From cysts to size, here's what you need to know about keeping your breasts healthy.
1. All lumps are not created equal
If you've ever felt a lump or bump in your breast, you'll know the sick feeling it can instantly cause in the pit of your stomach. But don't panic yet: There are lots of things it could be besides breast cancer. "Very often I will see premenopausal women with palpable breast masses that turn out to be cysts or benign [noncancerous] lumps called fibroadenomas," says Melinda Wu, a family physician with Women's College Hospital in Toronto who has worked at both the Henrietta Banting Breast Centre and the Princess Margaret Hospital Breast Clinic.
If the lump is suspicious, your doctor will typically do a clinical exam and order a diagnostic mammogram and ultrasound. Sometimes lumps require biopsies, but 80 percent of biopsied lumps turn out to be benign, explains Wu. That doesn't mean you shouldn't be mindful; get to know your breasts and have any lumps checked out. According to the Breast Cancer Society of Canada, breast cancer affects one in nine women, with 23,800 women estimated to be diagnosed in 2013. And the risk increases as you age.
2. Get the 411 on cysts
Breast cysts (fluid-filled sacs) are exceedingly common in premenopausal women in the 35 to 50 age group. While cysts aren't linked to an increased risk of breast cancer, if you have a complicated cyst (one that has a solid component to it), your doc should monitor it using ultrasounds to ensure the size remains stable – especially if you are postmenopausal. Also, remember that cysts tend to grow in size and tenderness leading up to your period as your hormone levels fluctuate.
3. Breast pain is usually normal
"Lots of women come to us about breast pain, and we often don't know what causes it," says Wu. "But we do know that breast pain is not a marker for breast cancer." For some people, pain is caused by deep breast cysts. Of course, if the pain is persistent, you should see your family doctor to make sure it's nothing more serious. Lifestyle changes such as limiting alcohol, increasing water intake, exercising regularly and wearing aproperly fitted bracan all help with breast pain, says Wu.
4. Your breasts will change with age
To add insult to aging, as you get older your breasts become less dense and more fatty. But there's a positive side to this: The reduced density makes it easier to spot any problems on a mammogram. "The reasons we generally don't do mammograms in young women are because the incidence of breast cancer is very low in this population and because breast tissue is dense and mostly glandular as it's preparing for breast-feeding," explains Dr. May Lynn Quan, an associate professor of surgery and oncology at the University of Calgary and the surgical lead for the Alberta Health Services Calgary Breast Health Program. Mammograms are X-rays, she says, so they pick up things that are dense, such as bones, glandular tissue and tumours.
When should you start getting screened? For the average woman without a family history or risk factors for breast cancer, Wu recommends having a mammogram every two years, starting at age 50; at 40, have a discussion with your family doctor about breast screening. (Risk factors include having certain kinds of noncancerous breast lumps, starting menstruation before age 12 and menopause later than 55, smoking, drinking excessively, and never having children or having children after 30.) Take note: It's important to go to the same mammogram centre each time so your results can be compared with your previous screenings, says Wu.
5. You can't really change your breast size
Despite Frenchy's comical attempts in Grease to make her breasts bigger with exercise, it doesn't work that way. Breasts are not muscular; they're organs with connective tissue that fits together to make their infrastructure. When you do muscle training, you are targeting your pectoral muscles, which lie underneath your breasts. Your natural breast size is not based purely on your mom's bustiness, says Wu. There is a reliable breast size pattern, but it doesn't necessarily come from one side of the family, she says. Multiple factors affect how big your breasts become (not to mention weight fluctuations and pregnancy, which can make them more pendulous and elongated). And if your breasts aren't perfectly symmetrical, you're definitely not alone. "It's just how you are made," says Wu. It's common to have one breast or nipple that is larger or otherwise different; it's only an issue if the asymmetry has developed recently. If one of your breasts is hot or swollen, see a doctor ASAP.
