As Breast Cancer Awareness Month gets underway, women are being urged to be aware of whether their breasts have low or high density as dense tissue can hide cancers. According to Dr. Temeika Fairley, the fibrous and glandular tissue looks white on a mammogram and so does a possible tumor. She said since it’s hard to tell the difference between a tumor and dense breast tissue, a small tumor may be missed.
“If you have dense breasts, you are encouraged to talk to your doctor about your risk of getting breast cancer,” said Fairley, a senior health scientist at the United States (US) Centers for Disease Control (CDC) and Prevention. “Dense breasts are just one of several risk factors for breast cancer. Your doctor will also consider other factors like your age and family history of cancer.”
A woman’s breast has three kinds of tissue. Glandular tissue, which includes the part of the breast that makes milk called the lobes and the tubes that carry the milk to the nipple called ducts. Fibrous tissue holds the breast tissue in place. Fatty tissue fills the space between the fibrous tissue, lobes and ducts. It gives the breast their size and shape. Breast density reflects the amount of fibrous and glandular tissue in a woman’s breast compared to the amount of fatty tissue as seen on a mammogram, according to Fairley.
In a mammography report, Fairley said breast density is assigned to one of four categories.
“The breasts are almost entirely fatty, a few areas of dense tissue are scattered throughout the breast, the breasts are evenly dense throughout or the breasts are extremely dense. Women in the first two categories are said to have fatty breasts. Women in the second two categories are said to have dense breasts.”
Fairley said about half of women who are 40 or older have dense breasts.
“Women with dense breasts have a higher chance of getting breast cancer. The [denser] your breasts, the higher your risk. Dense tissue can hide cancers. The fibrous and glandular tissue looks white on a mammogram and so does a possible tumor. Since it’s hard to tell the difference between a tumor and dense breast tissue, a small tumor may be missed.”
In October, breast cancer and awareness are heightened. One of the most recognizable symbols, the breast cancer ribbon, has become the universal symbol of breast cancer, a disease in which cells in the breast grow out of control.
The pink ribbon illustrates the cause in raising awareness and bringing together women in solidarity. From a simple piece of ribbon affixed with a pin, a person is able to show their support for someone battling breast cancer, and the hope for a brighter future.
There are different types of breast cancer. The most common types of breast cancer are invasive ductal carcinoma, and invasive lobular carcinoma, according to the CDC.
In ductal, the cancer cells begin in the ducts, then grow outside the ducts into other parts of the breast tissue. Invasive cancer cells can also spread (metastasize) to other parts of the body.
In invasive, cancer cells begin in the lobules (a gland that makes milk), then spread from the lobules to the breast tissues that are close by. The invasive cancer cells can also spread to the other parts of the body.
The type of breast cancer depends on which cells in the breast turn into cancer, according to the CDC.
Globally, in the fight against breast cancer and the search for a cure for this insidious disease, the pink ribbon, the breast cancer symbol, is used by all countries in various shapes and sizes as the symbol of joy and hope.
The history of how this merging of ribbon and symbolism in the US came about is in two leaps. The first occurred in 1979, when a wife of a hostage who had been taken in Iran was inspired to tie yellow ribbons around trees in her front yard, signaling her desire to see her husband return home. Step two occurred 11 years later, when AIDS activists looked at the yellow ribbons that had been resurrected for soldiers fighting the Gulf War and turned the ribbon bright red, looped it, spruced it up and sent it on to the national stage during the Tony awards to represent those affected by AIDS.
The stage was set for the evolution of the breast cancer awareness ribbon.
Susan G. Komen for the Cure has used the color pink since its inception in 1982. The first Komen Race for the Cure logo design was an abstract female runner outlined with a pink ribbon and was used during the mid-1980s through early 1990s.
In 1990, the first breast cancer survivor program was launched at the Komen National Race for the Cure in Washington, DC. The survivors wore buttons that were printed in black and white. Later that year, the survivor program developed, and pink was used as the designated color for Komen to promote awareness and its programs. Pink visors were launched for survivor recognition.
In 1991, pink ribbons were distributed to all breast cancer survivors and participants of the Komen New York City Race for the Cure. In 1992, Alexandra Penney, editor-in-chief of Self magazine, wanted to put the magazine’s second annual Breast Cancer Awareness Month issue over the top. She did so by creating a ribbon and enlisting the cosmetics giants to distribute them in New York City stores. Thus, the birth of the pink ribbon.
Symptoms
As Breast Cancer Awareness Month is observed to recognize and keep the awareness, women and men are encouraged to recognize the symptoms that may indicate breast cancer, and to be cognizant of the fact that different people have different symptoms of breast cancer. And that some people do not have any signs or symptoms at all.
Symptoms people need to be aware of include a new lump in the breast or underarm (armpit); thickening or swelling of part of the breast; irritation or dimpling of breast skin; redness or flaky skin in the nipple area or the breast; pulling in of the nipple or pain in the nipple area; nipple discharge other than breast milk, including blood; any change in the size or the shape of the breast; and pain in any area of the breast.
They are also reminded that no breast is typical, and what is normal for one woman may not be normal for another woman. The way a person’s breasts look and feel can be affected by getting their period, having children, losing or gaining weight, and taking certain medications. Breasts, they say, also tend to change with age.
Risk factors
Risk factors you cannot change include getting older – the risk for breast cancer increases with age; most breast cancers are diagnosed after age 50; genetic mutations – inherited changes (mutations) to certain genes, such as BRCA1 and BRCA2. Women who have inherited these genetic changes are at higher risk of breast and ovarian cancer. Reproductive history – early menstrual periods before age 12 and starting menopause after age 55 – exposes women to hormones longer, raising their risk of getting breast cancer; having dense breasts – dense breasts have more connective tissue than fatty tissue, which can sometimes make it hard to see tumors on a mammogram. Women with dense breasts are more likely to get breast cancer. Personal history of breast cancer or certain noncancerous breast diseases; family history of breast or ovarian cancer; and previous treatment using radiation therapy.
Risk factors you can change include not being physically active – women who are not physically active have a higher risk of getting breast cancer; being overweight or obese after menopause – older women who are overweight or obese have a higher risk of getting breast cancer than those at a normal weight; taking hormones – some forms of hormone replacement therapy (those that include both estrogen and progesterone) taken during menopause can raise risk for breast cancer when taken for more than five years. Certain oral contraceptives (birth control pills) also have been found to raise breast cancer risk. Reproductive history – having the first pregnancy after age 30, not breastfeeding, and never having a full-term pregnancy – can raise breast cancer risk; and drinking alcohol – studies show that a woman’s risk for breast cancer increases with the more alcohol she drinks.
According to the CDC, research suggests that other factors such as smoking, being exposed to chemicals that can cause cancer, and changes in other hormones, due to night shift working, also may increase breast cancer risk.
People who are high risk for breast cancer include those with a strong family history of breast cancer or inherited changes in your BRCA1 and BRCA2 genes. They may also have a high risk for ovarian cancer.
Screening
Women are also encouraged to have themselves screened for breast cancer, before there are signs or symptoms of the disease. The CDC says although breast cancer screening cannot prevent breast cancer, it can help find breast cancer early, when it is easier to treat. Women are encouraged to talk to their doctor about which breast cancer screening tests – mammogram, breast magnetic resonance imaging (MRI) – are right for them, and when they should have them.
Other breast exams include a clinical breast exam by a doctor or nurse, who uses their hands to feel for lumps or other changes; and each individual being self-aware of how their breasts look and feel, so they can notice symptoms such as lumps, pain, or changes in size that may be of concern.
