Enjoying optimal health involves knowing your body and advocating for personalized medicine. Breast health is no exception. While breasts come in many shapes and sizes, they all carry the same tissues and function. Knowing your breast density, in particular, is essential. Some women have more fatty breasts, while others have denser breast tissue. I personally have dense breast tissue, which presents its own benefits and challenges.
What is dense breast tissue, and why does it matter? First of all, it’s not a negative! Approximately 40% of women who receive mammograms have dense breast tissue (1). Why would this be a problem? Since the 1990s, there has been an 80% increase in cancer cases. Dr. Connealy and I discuss cancer prevention in one of my latest podcast episodes. Part of prevention means knowing there are screening alternatives.
Many women over 40 receive regular breast cancer screenings. However, conventional methods come with increased radiation exposure. They also lead to false positives, unnecessary biopsies, and overtreatment. All of these cause so much unnecessary stress and anxiety. Before I delve into all that, let us establish the foundation by understanding what dense breast tissue is.
What Is Dense Breast Tissue?
Your breast tissue consists of a combination of other tissues. Of these, you have fatty tissue, fibrous tissue, and glandular tissue. The lobular and ductal cells make up the glandular tissue within the breast. This system creates and transports milk to our growing young. The fibrous tissue includes connective tissues that hold everything in place. Fatty tissue acts as a cushion and support system. The breast also contains blood vessels and lymphatic pathways (2). Those with dense breast tissue have more fibrous and glandular tissue. Different categories of tissues have unique appearances on imaging.
What determines whether you have dense breast tissue or not? Part of it has to do with the amount of estrogen in your body, particularly estradiol. Ovaries produce estradiol to support healthy reproduction. During childbearing years, your body makes more estradiol to create ductal proliferation. This simply means it creates more ductal cells to nourish your young. This is completely normal!
After menopause, however, the ovaries reduce their estradiol output. This causes the ductal and lobular glands to shrink in size. Fatty tissue helps fill the space. Women who are not on hormone replacement therapy typically have more fatty tissue. This shows up as black on their mammograms. This means they will likely have more fatty tissue and less glandular tissue.
Both glandular and fibrous tissue appear white on a mammogram. Cancer also shows up white on mammograms. This presents a challenge when screening for breast cancer. Since there is little differentiation, it’s easy to misdiagnose patients. It’s also easier to miss developing cysts or tumors. Additional tests may be required to ensure an accurate diagnosis. This is why dense breast tissue can be a risk factor for developing cancer.
Now that we’ve discussed what is dense breast tissue, let’s talk more about what causes it.
What Causes Dense Breast Tissue?
There are several factors influencing whether you have dense breast tissue or not. While genetics and age play a major role, diet and lifestyle are also a large part of the breast health puzzle.
Age
I already mentioned that estradiol encourages the growth of glandular tissue in breasts. This is why younger women tend to have denser breast tissue. During the ages of 14-44, estrogen levels increase to prepare the body for motherhood (3). This family of hormones helps direct a wide variety of functions. One function of estradiol is to create glandular tissue to help nourish your young. This uptick in glandular tissue makes more dense breast tissue. In my podcast with Dr. Kara Fitzgerald, ND, we discuss powerful ways to reverse aging to help you live longer, better.
Hormone Replacement Therapy (HRT)
I also mentioned that after menopause, estradiol drops significantly. Typically, this means the glandular tissue shrivels up and no longer produces milk. However, those taking bio-identical hormone replacement therapy (HRT) may also have more dense breast tissue. This is because the HRT provides estrogen-like hormones that replenish what they lose (4). Since breast tissue responds to the presence of estradiol, HRT can stimulate glandular tissue proliferation once again. In other words, it brings everything back to life!
Genetics
Some women are genetically predisposed to having more dense breast tissue. For example, women who are leaner or more muscular may have less fatty tissue in the breast. Or, if you have a family history of dense breast tissue, you are more likely to have it, too.
Lifestyle Factors
Diet, exercise, and body mass index (BMI) can also play a role. Women who eat more lean meats, vegetables, and fruit are more prone to dense breast tissue. We talk about the importance of nutrition and “eating the rainbow” in my podcast with nutrition scientist Dr. Deanna Minich.
They also tend to have a lower BMI. Diets full of processed foods, carbohydrates, and refined sugars contribute to a higher BMI. A higher BMI leads to more fatty tissue in the breast. Studies show women with obesity are at greater risk for developing breast cancer (5).
As you can see, there are many variables that play a role in breast health. Now you understand what it is and what causes dense breast tissue. Next, let me share the problems that come with conventional screening methods.
