Dense breast tissue is a common finding detected on a mammogram. It refers to the way breast tissue looks on a mammogram. If a recent mammogram showed you have dense breast tissue, you may wonder what this means for your health. Healthcare professionals know that dense breast tissue makes breast cancer screening more difficult. It's important to review your breast cancer risk factors with your healthcare team. The breasts are made up of dense breast tissue and fatty breast tissue. Dense breast tissue includes the milk glands, milk ducts, and supportive tissue in the breast, while fatty tissue is made of fat cells. On a mammogram image, the fatty breast tissue is transparent, making it easy to see through, while the dense breast tissue looks solid white and is harder to see through. The only way to know if you have dense breast tissue is to have a mammogram.
Understanding Breast Density
The healthcare professional who looks at your mammogram images decides whether you have dense breast tissue. This health professional is typically a radiologist. Radiologists are doctors with special training to interpret the images from an exam. The radiologist compares the amount of fatty tissue to dense tissue. Then the radiologist decides the level of breast density. Levels of density are described using the American College of Radiology's Breast Imaging Reporting and Data System, which is sometimes shortened to BI-RADS. The levels of density are often included in a mammogram report using letters:
- A: Almost entirely fatty means that the breasts are almost entirely made up of fatty tissue.
- B: Scattered areas of fibroglandular density means the breasts are mostly made up of fatty tissue.
- C: Heterogeneously dense means that most of the breast tissue is dense breast tissue.
- D: Extremely dense means that nearly all of the breast tissue is dense breast tissue.
In general, you're considered to have dense breasts if your mammogram report says you have heterogeneously dense or extremely dense breasts. Factors associated with dense breast tissue include being younger, as breast tissue tends to become less dense as you get older (though this doesn't happen in everyone), having a lower body mass index, and taking hormone therapy for menopause.
Risks Associated with Dense Breast Tissue
Dense breast tissue is a common finding. It doesn't mean there's something wrong. However, it:
- Increases the chance that breast cancer might be missed on a mammogram: Dense breast tissue is harder to see through on a mammogram image.
- Increases the risk of breast cancer: If you have dense breasts, your risk of breast cancer is modestly higher than someone who doesn't have dense breasts. The level of risk is thought to be similar to the risk of breast cancer in someone who has a relative who had the disease. On its own, having dense breast tissue doesn't give you a high risk of breast cancer.
Screening Options for Dense Breasts
In general, healthcare professionals recommend that women with an average risk of breast cancer begin screening with mammograms at age 40. Having dense breasts can make it harder to detect cancer on a mammogram. But mammograms are still effective for breast cancer screening if you have dense breasts. Newer mammogram technology gives healthcare professionals more detailed views of breast tissue. This may help improve the chances that cancer will be detected. For instance, nearly all mammogram machines in the United States make digital pictures instead of film pictures. Additionally, most healthcare facilities in the United States offer 3D mammograms.
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Several supplemental screening options are available:
- 3D mammogram: A 3D mammogram, also called breast tomosynthesis, uses X-rays to take pictures of the breast from many angles. A computer then puts the images together.
- Breast MRI: Breast MRI uses a magnetic field and radio waves to make 3D images of the breast tissue.
- Breast ultrasound: Ultrasound uses sound waves to make images of structures in the body. It shows the difference between solid masses and sacs filled with fluid, called cysts. Solid masses may be a sign of cancer.
- Contrast-enhanced digital mammogram: A contrast-enhanced digital mammogram uses contrast material that contains iodine. The contrast material can highlight possible areas of concern on a mammogram. The contrast material goes into a vein in your arm. You wait a few minutes for the contrast to reach the breast tissue.
- Molecular breast imaging: Molecular breast imaging uses a radioactive tracer and a special camera to make pictures of the breast tissue. The tracer has special material in it to help find areas that may have cancer.
There's some evidence that additional tests, such as ultrasound and MRI, may make it more likely that breast cancer is detected in dense breasts. There also is concern that tests such as ultrasound and MRI may find things that need additional testing but are later found to not be cancer. This is called a false-positive result. More research is needed to know which test is best. Every test has pros and cons. Talk about the options with your healthcare team.