6. Your breasts have a tail
OK, so they don't have an actual tail, but the tissue that leads into your armpit in a teardrop shape is called a "breast tail." Women tend to have a lot of dense tissue in the upper outer quadrants of their breasts. It carries up into the armpits, near some of the lymph nodes, which are a separate entity from your breasts. However, just as the lymph nodes in your neck can swell when you have a sore throat, the ones in your armpits can swell if there is a problem with your breasts, says Wu, so pay attention to any swelling there that doesn't dissipate.
7. You may have a third nipple
All joking aside, doctors do see this from time to time. These extramammary nipples are not uncommon and may or may not be connected to your milk ducts. You may not even know you have one, because it won't necessarily look like a nipple; people often think it's a mole, explains Wu. Picture the milk line on the underside of a cat; you can look for them in the same area on your own torso, as well as in your armpits.
8. Cancer is not all in your genes
While Angelina Jolie may have had a high breast cancer risk due to the BRCA1 gene, "most women who walk through my door have no risk factors besides being a woman and being postmenopausal," says Quan. "Twenty-five percent of women will have a family history of some sort, and only five to 10 percent of women will have breast cancer because of a gene mutation." If multiple people on both sides of your family have had breast cancer, you can seek counselling from a genetic specialist to figure out your next steps.
9. Your weight affects your overall breast health
Staying in shape isn't just about fitting into your skinny jeans. Maintaining a low amount of abdominal fat is key for cancer survivors and women who are at high risk for developing breast cancer, says Wu. "People tend to make estrogen from abdominal fat, and the ovaries stop producing estrogen through menopause," says Wu. "A higher weight means more estrogen, which can lead to more lumps and bumps." She recommends decreasing your overall BMI, and Quan agrees. "For women who have had cancer, the one thing we know is that weight gain has been associated with higher rates of recurrence," she says. If that's not motivation to hit the gym, we don't know what is.
10. Nipples can be a key breast health indicator
Think of your breasts like inverted trees, says Quan, with multiple ducts branching from your nipples. The key function of your breasts is to make milk, so some discharge can be normal. If you have discharge coming out of only one duct in one breast, it means it's coming from a specific duct on the tree – which can be concerning, says Quan. "We worry when nipple discharge is only on one side, if it's bloody, if it happens on its own (without squeezing), if there is a family history of breast cancer or if there's a palpable lump," says Wu. Also, if one nipple suddenly inverts or you have a rash around the areola, get it checked out, as these can be indicative of cancer.
Planning a picnic or family barbecue anytime soon? Give yourself one less thing to worry about and go for one of our easy pasta salad recipes. It's sure to be a hit!
Pasta salads are great to make ahead, and are absolute tops for large groups. They also take the cake for being an extremely versatile dish – with a host of added ingredients, toppings and dressings, simple pasta salads can go from humble side to star entrée in no time.
We asked Test Kitchen food specialist Amanda Barnier to share some top tips for preparing pasta salads, and why they're a crowd favourite. Here's what she had to share:
Pasta salads: the perfect make-ahead dish
"Pasta salads can easily be prepped in advance and can feed a crowd with little effort," Amanda says. "It can be made in advance and cooled immediately after cooking."
One important tip to remember, she adds, is to "add dressing the day it's being served, because it will quickly absorb the dressing."
Pasta salad favourites
"I like using cheese filled tortellini for a hearty salad. Soba and rice noodles are great with Asian dressings, whole grain and coloured pastas," Amanda says.
How to store pasta salads
"Keep salads well wrapped and refrigerated," she says. "Salad has the same storage life as its ingredients. Seafood is best eaten within 2 days, and chicken (within) 2 to 3 days. If traveling, be sure to store pasta salads in coolers packed with lots of ice."
"Proteins should not be within 4 C and 60 C for longer than a four hour period," she adds.
The long and short of it: best pasta shapes
"Short shapes are best with vinaigrettes and creamy dressings, and chunky ingredients such as chopped vegetables and beans," Amanda says.
"Long pasta shapes are better used with thinly sliced vegetables, proteins, herbs, spices and vinaigrettes."
