Overweight women need frequent mammograms

Women with higher body mass index (BMI) face an increased risk of not detecting their breast tumor until it has become large, they need shorter intervals between mammography screening exams. BMI is a measure of body fat based on height and weight, with overweight defined as a BMI of 25 or more. High BMI is associated with a number of health risks, including diabetes and heart disease. However, BMI is not considered as part of breast cancer screening guidelines.

Researchers set out to identify risk factors associated with tumors not being detected until larger than 2 centimeters (cm), or about the size of a peanut, and to examine the implications for long-term prognosis. The 2-cm size is important because it is one of the parameters used to separate stage I and stage II cancers. In addition, tumor size is known to be strongly associated with prognosis.The researchers followed the patients until history and looked for how disease progression was related to BMI and breast density.

For cancers detected at screening, both BMI and breast density were associated with having a large tumor at diagnosis. However, for interval cancers, or cancers detected within two years of a normal mammogram, only BMI was linked with having a large tumor. Women with higher BMI had worse prognosis than women with lower BMI among interval cancers.

Breast density showed no significant association with disease progression. Besides the larger interval cancers, women with high BMI may have other factors that put them at risk for a worse prognosis, including the molecular composition of the tumors and hormone receptor expression levels that make them harder to treat.
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Dense breast and risk of developing cancer

Women breast can be placed into four categories of breast density.
Mostly fatty: The breasts are made up of mostly fat and contain little fibrous and glandular tissue. This means the mammogram would show anything that is abnormal.

Scattered density: The breasts have quite a bit of fat, but there are a few areas of fibrous and glandular tissue.
Consistent density: The breasts have many areas of fibrous and glandular tissue that are evenly distributed through the breasts. This can make it hard to see small masses in the breast.

Extremely dense: The breasts have a lot of fibrous and glandular tissue. This may make it hard to see a cancer on a mammogram because the cancer can look like normal tissue.

Weight, family history of breast cancer, and having first baby after the age of 30 are some of the risk factors of breast cancer.
Breast density is not based on how your breasts feel during your self examination or your doctor's physical examination.

Mammograms determine the categories of your breasts density. Dense breasts make tumours much harder to detect,
because fat is transparent on a scan, but dense tissue is solid and can make it difficult to see through.

Women who have more dense breast tissue than fat are at risk of developing cancer. Experts said dense tissue makes tumours in the breasts harder to spot on mammograms.

Dense breasts have less fatty tissue and more non-fatty tissue compared to breasts that aren't dense. If you have
dense breasts - maintain a healthy weight, exercise regularly, limit alcohol intake, eat plant based diet and avoid smoking to reduce your risk of developing breast cancer.

Monthly self examination and yearly examination by your doctor can also help. Digital mammography  is recommended because film mammography may not be effective.

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