mammogram. In most states, this form letter now also tells you if you have dense breasts, and, in some states, your specific density category. However, the content of the letter varies widely by state and may not include specific details about your situation. Most of the letters will advise you to discuss your results with your doctor. Your breast density is also included in the final mammography report to your healthcare provider, prepared by the radiologist who read the images. If you live outside the United States, you may or may not be notified about your breast density, depending on the regulations in your country. DenseBreast-info.org is a good resource for finding out what the laws are where you live.
Having dense breasts isnât your fault, and it isnât something you can control. Breast density is thought to be inherited in part, although the amount of dense breast tissue you have can change over time. Breast density can decrease as you go through menopause.
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What Are Some Of The Screening Tests And Other Services That Are Available At Msk Westchester
We offer 2-D and 3-D mammography, screening breast ultrasounds, and breast MRIs. Breast cancer screening services are available to MSK employees and their family members, MSK patients, and women in the community. Any woman who needs a screening mammogram can make an appointment to get one at MSK. We accept outside prescriptions for screening mammography and breast ultrasounds.
For those who need a breast biopsy, we perform a number of nonsurgical procedures at MSK Westchester. These include percutaneous ultrasound-guided core biopsies, fine-needle aspirations, stereotactic breast biopsies, and MRI-guided biopsies. People who are having surgery at Memorial Hospital in Manhattan can have their preoperative seed localizations and sentinel node injections done at MSK Westchester.
We are excited that well soon be able to offer contrast-enhanced mammography at MSK Westchester. This technique, which gives us a vascular map of the breast, similar to an MRI, was first piloted at MSKs Evelyn H. Lauder Breast Center in Manhattan. We are glad to expand that service to the regional sites, including MSK Westchester and MSK Commack. Its a very specialized procedure that, to the best of my knowledge, is not available anywhere else in Westchester County.
Why Is Breast Density Important
Breast density is important for two main reasons:
- Women who have dense breast tissue have a higher risk of breast cancer compared to women with less dense breast tissue. Its unclear at this time why dense breast tissue is linked to breast cancer risk. It may be that dense breast tissue has more cells that can develop into abnormal cells.
- Dense breast tissue also makes it harder for radiologists to see cancer on mammograms. Dense breast tissue looks white on a mammogram. Breast masses and cancers can also look white, so the dense tissue can make it harder to see them. In contrast, fatty tissue looks almost black on a mammogram, so its easier to see a tumor that looks white if most of the breast is fat tissue.
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Md Breast Cancer Risk And Molecular Subtypes Of Breast Cancer
Data from 6 studies showed a positive association between MD and the risk for invasive tumors across all ages, where the highest level of dense tissue showed a twofold increase in risk compared to the average level of dense tissue . In one study, there was a positive association between MD and ER HER2 breast cancers in women younger than 55 compared to women who were older than 55 years of age . Human epidermal growth factor receptor 2 is a member of the epidermal growth factor receptor family and is overexpressed in about 30% of invasive breast cancers. High MD is strongly associated with large tumors, positive lymph nodes, and ER tumors in women younger than 55 years of age . This suggests that MD could potentially play a role in the aggressiveness of breast cancers however, more controlled studies need to be conducted to confirm these observations . In another study that included 733 women with invasive breast cancers , there was a higher association of MD with ER-negative tumors, including triple-negative breast cancer cases, compared to luminal A breast cancers . An association between high MD and androgen receptor -negative tumors was also observed, but this association was reported to be weak . Future studies need to address and confirm MD and its association with subtypes and aggressiveness of the breast cancer.
Should I Have Any Other Screening Tests If I Have Dense Breast Tissue
At this time, experts do not agree what other tests, if any, should be done in addition to mammograms in women with dense breasts.
Digital breast tomosynthesis can find some cancers not seen on regular mammograms. Some studies have suggested 3D mammography might be particularly helpful in women with dense breasts. It can be used as a screening test along with or instead of standard mammography, although it isnt yet available at all imaging centers.