Tips for making pasta salad
"If making a pasta salad in advance, rinse with cold water to stop the cooking process and drain well," she advises. "Add dressing just prior to serving. Pasta quickly absorbs liquids; if the dressing is added too soon, the pasta will absorb it."
So whether you prefer chunky pasta salads with a cool, creamy dressing perfect for summer picnics, or entrée-worthy pasta salads with long rice noodles and a tangy vinaigrette, you're sure to find a new favourite with from our collection.
Mediterranean Orzo Salad
This salad highlights many fresh flavours of the Mediterranean and is at its best when made with good-quality olive oil.
Photography by Jeff Coulson
The Best Macaroni Salad
This is a great keeper salad and perfect for a picnic or BBQ. Just make sure you pack it with plenty of ice packs to keep it nice and cold, both during transportation and at the table.
Photography by Annabelle Waugh
Chicken, Broccoli and Bocconcini Pasta Salad
Make this pasta salad for the whole family—the kids will love the mild dressing and round bocconcini cheese, while the adults will appreciate it as a light alternative to a sandwich.
Warm Roasted Red Pepper Pasta Salad
The dressing lends a taste of summer any time of year. The red peppers provide vitamins A and C and potassium. Quick and easy to make, this salad is perfect to take to a last-minute potluck or picnic.
Tuna Pasta Salad
Using tuna packed in both oil and broth means you'll need less oil in the dressing.
Salmon Pasta Salad
Start with melon wedges to whet your appetite for this quick and light dinner.
Grilled Vegetable Pasta Salad
Grilled market-fresh veggies meet marinated olives and artichokes in this healthy dish made with whole wheat rotini. So chock full with taste and texture, carnivores won't complain about this vegetarian dish.
Breaking up is hard to do. It's even harder if you still love and respect the person who you've grown apart from.
In these long-term relationships, you likely don't want to leave your partner high and dry (especially if you're living together), but you want to be able to have a clear break so you can both move forward on good terms.
1. Bite the bullet: "Usually when a person has gotten to the point of wanting to end a relationship, the other person can sense that the relationship is in trouble. If your partner is extremely surprised, it means that you havent done a good job explaining your feelings all along," says Dr. Seth. Be communicative with your partner. Let them know that you are having doubts, express your concerns and don't let things linger. In a long-term relationship, you have had time to clearly assess whether your relationship has room to grow. If you feel it doesn't, let your partner know sooner rather than later.
2. Choose your timing wisely: Many people are reluctant to break up with their partner in person, and choose to do so in writing, whether that be via a letter, email or (sadly) text message. This could be to give their partner time to let the break up sink in before having to see them in person or to be able to explain themselves without being interrupted or guilted into staying. Dr. Seth recommends giving your partner the respect to have a discussion in person, but being mindful of the timing. "Get into the discussion when your partner isnt already stressed and has time to process the issue. If he has a meeting in an hour or has to go to work, wait until he has plenty of time to deal with the breakup when you finally broach the issue," says Dr. Seth.
3. Be assertive: "Acknowledge that the relationship hasn't been working out for you for a while, and say clearly that you want to end the relationship," says Dr. Seth, adding "Dont make any promises about staying friends or wanting to see each other, because time will tell what kind of relationship you want."
4. Discuss logistics as a team: If you're still living together, it's both of your responsibility to figure out the next steps. "You may be the one who makes the decision to end the relationship, but you need to make all the logistical decisions together," says Dr. Seth. "If one member of the couple wants to end it but the other does not, the initiator of the breakup should offer to make certain sacrifices: moving out and letting the other person keep the place they shared; giving the other person plane tickets that were purchased a while ago for a future vacation," says Dr. Seth in regards to the trickier logistics that have to be figured out. "It is the kindest practice for you to make certain sacrifices if you are the one ending the relationship, so offer to move out or pay any early lease termination fees," says Dr. Seth. It's a small price to pay to have piece of mind and peace between the two of you, despite coming to an end.
5. Online 'decoupling': Couples should have a discussion about how to handle social media awkwardness when they break up. They can send a mass email to friends announcing the breakup but most couples feel more comfortable to let people know as the situation presents itself. I find that remaining friends on social media post-breakup makes the adjustment to singledom more difficult, so couples should consider unfriending each other at least for the first few months when emotions tend to run high.
