ARE YOUR BREASTS DENSE? YOU MIGHT BE AT RISK OF DEVELOPING BREAST CANCER!

Do you know that higher breast density is associated with higher risk of developing breast cancer? The article below seems to support the evidence (click here for the full article). 

This article suggests that it is not good enough to do mammogram at 40 years old and older to detect breast cancer. Breast density percent which can be calculated from mammogram are convincingly suggesting the link between denser breast with higher risk of developing breast cancer. Sounds like we have another useful modifiable risk factor which can help us in our quest of preventing breast cancer that attacks 1 in 16 women in Malaysia.

But we have a problem. We don't routinely do mammogram for women below 40 years old. This is due to 2 reasons; 1) Women less than 40 years old have denser breast which may mask any abnormal breast growth thus negatively affecting the mammogram's sensitivity to detect cancer. 2) If this rule is not strictly adhered to, we will be having lots of women in their teens and 20's doing mammogram for screening purpose and subjecting their developing breasts to potentially harmful X-ray radiations. Young women may risk developing breast cancer when they are older if their breasts are exposed to ionizing radiation like mammogram when their breast are immature and still developing.

But all hope is not lost. A rather convincing estimation of breast density can be achieved with ultrasonography of the breasts. Ultrasound breast does not emit ionizing radiation, thus it is safe to do (even repeatedly) on young or developing breasts.


Alternatively, in my clinical practice, a low-tech and simple manual breast examination would reliably distinguish a lumpy breast from a normal (non-lumpy) breast tissue. Establishing an abnormal breast growth (ie Cancer) among lumpy breast tissues is more challenging. 

In other words, a lumpy breast detected by manual breast examination is more likely to be a dense breast. Alternatively, a non-lumpy breast tissue detected by manual breast examination is more likely to be not dense.


So what can we do when we know our breast is dense? The current medical establishment approach to breast care is rather fatalistic in my personal opinion. They are focusing on detecting abnormalities (breast cancer) early rather than prevent its occurrence altogether. It is equivalent to saying that we are expecting a robber to come to our house (because of certain risk factors) and our only strategy is to anticipate the robber's arrival as early as possible so that we can catch the robber successfully. Nothing wrong with that idea. But personally, I would rather establish a local security force and stop any unregistered stranger from entering the gated neighborhood. I don't know about you but my family feels less traumatized if I can stop the robber from even entering my neighborhood altogether.

Risk factors for developing breast cancer are well-established namely:

• Older age (the older she gets, the higher her risk)
• Age of menarche (the earlier her first menses, the higher her risk)
• Nulliparous (never given birth before, the higher her risk)
• Late child birth (the later she delays having a baby, the higher her risk)
• Not breast feeding (higher risk compared to moms who breastfeed)
• Use of oral contraceptive (the earlier and longer duration of OCPs use, the higher her risk)
• Positive family history of breast cancers in 1st degree relatives (15% chance higher risk)
• Frequency of previous benign breast growth (the more growth, the higher her risk)
• Genetics (BRCA1 & BRACA2); if she has this gene, the higher her risk. Remember Angelina Jolie removing both her breasts for this?)   

I am not sure if you have noticed that most of the risk factors above are beyond your control. You don't get to choose your parents, do you? And it is not like you can stop aging or delay menarche or when you will meet your Mr Right and procreate.

Therefore, detecting a dense breast by virtue of self-breast examination or ultrasonographic examination at the doctor's office seemed to be a more practical and acceptable solution.

So what causes dense breast? When we say dense breast, we are actually referring to the 'water' component of the breast rather than the fat tissues. In mammogram, the milk glands, blood vessels and lymphatics complex which constitutes the 'water' component of the breast appears white and so is differentiated from the fat tissues that appears darker. The percentage density is thus calculated.

Breast density can be influenced by hormones such as estrogen and human growth hormones. Apart from stimulatory effects, these hormones cause water retention. Any obstruction in the lymphatic, mammary ducts and venous return can compromise the breast fluid circulation.

Therefore, non-pharmaceutical methods of improving breast lymphatics and blood circulations includes:

• Massage and suction devices: providing direct positive and negative pressures, assisting in the flow of fluids in the intra-vascular, intra-compartmental, and trans-cellular compartments of the breast.
• Direct Tactile Vibrations at 120Hz: reducing blood vessels resistance by unclogging capillaries and preventing stasis of the lymphatics at the extracellular spaces.
• Far-Infra Red (3-12 um): stimulatory effects on cells and tissues, promoting healing.
• Negative ions: restoring the negative charge/cations on cell surfaces and the cellular milieu for optimal cell functioning and intra-cellular communication/signalling.

Devices which support breast care are available in the market. Nevertheless, it cannot be over-emphasized that a good diet, regular exercise, normal sleep wake cycle, loving relationships and inner peace are all essential components in a holistic model of breast care.