What women need to know about dense breasts Image by: svetikd
Having dense breasts increases your breast cancer risk and makes tumours harder to find. Doctors explain the puzzle behind this common condition.
Just when you thought you were up to speed on breast cancer risk factors, a new game changer has physicians and clinicians talking: dense breasts. Misunderstood and often incorrectly associated with bumpy, hard or occasionally sore breasts, dense tissue is more worrisome than you think.
What are dense breasts?
Your breasts are comprised of three types of tissue: fat, epithelium (the glands and ducts that produce milk) and stroma (supporting tissue). Breasts with a higher ratio of epithelium and stroma to fat are considered dense. According to Dr. Norman Boyd, senior scientist at the Campbell Family Cancer Research Institute at the Princess Margaret Cancer Centre in Toronto, women with dense breasts have this tissue ratio for the majority of their adult lives. "The tissue develops in adolescence when the breasts form," he says. "Past the age of 40, it gradually decreases and is replaced by fat on average by about one percent every year." Once a woman reaches menopause, that natural decrease in density jumps to eight percent on average; however, some women still have dense breasts into their 60s and beyond.
Breast density is quite common. "It’s been estimated that approximately 50 percent of women have heterogeneously dense and/or extremely dense breast tissue," says Dr. Christine Wilson, medical director of the screening mammography program at the BC Cancer Agency. Risk factors that influence density include genetics (Dr. Boyd says that 60 percent of breast density variation can be ex plained by genes), delayed childbearing, combined estrogen/progesterone hormone replacement therapy (HRT) and a family history of breast cancer.
Dense breasts cannot be diagnosed by touch, appearance or symptoms of dis comfort. "Some women have really firm breasts that suggest that they may be dense, but we don’t know for sure until their breasts are viewed with mammography," says Dr. Ruth Heisey, chief of the department of family and community medicine at Women’s College Hospital and a GP oncologist specializing in breast diseases at Toronto’s Princess Margaret Hospital. A clinician who spots what appears to be excessive density during screening mammography may call you back for further examination if it is also accompanied by symptoms such as a lump or pain. "We don’t want to miss something that we can’t see on the mammogram," says Dr. Wilson. Each province and territory operates under different protocols. Most centres may follow up with a breast ultrasound, while some will turn to magnetic resonance imaging (MRI) to rule out hidden cancers. If they’re following current mammography guidelines in Canada, many women won’t know that they have this problem until they go for their first mammogram at age 50.
Surprising health risks
If healthy breasts can be bumpy and hard, why does excessive density matter? There are several reasons. "Women with density of 75 percent or more of the breast have a risk of breast cancer that is four or five times higher than that of women of the same age who have little or no density," says Dr. Boyd. "And breast density is a much stronger risk factor than family history of breast cancer, which is twice that of women without a family history." The only factor that’s a larger risk for breast cancer is if you carry the BRCA1 or BRCA2 gene.
Not only does density increase your risk, but it makes tumours more difficult to spot. Mammography X-rays can easily pass through fat, but have difficulty penetrating dense epithelium tissue. To the trained clinician examining the mammogram, dense tissue and tumours both appear white on the X-ray, making it tricky to differentiate between healthy and cancerous breast tissue.
There are currently two proven strategies to reduce density. "If somebody is taking combined HRT featuring both estrogen and progesterone, density will lessen slightly if she stops it," says Dr. Boyd. "The other strategy is the drug tamoxifen, which can reduce density, but it can increase the risk of blood clots going to the lungs, so it’s not something that everyone wants to take." Not all women with dense breasts can take advantage of these two strategies, so research is ongoing to uncover alternative solutions.
Dr. Caroline Diorio, an assistant professor in the department of social and preventative medicine at Université Laval in Quebec, is currently researching ways that lifestyle changes can alter breast density. Her latest study, published in June and funded by grants from the Canadian Breast Cancer Research Alliance, found an association between high-sugar diets and increased breast density in pre- and postmenopausal women. "I cannot say that [sugar] is causing an increase in breast density, but women who eat more sweet foods seem to have a higher density than women who eat less," she says. "I believe if we change our habits, we can reduce our density, but we need more studies to prove it."