6. Handling friends and families post breakup questions: If the two of you were together for a while, its not just the two of you who will experience a breakup. "Family members and friends also became attached to you and your partner, so a loss is felt on many levels. When you break up, ask the other person whether its okay to stay in touch with any of his or friends or family you grew to care about," says Dr. Seth. By doing so you're both making the other aware of your boundaries, and can work within them to ensure no one is upset.
Here are some scary truths: 70 percent of new Alzheimer's patients in Canada will be women, and we're diagnosed with depression and dementia at twice the rate of men. But new research says there are three simple lifestyle changes we can make right now to keep our brains healthy as we age.
You brush your teeth to prevent tooth decay and check your blood pressure to monitor for signs of heart problems. But are you doing anything to keep your brain in tip-top shape? Because you should be. Brain health, which experts define as a combination of cognitive (memory, attention, thinking) and mental (emotional well-being) fitness, is a major, albeit under-the- radar, health issue for Canadian women.
It's major because as we age, so do our brains. Vascular changes can decrease blood flow; we can lose volume in key areas, including the hippocampus and the prefrontal cortex, the regions responsible for learning and memory. Myelin, a fatty material that makes up the protective coating around nerve fibres, starts to deteriorate, causing the brain to slow down. And nerve cells can develop plaques and tangles— structures caused by the buildup of proteins called beta-amyloids that can disrupt the brain's normal function. In some people, these and other signs of normal aging can cause mental health problems, strokes and brain disorders such as dementia and Alzheimer's, and increase the risk of diseases such as multiple sclerosis.
Brain health is an under-the-radar issue because, though women are more likely to experience cognitive decline (thanks to dementia or Alzheimer's) and to suffer from depression, most of the research on these conditions still focuses on men.
Thankfully, studies are showing that straightforward lifestyle changes—exercising regularly and not smoking are at the top of the list—help shore up what researchers call "cognitive reserve," a buffer that "delays the changes or makes your body better equipped to handle those changes," says Lauren Drogos, a brain researcher at the University of Calgary.
In fact, Drogos says there's evidence to show that, in some people, even serious symptoms do not necessarily develop into cognitive impairment. She points to the Nun Study, a famous long-running research project on aging and Alzheimer's that has been tracking 678 nuns from convents across the United States since the mid-1980s. One of the nuns, Sister Mary, died at the age of 101 showing no outward signs of cognitive decline—but when researchers examined her brain, they were shocked to find she had "abundant neurofibrillary tangles and senile plaques, the classic lesions of Alzheimer's disease." Scientists don't know exactly why some people can have severe symptoms, such as plaques and tangles, without experiencing cognitive decline, but, happily, cases like Sister Mary do show that dementia isn't an inevitable part of aging.
And since women are more likely than men to be diagnosed with many of these problems, the more we consider brain health when making our day-to-day lifestyle decisions, the better. (Bonus: These changes also benefit your heart and help prevent other diseases, including Type 2 diabetes and cancer.) So here's what you can do to take care of your brain.
This is your brain on exercise If you had to pick just one lifestyle change to make in the name of brain health, experts agree exercise tops the list—especially for women.
We consider neuroplasticity, the brain's capacity to form new neural connections, an exciting part of a child's development, but we now know our brains can continue to grow, repair and improve as adults, too. Physical activity is a well-researched trigger. Not only can working out bolster our day-to-day functioning and alertness but it also appears to help us repair brain damage. Plus, it slows down aging and the onset of age-related brain diseases.
Working up a sweat and pumping up your heart rate can lead to a healthier vascular system in the brain, which decreases blood pressure and oxidative stress (when your body's antioxidants can't fight off free radicals), and increases antioxidant activity, according to Marc Poulin, an Alzheimer's researcher and professor of physiology at the University of Calgary. Vigorous exercise also floods the bloodstream with a protein called brain-derived neurotrophic factor, which readies the body for repair and heightens the brain's ability to learn and form new memories. Plus, hitting the gym helps the brain repair myelin; a lack of the nerve fibre–protecting substance is a factor in developing multiple sclerosis.
