How to Decrease Breast Density to Reduce Breast Cancer Risk

breast density mammogram

If you have been told after a mammogram, ultrasound or MRI that you have “increased breast density”, listen up. Increased breast density, as detected through these screening techniques, is a strong known risk factor for breast cancer.[1]

So what does it mean? Breast tissue is composed of fat, glandular and connective tissue. Fat is less dense and appears dark on a mammogram, while glandular and connective tissues are more dense and appear light. When more glandular and connective tissue are present, breast density is greater.[2]

And here’s the rub. The risk of breast cancer is four to five times greater in women who have increased density in more than 75% of their breast tissue, than in women with little or no density in the breast. One third of all breast cancers are found in women who have increased breast density in over 50% of their breast tissue.[3]

The good news –  breast density can diminish over time. However, women whose breast density does not diminish over time are more likely to be diagnosed with breast cancer.[4] I’ll explain how to reduce breast density shortly.

One study showed that women who had been diagnosed with breast cancer and who were able to decrease their percent density by ≥10%, had a 55% decreased risk of breast cancer in the opposite breast, relative to women who had little or no change in density from baseline to first follow-up mammogram.[5]

Screening mammograms of US women between 2007-2010 determined that 43.3% of women 40 to 74 years of age had extremely dense breasts. This proportion was inversely associated with age and body mass index – in other words the thinner you are, the more likely your breasts are dense. An estimated 27.6 million US women aged 40 to 74 years have extremely dense breasts. Women aged 40 to 49 years account for 44.3% of this group.[6]

What causes increased breast density? Women can be primed to have increased breast density because of genetic factors, exposure to higher estrogen levels in utero, dietary and lifestyle habits, menstrual and reproductive factors, environmental factors and hormonal signatures. Breast tissue develops primarily during puberty and is altered during pregnancy, breastfeeding and menopause.[7] [8] [9]

Breast density can be decreased with dietary, nutritional and lifestyle interventions, thus potentially lessening the global burden of breast cancer. In my naturopathic practice I have seen a decrease in breast density as measured using mammograms or MRIs when women follow some or all of the guidelines listed below.

Ways of Assessing Breast Density

  • Mammography[10]
  • MRI[11]
  • Ultrasound[12]
  • Skilled Clinical Breast Exam may not match mammographic exam – high and low densities were detected in 84.5% and 15.5% of clinical breast examinations and 59.7% and 40.3% of mammographies, respectively. There was a significant difference between breast tissue densities in breast examination with those in mammography[13]

Mammographic Grading System for Breast Density

In the US the American College of Radiology developed a Breast Imaging Reporting and Data System scoring method using a 1-4 rating system. This classification system allows radiologists to measure and describe breast density as follows:

BI-RADS 1:   less than 25% Dense Breast Tissue

BI-RADS 2:   26-50% Dense Breast Tissue

BI-RADS 3:   51-75% Dense Breast Tissue

BI-RADS 4:   more than 75% Dense Breast Tissue

Age and Breast Density

¾ of women in their 30’s have increased breast density

¼ of women in their 70’s have increased breast density

Causes of Increased Breast Density

There are genetic, neonatal, reproductive, hormonal, lifestyle, dietary, nutritional and environmental factors that can increase breast density.

Genetic Factors that Increase Breast Density

  • twin studies show that breast density is highly heritable, with inherited factors accounting for 63% of cases[14]
  • Ashkenazi Jews are more likely to have increased breast density compared to other Caucasians[15]

Neonatal Factors that Increase Breast Density Later in Life

  • higher birth weight (>4000 grams or 8 lb, 13 oz ) is correlated with premenopausal breast cancer, in comparison to lower birth weight (<2500 grams or 5 lb, 8 oz)[16]

Hormonal Factors that Increase Breast Density

  • increased estradiol[17] [18], estrone[19], insulin, IGF-1[20] [21], prolactin[22]
  • use of birth control pill
  • use of hormone replacement therapy[23] [24]
  • increased weight gain in adulthood[25]