Dr. Diorio also published a study in January on the consumption of omega-3 fatty acids. "My study suggests that post- menopausal women who consumed higher intake of long-chain omega-3 fatty acids, found mostly in fish, had less dense breasts." Her 2005 study also showed an association between an increased intake of vitamin D and calcium, and lower density readings in premenopausal women. While these findings are encouraging, more research is needed to confirm results and provide guidance on how to adopt these lifestyle changes.
Making proactive changes could reduce your risk of breast cancer "Maintaining a healthy weight, drinking no more than one alcoholic drink per day on average, taking 1,000 IU of vitamin D daily, and exercising regularly have been shown to be effective in reducing breast cancer risk," says Dr. Heisey.
While the chances of cancer are greater for women with dense breasts, it doesn’t guarantee you will develop the disease. "I view it like knowing that you have relatives with breast cancer," says Dr. Boyd. "There’s nothing you can do to change your relatives, but what does that knowledge do? It may increase your awareness, so if anything changes in the breast, you’re more likely to have it investigated, by medical experts at and it may encourage you to take steps to reduce your risk."
Salt and Pepper Steak Rub
Photography by Ryan Brook Image by: Salt and Pepper Steak Rub <br /> Photography by Ryan Brook
Infused water Source: Ryan Brook
Weight loss goals can seem insurmountable. To lose each pound of fat, you need to cut 3,500 calories, and that number can sound scary. But taking little steps to cut just 100 or 200 calories at a time goes a long way. Use two of these tips each day and you'll lose a pound in a little over a week—no starvation necessary.
We all know about the dangers of soda, but even drinking unsweetened juice will give you a sugar rush at a rate of 120 calories per cup. And chances are you don't just drink a cup. Individual serving-size bottles of juice are typically about 450 mL, and can clock in at over 200 calories. But if you're a juice drinker, it can be hard to switch to water right away. Try muddling some watermelon and mint into your water to get all kinds of flavour, and a touch of sweetness, for almost no calories. Or make iced tea using a fruity flavoured tea, and skip the sugar.
Who doesn't love pasta? But when your fettuccine comes with around 400 calories in two cups (even before the sauce!), you can feel guilty about eating it. Try replacing half the pasta with a cup of zucchini that's been cut into thin strips to match the shape of the pasta. Just throw it in the water a couple of minutes before the noodles are done. You'll still get the flavour and texture of the pasta that you crave, but with almost half the calories, because that cup of zucchini has just 30 calories.
Did you know that half a cup of barbeque sauce can contain about 250 calories? If you're someone who uses sauces liberally, this could be a big source of extra calories for you. Instead, give your meats a spice rub, which contains virtually no calories. And keep an eye on stir-fry sauces, such as teriyaki. You can often get a lot of flavour using spices (think fresh ginger, garlic and herbs) and little soy sauce, instead of using a rich sugar-filled sauce.
According to a study from the New England Journal of Medicine, potato chips are in fact the biggest contributor to obesity. In a study that found Americans gain about a pound a year, chips were the biggest cause of that weight gain. Though a serving might have about 160 calories, chances are you eat at least two to three times that. Instead, bake a cup of kale mixed with a teaspoon of oil and a bit of salt to make your own kale chips. For about 70 calories, you'll get a much more nutrient-dense snack that won't make you pack on the pounds.
If you haven't yet heard of cauliflower rice, you're missing out. This simple recipe is the perfect low-calorie replacement for white rice, which will set you back about 250 calories. Just process cauliflower florets in a food processor or grate them with a box grater, then cook with a bit of water or oil until soft. Use it for the bed of rice below meat or fish, or on the side of a curry dish. The cauliflower mimics the texture of rice but has only about 30 calories per cup.