Studies have shown that breast ultrasound and possibly magnetic resonance imaging can also help find some breast cancers that cant be seen on mammograms. But ultrasound and MRI can also show more findings that are not cancer. This can lead to more tests and unnecessary biopsies. And the cost of an ultrasound or MRI may not be covered by insurance.
Talk to your health care provider about whether you should consider any of these tests.
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Other Methods Of Breast Cancer Screening
There are other methods of screening if you’re at high risk. If there’s a lump that you or your clinician noted, then an ultrasound might be useful. If you carry a breast cancer gene that puts you at risk, then an MRI might be recommended.
For all of us, though, the invention of digital mammography several years ago made mammograms much better at looking through dense breasts. So there’s been less of a chance of missing something. And there are also some new techniques.
How Do Dense Breasts Affect Self
Breast self-exams are no longer included in the federal guidelines. What matters is getting comfortable with what your breasts feel like. No breast feels the same. What youre looking for is a change. If all of a sudden you feel a ball or a mass youve never felt before, thats something you need to bring to the attention of your doctor.
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Dense Breasts: What It Means Cancer Risk & 5 Tips To Protect Yourself
Dr. V. Samundeswari Mahesh, Senior Consultant Radiologist,Indias Leading Mammography Expert
Your breasts may not feel different if they are dense. Also, breast density is not related to firmness or size. You can only tell if someone has dense breast tissue on a mammogram.
Breasts are known as dense if you have more fibrous and glandular tissue than fatty tissue as seen on a mammogram.
Its normal if you have high breast density. Dense breasts are common, especially at a younger age. However, for some women, the density doesnt reduce with age.
Why is it important for you to know your breast density?
Women with dense breast tissue are more prone to breast cancer.
Breast cancer in women with dense breasts was about 22% more than in women with non-dense breasts as measured by a Norwegian study that examined 3,07,015 digital screening records of over 1,00,000 women.
Starting an annual mammography screening routine at age 30 may benefit the women with dense breasts as found by another large US study of more than 5 million mammograms.
Its unclear to medical science at this time why dense breasts present more breast cancer risk. Probably because dense breast tissue has more cells that can grow abnormally to become cancer cells.
How can I find out my breast density?
If you are above 30 years of age and do not know your breast density, you may want to get a mammogram done to find out about it.
If I have dense breasts, do I need any other tests in addition to screening mammograms?
Dense Breasts And Cancer: Tips To Empower You And Improve Your Breast Health
Topics
Standard mammograms are an optimal screening tool to find breast cancer in most patients. When breast radiologists review the mammogram results, they can see the ratio of dense to non-dense breast tissue and assign a category of breast density. If the category is dense breasts, then its important for the patient to learn more about the condition, as it poses an increased risk for breast cancer.
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My Mammogram Results Say I Have Dense Breast Tissue Am I Normal
Dont panic. Dense breast tissue is not cancer. The results are merely informing you that, like 40 percent of American women, your breast tissue is particularly fibrous. This does, however, make it more difficult for a mammogram to see through the entire breast. Dr. Kirtly Parker Jones explains dense breasts in further detail and what alternative screening methods might work the best for you.
Dr. Jones:
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Higher Bmi Linked To Lower Density
Typically women with a high BMI have lower breast density, though age is a strong determinant of breast density as well, said first author Natalie Engmann, a PhD candidate in the UCSF Department of Epidemiology and Biostatistics. Dense breasts are more common in younger women and most women experience a sharp decline during menopause that continues in the post-menopausal period. However, post-menopausal estrogen and progestin therapy can reverse the decline of breast density with age.
The researchers compared the population attributable risk of breast cancer risk factors, which assesses the impact of each risk factor on the development of disease in an entire population. They calculated the effect of each risk factor, using 18,437 women with breast cancer, compared to 184,309 women of the same age who did not have the disease.
They found that breast density was the most prevalent risk factor and that 39.3 percent of breast cancers in pre-menopausal women and 26.2 percent in post-menopausal women had the potential to have been prevented if all women with higher breast density, BI-RADS categories C and D, had been shifted to lower-density BI-RADS category B.