The Issue with Dense Breast Tissue and Mammograms
Women with dense breast tissue often encounter several issues with mammograms. This is why I strongly recommend exploring alternatives to mammograms. Let me walk you through them.
Dense Breast Tissue and Mammograms
Especially if you have a family history, it's never too early to begin breast cancer screenings. Mammograms use X-ray beams to create 2D images of the breast (6). Since the image is 2D, the machine uses a plate to flatten or compress the breast. This can be uncomfortable for many women. These 2D images show the general shape of the breast, as well as black and white contrast. Women with dense breast tissue may have a more difficult time with mammograms.
Remember, both glandular and connective tissue show up white on a mammogram. Tumors or calcifications can also appear white. This makes it hard to interpret the radiographic image and leads to false positives. If your healthcare provider isn’t sure what they are seeing, they may request a biopsy or additional testing. This can lead to unnecessary stress and anxiety.
Limitations of Mammograms for Dense Breasts
In addition to false positives, mammograms also carry a high risk of missing cancer. Tumors that show up in a cloud of dense breast tissue may be easily overlooked. This leads many women to ask, “Is DCIS cancer or not?” DCIS (ductal carcinoma in situ) is a non-invasive cancer confined to the ducts, but it can progress if untreated. The level of uncertainty highlights the need for safer, more accurate screening methods. This can lead to women not receiving the care they need.
What if there were screening alternatives for women with dense breast tissue? Better yet, what if these methods led to better outcomes across the board? Good news, there is!
5 Alternative Screening Methods for Dense Breast Tissue
I’ve been down the road of mammograms, biopsies, and the emotional turmoil that comes with it. I later discovered alternative screening methods that bypass the radiation, pain, and discomfort. If you have dense breast tissue, consider the following alternative screening methods.
#1 Ultrasound
If you're looking for a gentle and non-invasive approach, ultrasound is a great choice. It uses high-frequency sound waves to create soft tissue images and guide biopsy needles.
As with any diagnostic, human errors do happen. Still, it's faster and more straightforward for those with dense breast tissue. As of right now, most people have to pay out of pocket. However, my hope is that this will change in the future.
#2 Thermography
One complementary tool I like is thermography. It uses infrared thermal imaging to detect heat and blood flow in your body. This noninvasive technique can pick up abnormalities such as tumors or cysts. It’s a great option for women with dense breast tissue. It also discovers metabolic changes before any anatomical changes occur (9). It works well as a screening tool in tandem with other noninvasive methods.
#3 MRI without Contrast
If you want a detailed image of dense breast tissue, magnetic resonance imaging (MRI) may be a good option. Many MRIs use contrast dye to highlight tissue abnormalities. However, this chemical can accumulate in soft tissues, causing long-term health complications. You can opt for an MRI without contrast to avoid toxic gadolinium exposure.
#4 QT Imaging
One alternative screening method is QT imaging. It uses reflection and transmission technology to create 3D images of the breast tissue. That means there’s no radiation and no discomfort! These alternatives to mammograms align with the microscopic anatomy of breast tissue.
What makes QT imaging great is that it produces a more accurate picture of the health of your breast. Women with dense breast tissue can benefit greatly from this. One clinical trial even showed it to be as effective as mammograms in detecting breast tissue abnormalities (7). This reduces the risk of false positives and false negatives.
#5 Datar
DATAR is a simple blood test that works well for women with dense breast tissue. This FDA-approved test uses ground-breaking technology to detect cancer in its early stages. There is no radiation involved, reducing the risk of overdiagnosis. You also don’t have to worry about painful compressions.
Personalized Breast Health
The future of medicine is preventive and personalized. No two people are the same, and everyone’s journey looks different. You may have never heard about dense breast tissue. Knowing whether you have it or not can empower you to choose screening options that are right for you.
Maybe you’re concerned about breast cancer. Or, you may have already received a diagnosis. Either way, women with dense breast tissue should advocate for diagnostic alternatives. This can significantly reduce their risk of radiation exposure. Opt for regularly scheduling three scans: Thermography, QT Imaging, and MRI without contrast. Doing so can reduce the risk of both false positives and false negatives.
I recently had the pleasure of inviting Dr. Jenn Simmons to my podcast. In this episode, we discuss her book The Smart Woman’s Guide to Breast Cancer. We also dive deep into some of the root causes, how nutrition plays a role, as well as other lifestyle factors. We also geek out on the revolutionary technology behind PerfeQTion Imaging. Give it a listen and let me know your biggest takeaways in the comments below!
Article Resources
Leave a Comment