Exercising can also restore crucial brain volume. Research has shown that the hippocampus— home to memory, learning and emotion—starts shrinking after age 55 by about one to two percent a year, but just one year of moderate-intensity aerobic exercise done three days a week can increase its size by two percent.
And while most of the research is about the benefits of getting in your cardio, Dr. Teresa Liu-Ambrose, an associate professor and Canada research chair at The University of British Columbia and the Vancouver Coastal Health Research Institute, says strength training is also effective, as it can enhance brain performance and function by 11 to 17 percent. "Women live longer [than men], and age itself is the greatest risk factor for dementia," she says. "But the good news is when we look at the benefit of aerobic exercise on cognition in older adults, women seem to benefit more."
The takeaway: You can reap the rewards from even a 15-minute walk. Of course, the longer you exercise, the better, especially if you get your sweat on and your heart rate up. If you want to tick a few other brain health tips off your list, consider joining a team sport. It blends physical, social and cognitive skills, and "can also add pleasure and meaning to our lives," says Dr. Nasreen Khatri, a registered clinical psychologist, gerontologist and neuroscientist at the Rotman Research Institute at Baycrest Health Sciences in Toronto.
If you have an office job and find you're sedentary most of the day, take a few minutes every hour or so to get up and move around. Research also suggests switching to a standup desk may improve your brain function.
Did you know? Taking care of a loved one—most often a spouse in your later years—can be a risk factor for developing depression and, eventually, dementia . But research out of the Rotman Research Institute at Baycrest Health Sciences in Toronto found, for the first time, that cognitive behavioural therapy, a form of talk therapy, can improve both mood and cognition.
This is your brain on sleep After a good night's sleep, you feel alert and ready to tackle the day. But that's not just because your brain has been resting. It has also been busy filing away memories and taking out the trash, so to speak, thanks to the glymphatic system, which washes the brain of waste materials. For example, a protein called betaamyloid, which is known to play a role in the development of Alzheimer's, acts as a neurotoxin when it builds up, killing neural cells in the brain. But a good sleep removes excess beta-amyloid and other waste materials, says Dr. Liu-Ambrose.
Because one of the common symptoms of Alzheimer's is disrupted sleep, it's unclear whether a lack of shut-eye should be considered part of the progression of the disease or a risk factor on its own, due to the buildup of beta-amyloids.
Nevertheless, poor sleep hastens your brain's aging process—much like sitting in the sun sans SPF speeds up your skin's aging process. And disturbed sleeping has been linked to all aspects of brain health, including an increased risk of depression and a decline in cognitive functions such as memory and reasoning. In one U.K. study out of University College London Medical School, middle-aged women who reported a drop in the average number of hours they slept had lower scores on cognitive tests involving reasoning and vocabulary.
What's more, our central clocks—a.k.a. our circadian rhythms—can drift from the patterns of our childhood, making it hard to get that much-needed rest. "As we age, our central clock is less sensitive to stimuli like light, food and physical activity," says Dr. Liu-Ambrose; this change makes it harder to fall, and stay, asleep. We can also become more vulnerable to stress and anxiety, which further disrupt those rhythms.
One way to combat these fluctuations is to try what seasoned travellers do for jet-lag recovery: Get exposure to real daylight and eat your meals on time to nudge your brain into a routine. And don't use bright screens at night, especially before bed, because they mimic sunlight and tell our circadian system that it's day, not night—and, therefore, not time to sleep. Those who need more help might consider light therapies that have been developed to treat seasonal affective disorder, says Dr. Liu-Ambrose.
The takeaway: Many researchers consider six to eight hours of sleep a night to be the standard sweet spot, though this can vary by individual. If you're routinely getting less than that and waking often in the night, not feeling refreshed in the morning and experiencing bouts of sleepiness during the day, talk to your doctor about sleep strategies—especially if you're experiencing anxiety or depression. In the short term, napping can reverse some of the effects of poor sleep, including memory loss and increased stress. And you only need a 30-minute catnap to feel the results.