The researchers found that 22.8 percent of breast cancers in this group could have been averted if obese and overweight women attained a body mass index of less than 25, the equivalent of 155 lbs for a woman of 5 feet 6 inches.
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Formulate A Screening Plan With Your Doctor
Many states, including California, Virginia, and New York, require radiologists to tell you if your breasts are extremely dense.
While having dense breasts doesnt necessarily mean you will develop breast cancer, knowing you have dense breasts is a step toward health awareness. Ask your doctor to suggest a screening plan if you have dense breasts or other risk factors for breast cancer.
The United States Preventive Services Task Force recommends a mammogram every 2 years for those between 50 and 70 years old. Early screening or other diagnostic tests may be recommended from ages 40 to 49 depending on personal risk factors.
Cancer Screening For Women With Dense Breasts
Mammograms don’t always reveal cancers that may be present in dense breasts. Small cancers can be hidden by dense tissue, since both appear white on a mammogram. The more density there is, the harder it is for a radiologist to see an abnormality. Know your breast density and make it part of a conversation with your doctor about your annual screening plan.
Newer technology known as digital breast tomosynthesis , sometimes called three-dimensional mammography, appears to be more accurate than traditional 2D mammography for women with heterogeneously dense breasts. Like traditional mammography, 3D mammography takes two views of each breast, but then creates images of thin slices of the breast tissue for the radiologist to read. These slices are somewhat like a CT scan result, showing slivers of the breast with the overlying tissue peeled away. This can allow the radiologist to see lesions hidden within the tissue and better characterize their appearance. Check to see if your imaging center offers 3D mammography, and if not, ask your doctor if you can switch to one that does.
Most states still do not require insurance coverage for supplemental screening however, these tests will likely be covered if ordered by a health provider. DenseBreast-info.org maintains a map of legislation by U.S. state and also has information for people in Europe. Talk to your doctor to see what he or she recommends if youâre concerned about breast density.
The most common options are:
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Does Having Dense Breast Tissue Affect A Womans Mammogram
Mammograms can be harder to read in women with dense breasts than in women with fatty breasts. That’s because dense breast tissue and some abnormal breast changes, such as calcifications and tumors, appear as white areas in the mammogram. As a result, mammography is less sensitive in women with dense breasts â that is, it is more likely to miss cancer. Women with dense breasts may be called back for follow-up tests more often than women with fatty breasts. Dense breasts can also put women at higher risk of interval breast cancer. This is breast cancer that is diagnosed within 12 months of a normal mammogram result.
Can I Change My Breast Density
No breast density is determined by genetics, age, menopause status and family history. Weight gain and certain medications can also influence your breast density.
Though your breast density cant be changed, information is power. Being aware of your breast density classification can help you and your doctor make informed choices about your care.
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How Common Are Dense Breasts
Nearly half of all women age 40 and older who get mammograms are found to have dense breasts. Breast density is often inherited, but other factors can influence it. Factors associated with lower breast density include increasing age, having children, and using tamoxifen. Factors associated with higher breast density include using postmenopausal hormone replacement therapy and having a low body mass index.
If All Of These Tests Are Covered By Insurance In Illinois Which One Should I Get
In this era of personalized medicine, we have all these amazing tools and we want to pick the right one for you. Talk to your radiologist about what would be the most appropriate test for you and your risk status. If you already have documented dense breast tissue on a prior mammogram, you should consider getting a 3D mammogram on your next screening mammogram and perhaps supplement it with a whole breast ultrasound or breast MRI. The key is to understand your risks and know that there are tools to perform the correct test for you.
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Dense Breasts Are Normal
So if you got the letter saying that your breasts were dense, don’t freak out. You are normal. If you’re at high risk for breast cancer, talk with your doctor and maybe another imaging technique would be right for you. And you can check out the website areyoudense.org and that can explain a little, and you can celebrate the fact that you still have young breasts. At least on mammogram.
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