Dietary Recommendations for Managing Dense Breast Tissue
While fat content in what you eat and exercise do not directly change breast density, research suggests that certain foods may influence breast cancer risk and potentially breast density. However, if you lose or gain a lot of weight, your breasts can look more or less dense on your mammogram - though the amount of dense tissue will stay the same. This is because if you gain weight, there will be more fatty tissue (non-dense) in your breasts. If you lose weight, you will lose fatty tissue from your breasts.
Foods to Include in Your Diet
- Leafy Green Vegetables: Kale, arugula, spinach, mustard greens, and chard contain carotenoid antioxidants, including beta-carotene, lutein, and zeaxanthin. Higher blood levels of these antioxidants are associated with reduced breast cancer risk. These vegetables also contain folate, a B vitamin that may help protect against breast cancer.
- Cruciferous Vegetables: Cauliflower, cabbage, and broccoli contain glucosinolate compounds, which your body can convert into molecules called isothiocyanates, which have significant anticancer potential.
- Allium Vegetables: Garlic, onions, and leeks boast an array of nutrients, including organosulfur compounds, flavonoid antioxidants, and vitamin C, which may have powerful anticancer properties.
- Citrus Fruits: Oranges, grapefruits, lemons, limes, and tangerines are teeming with compounds that may protect against breast cancer, including folate, vitamin C, carotenoids, and flavonoid antioxidants.
- Berries: Antioxidants in berries, including flavonoids and anthocyanins, have been shown to protect against cellular damage and the development and spread of cancer cells.
- Peaches, Apples, Pears, and Grapes: These fruits have been shown to safeguard against breast cancer.
- Fatty Fish: Salmon, sardines, and mackerel are known for their impressive health benefits. Their omega-3 fats, selenium, and antioxidants like astaxanthin may protect against cancer.
- Fermented Foods: Yogurt, kimchi, miso, and sauerkraut contain probiotics and other nutrients that may safeguard against breast cancer.
- Beans: Beans are loaded with fiber, vitamins, and minerals. Specifically, their high fiber content may protect against breast cancer.
- Herbs and Spices: Herbs and spices contain plant compounds that may help protect against breast cancer. These include vitamins, fatty acids, and polyphenol antioxidants.
- Whole Grains: Wheat, brown rice, barley, quinoa, and rye are rich in important nutrients, including fiber, vitamins, minerals, and antioxidants, and may possess powerful cancer-fighting properties.
- Walnuts: Walnuts have many benefits and are a great source of heart-healthy fats, including alpha-linolenic acid. Some research suggests that adding walnuts and other types of nuts to your diet could even help protect against breast cancer.
- Olive Oil: Olive oil may also be useful in reducing breast cancer risk.
Foods to Limit or Avoid
- Alcohol: Alcohol use, especially heavy drinking, may significantly increase your risk of breast cancer.
- Fast Food: Eating fast food regularly has many downsides, including an increased risk of heart disease, diabetes, obesity, and breast cancer.
- Fried Foods: Research shows that a diet high in fried foods may significantly increase your risk of breast cancer.
- Processed Meats: Processed meats like bacon and sausage may raise your risk of breast cancer.
- Added Sugar: A diet high in added sugar may significantly raise your risk of breast cancer by increasing inflammation and the expression of certain enzymes related to cancer growth and spread.
- Refined Carbs: Diets high in refined carbs may increase breast cancer risk.
Additional Considerations
- Vitamin D: Women who are low on vitamin D and dietary calcium are at higher risk for developing breast cancer. Vitamin D is what helps your body absorb calcium to support strong bone health and both nutrients may be directly tied to stopping breast cancer cells from growing.
- Hydration: Staying hydrated can also encourage the growth, survival, and reproduction of healthy cells in your body, which can reduce your risk of developing several cancers, including breast cancer.
Additional Factors to Consider
In addition to diet, other lifestyle choices may affect your cancer risk. Engaging in regular exercise, getting enough rest, and avoiding smoking offer significant protection against breast cancer. Maintaining a moderate body weight may also help reduce your risk. Furthermore, some research suggests that certain skin care products may increase breast cancer risk.
The Importance of Regular Screenings
Time and menopause are the only things that can significantly reduce breast density, but by following dietary and lifestyle tips, you can help decrease your overall risk of breast cancer. Keep in mind, however, that even those at lower risk are not exempt from the ever-present disease that has taken so many lives. By getting a breast cancer screening regularly, you can have a better chance of catching any issues early, while they’re easier to treat.
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