This is your brain on a healthy diet There's no perfect "brain food," but eating a nutritious diet (lots of veggies and fruit, lean meat, fish and healthy fats) is the smartest way to maintain long-term brain function and memory, and to slow the development of brain diseases.
Getting enough of specific nutrients like omega-3 fatty acids is important but not the holy grail. University of Pittsburgh researchers recently found that people who eat broiled or baked fish at least once a week have larger brain volumes in the areas used for memory and cognition, despite varying levels of omega-3 in the fish they ate. Senior researcher James Becker concluded that he and his colleagues were "tapping into a more general set of lifestyle factors that were affecting brain health, of which diet is just one part."
In a 2015 study from Rush University Medical Center in Chicago, researchers looked at the broad set of eating habits of more than 900 people over 4 1/2 years and found that those who adhered to a diet high in fish, vegetables, nuts and berries, and low in fat and sugar, slowed down their brains' aging by about 7 1/2 years when compared to those with less-healthy diets. The healthy eaters cut their risk of Alzheimer's by up to 53 percent. And even when those people only adhered to the diet part time, they saw some benefits— an effect that has not been found in other diets, says Drogos.
The researchers dubbed the most promising cluster of these eating habits the MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diet, which blends the longevity-boosting Mediterranean diet and the heart-healthy low-fat DASH (Dietary Approaches to Stop Hypertension) diet that doctors recommend to patients at risk of high blood pressure and heart disease. More studies need to be done on why it works, but in the meantime, there's no downside to eating healthier and ditching the junk.
The takeaway: Add more veggies to your diet. Research shows that older adults who report eating more of this food group perform better in mentally stimulating activities than those who don't.
Did you know? "Menopause brain" is a real thing. As with "pregnancy brain," its more famous counterpart, women approaching menopause really do experience memory problems and brain fog. Researchers think a drop in estrogen levels might be the cause.
Can you train your brain? Does firing up a brain-training app actually help improve your memory and ward off dementia? Sorry to disappoint, but right now, evidence for the benefits of computer-based brain games is weak, says Dr. Teresa Liu-Ambrose, an associate professor and Canada research chair at The University of British Columbia and the Vancouver Coastal HealthResearch Institute. Brain games appear to help you learn to play them better, but research doesn't show that those tasks transfer to other aspects of brain performance. The same goes for crossword puzzles and sudoku, which help your vocabulary and math skills, but nothing more.
How to maintain your mental edge at any age
In your 30s: This is the time to make sure you establish healthy habits—such as getting plenty of exercise and sleep, and eating a good diet—that will affect your brain health throughout your adult years. "When it comes to maintaining brain health, the best time to start is yesterday," says Dr. Nasreen Khatri, a registered clinical psychologist, gerontologist and neuroscientist at the Rotman Research Institute at Baycrest Health Sciences in Toronto. If you feel you need a boost at work, consider old-fashioned writing instead of typing on your computer. A study in the journal Psychological Science found that university students who made handwritten notes were better equipped to recall conceptual ideas from their professors' lectures than those who had typed notes on their laptops.
In your 40s and 50s: People in this age group are part of the "sandwich generation," and often face caring for their aging parents on top of dealing with their other work, financial and parenting obligations. So, unsurprisingly, they're super stressed—and this can affect both mental health and day-to-day brain function. Dr. Khatri says it's essential to prioritize and edit out activities and commitments that increase stress without adding value to your productivity or happiness. That's because "maintaining mental health in early and mid life is key to safeguarding cognitive health later on," she says. "Untreated depression in midlife doubles your risk of developing dementia in later life."
In your 60s and beyond: In your senior years, socializing with friends and family, and picking up activities that allow you to connect, such as volunteering, are key to maintaining brain health. And sorry, keeping up with folks on Facebook isn't enough. "Ask yourself: Is social media rounding out my real-life social experiences?" suggests Dr. Khatri. What you need is face-to-face interaction.