Hamburger buns can easily contain 200 calories or more. Instead of a bun, sandwich your burger or chicken breast with veggies that contain almost no calories. You've heard of using lettuce instead of a bun, but how about grilled portobello mushrooms? Or a tomato cut in half? If you can't give up bread entirely, try a small wrap, which should cut the calories in half. Thinking outside the bun will help you lighten up your meal.
Buying a bra when you're a C cup or larger doesn't have to be a nightmare if you know what brands cater to your ample curves. Check out our list of the best bra brands for larger sizes in every price range.
Not only is Addition Elle the fashion go-to for fuller-figured women but it also offers a selection of sleek and seductive bras. The bra sizes start at 38C and go up to 44H in some styles. What better place to get a bra than a company that knows all about how to hug curves? Addition Elle Flawless T-ser bra, $55, additionelle.com.
PrimaDonna has been designing bras for bigger busts since 1865—that’s more than 150 years of experience. The brand offers sizes ranging from B-cup to J-cup, with a collection that includes padded bras, underwire, pushups and minimizers. Not only do these bras provide amazing support but PrimaDonna also uses stunning designs and materials to make you feel sexy all the time. Prima Donna "Madison" full cup bra, $145, melmira.com.
Wacoal boasts superior quality, easy wear and elegant aesthetics. Most bras are available up to a G-cup, and there’s a fantastic selection of styles. Wacoal has a diffusion line, too, for its younger clientele, called B.tempt’d, offering fun and colourful varieties. Wacoal is the parent company of Elomi and Fantasie, which are considered exceptional labels for women with a larger bust. Wacoal "Awareness" soft cup bra, $82, nordstrom.com.
There’s no surprise that French designer Chantelle has some of the most beautiful patterns and shapes for bras. The brand creates an elegant collection of lingerie that lifts, separates and minimizes, depending on your needs. In any given season, Chantelle offers 165 styles exclusively for women with DD-cup breasts and above. Chantelle "Hedona" bra, $95, lineaintima.com.
This company prides itself on being “experts in comfort,” and when it comes to wearing a bra all day, comfort is of utmost importance. With more than 100 years of experience, Glamorise has perfected the fit of bras for larger breasts. The brand is also credited for inventing the first-ever sports bra, back in 1975. Glamorise Elegance satin and lace Wonderwire bra, $75, thebay.com.
In 1948, Simone Pérèle set out to liberate the female body from girdles and corsets by fusing comfort with chic designs. Most bras in the collection are available up to a G-cup and offer extra lift, thanks to vertical seams. Simone Pérèle "Wish" full cup bra, $139, lineaintima.com.
Based out of Germany, Rosa Faia has a designated section for larger breasts. The brand has a collection of well-loved basics and fancier fashion bras, complete with smooth lace, that reach up to an H-cup. Rosa Faia guarantees comfort with an ergonomically shaped underwire that also aids in support. Rosa Faia "Aurelia" seamless underwire bra, $92, anita.com.
Founded in Europe in the late 1800s, Triumph has had continued success developing comfortable and striking bras for women with varying breast sizes. Some of the brand’s cuts go up to an H-cup. In 2015, Triumph launched its “Find the One” campaign to help women find the right bra size. The company’s website hosts a questionnaire that will help you determine if you’re wearing the wrong size. Spoiler alert: You probably are. Triumph "1860" smooth-skin underwire bra, $50, thebay.com.
One of your first bras was probably by WonderBra, and if you haven’t checked out the company since, it may be time to revisit the brand. WonderBra offers cup sizes up to a DDD and varying support levels, depending on the cut. There’s an outstanding selection of styles, ranging from simple to ornate, to fit your lifestyle and price point. Using innovative fabrics, the bras won’t scratch or poke you, either. WonderBra "W4436" Breathable T-shirt Bra, $45, wonderbra.ca.