Menstrual and Reproductive Factors that Increase Breast Density

  • earlier age at onset of menstruation (<11 yrs old)[26]
  • shorter menstrual cycle length (< 25 days)
  • later age at menopause (>53 years)
  • premenopausal women have increased density compared to postmenopausal women[27]
  • prior benign breast disease[28]
  • parity (not having children) is significantly inversely associated with breast density
  • mean percent dense breast volume (%DBV) decreases from 20.5 % in women who have not given birth to 16.0 % in women who have given birth to a child
  • breast density is inversely associated with the age women start using hormonal contraceptives
  • breast density increases the longer hormonal contraceptives are used
  • mean %DBV decreases from 21.7 % in women who start using hormones at 12-17 years of age to 14.7 % in those who start using hormones at 22-28 years of age
  • age at which women started using hormonal contraceptives and duration of hormone use are inversely correlated
  • mean %DBV increased from 15.8 % in women who used hormones for not more than 2.0 years to 22.0 % in women who used hormones for more than 8 years[29]

Dietary Factors that Increase Breast Density

  • increased red meat consumption, particularly in adolescence[30]
  • alcohol consumption[31] [32]
  • saturated fats (meat, butter, ice cream)[33]
  • high glycemic load, from simple sugars and refined carbohydrates[34] [35]

Environmental Factors that Increase Breast Density

  • Postmenopausal women with high serum levels of bisphenol A (from hard plastics, canned food) and mono-ethyl phthalate (from soft plastics) had elevated breast density[36]

 

Ways to Reduce Breast Density:

 

Menstrual and Reproductive Factors that Decrease Breast Density and Cancer Risk

  • have a child before age 24[37]
  • have three or more children[38] [39] [40]
  • breastfeed your children for 6 months or longer

Dietary Recommendations that May Decrease Breast Density:

What to Decrease or Avoid in Your Diet:

  • Decrease or eliminate red meat, transition towards a plant-based diet
  • Decrease saturated fat (meat, butter, ice cream, fatty cheese)
  • Decrease sugar, refined carbohydrates and high glycemic carbohydrates
  • Avoid alcohol or limit to less than 3 alcoholic beverages per week
  • Eliminate caffeine
  • Decrease caloric intake[41]

Consume Daily:

  • increase fiber to 45 mg/day[42] – use chia, flax, legumes, psyllium, rice bran, wheat bran if tolerated
  • use 2 or more Tbsp freshly ground flaxseed[43]
  • eat 1-2 cups of legumes[44] daily (bean soup, bean dip, bean and grain casserole)
  • eat 6 servings of vegetables daily (2 cups salad, 2 cups steamed vegetables)
  • eat vegetables containing carotenoids[45] (carrots, squash, sweet potato)
  • eat 2 Tbsp or 3000 mg of linolenic acid from flax and/or fish oil[46] [47]. Pour flaxseed oil over rice, pasta, baked potato; add to salad dressing, use in smoothies. Never heat it. Keep refrigerated.
  • use 1 Tbsp olive oil[48] [49]daily in salad dressing
  • use ½ cup organic tofu or 1 glass soymilk[50] daily, or both. Avoid if allergic.
  • drink green tea[51] or take a green tea supplement
  • use rosemary as an herb and as tea

Nutritional Factors that May Decrease Breast Density

  • vitamin D >1750 IU/day[52] [53] – recommend 3000 IU or more
  • calcium >700 mg/day[54] – recommend it be taken with magnesium glycinate

Other Nutritional Supplements that May Help to Reduce Breast Cancer Risk

Lifestyle Factors that May Help to Reduce Breast Cancer Risk:

  • Exercise 40 minutes a day
  • Spend more lifetime hours in the sun[lxx]
  • Avoid weight gain during adulthood and after menopause
  • Avoid the birth control pill and hormone replacement therapy
  • Avoid plastics containing bisphenol-A and phthalates, especially during pregnancy
  • Use organically grown food as often as possible[lxxi]
About the Author:

Sat Dharam Kaur ND is a naturopathic doctor practicing in Owen Sound, Ontario, Canada, and author of the Complete Natural Medicine Guide to Breast Cancer and the Complete Natural Medicine Guide to Women’s Health. She travels internationally, educating women in ways to reduce breast cancer risk using the Healthy Breast Program, and trains other women to teach the program in an effort to decrease the rising global epidemic of breast cancer.

For more information and guidance on breast cancer prevention and/or recovery, see http://mammalive.net/upcoming-courses/.

We invite you to partner with us in educating women in ways to reduce breast cancer risk through our October international #breasthealthchallenge campaign.

References:

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