Routine Gynecologic Care

All women should undergo mammograms throughout their lives, ideally starting at age 40 (or earlier for those with a family history or certain genetic traits). However, some women may be concerned that mammography might not work for them because of their breast tissue type.

Dense breast tissue can make interpreting a mammogram more difficult because the image is cloudier and full of white patterning. Still, women with even very dense breasts can benefit from regular mammograms.

It is essential to make the most of these appointments to understand what breast density has to do with mammogram results, how these mammograms can be interpreted, and ways that patients can maximize the accuracy of their mammography reports.

Do You Have Dense Breasts?

Before a woman can approach her mammogram with information about her breast density, she must understand whether or not she has dense breasts in the first place. Breast “density” is the composition of the breast tissue.

In many women, the breasts are made up largely of fatty tissue, which appears grayish on mammography imaging. Within breasts, fibrous tissue (thicker bands or sections of the breast) helps to give these anatomical features their shape, holding the breasts in place.

The fatty and fibrous tissue does not interfere with breast imaging for most people. However, some women have very thick fibrous tissue or may have an abundance of glandular tissues, the milk-producing glands, and ducts that carry the milk.

Together, these features can make the breast dense, obscuring findings more easily visualized in fatty areas. Women can range from almost entirely fatty breasts, which are easy to scan, to dense breasts with minimal fat, which can be much more challenging.

How to Read Mammograms With a Breast Density Report

As of 2024, the FDA now requires that every mammogram include a patient’s breast density report. Patients can read this information for themselves; the report will directly specify that the patient’s breasts are either “dense” or “not dense.”

This determination is made by categorizing the breast on a scale from A to D, which will also be included in the report:

• Category A: The breast is made up almost exclusively of fatty tissues.
• Category B: Some areas of glandular and fibrous tissue exist but are scattered and minor.
• Category C: A large portion of the breast is made of fibrous and glandular tissue (this is called being heterogeneously dense).
• Category D: Breasts are made almost entirely of dense tissues with very little fat.

Do Mammograms Work on Dense Breast Tissue?

Even in Category D women, mammograms are still an essential part of healthcare. While it is true that clearly visualizing all parts of the breast tissue can be more difficult when that tissue is dense, a professional can still spot problematic areas that may lead to cancerous growth.

This rate of success in identifying cancer early is still higher and more effective than waiting for symptoms to develop from cancerous growth and then pursuing treatment.

How to Get the Clearest Results

Dense breast tissue can make mammograms a little more challenging, but this is something that skilled professionals see all the time; in fact, around half of women have dense breasts. While a woman cannot change the tissue composition of her own body, there are some things she can do to facilitate clearer, more accurate results during a mammogram:

• Work with a skilled team: Some providers have more experience with dense breast tissue than others. Select a mammography team that works with imaging on dense breasts frequently, as they will be more knowledgeable about what to look for.
• Get mammograms regularly: For women with dense breast tissue, frequent mammograms are essential. Having a history of breast tissue images will allow the doctor to see gradual changes over time, clarifying which parts of the breast are normal and which are not. This additional resource increases the likelihood of finding problematic growths in dense breast tissue.
• All women should be careful to follow their doctor’s instructions before mammograms, but this can be especially important for those with dense breast tissue. Avoid wearing lotion or other cosmetics that could interfere with the mammogram to make sure doctors take a clear picture.

Trust Your Mammograms to Professionals

Dense breast tissue can make mammograms more difficult, but it should not discourage patients from getting scanned. In fact, it is more important than ever for women with dense breasts to get regular mammograms because having a history of images can lead mammograms to be more accurate.

Trust a team that regularly scans dense breasts for the best results. Contact Raleigh Gynecology & Wellness today to schedule your mammogram.

Many factors contribute to breast cancer risk, from family history to genetic predisposition. However, few people realize that the foods they eat and dietary habits they consider routine may also play a role in their mammography outcomes.

While no superfood prevents breast cancer—nor is there a single food that causes it—a person’s overarching dietary choices influence how the body’s cells grow and divide. A few small changes to your diet can go a long way toward decreasing your risk of breast cancer and enjoying better overall health.

Learn how certain foods and dietary habits can influence breast health and mammogram outcomes so you can make informed decisions about diet, health, and wellness.

Why Fat Is Tied to Cancer

A high-fat diet also tends to be higher in calories, as fat is a calorically dense substance. However, this does not necessarily mean that eating fat is a poor choice; some types of fat, such as mono- and polyunsaturated fats, are good for health and can be found in nutritious items such as avocados and salmon.

The problem with fat arises when a person consumes too many calories, building up excess fat cells in the body. A person who is overweight or obese is typically also at a higher risk of breast cancer due to how fat cells impact hormones. Fat produces estrogen, which is a foundational hormonal component of breast tissue growth.

When the cells in the breasts grow faster and more abundantly, they also replicate faster, which increases the odds that a cell will become abnormal and transition into cancer.

Switching to healthy fats in the diet and avoiding the consumption of excess calories can keep the breast tissue healthy.

The Role of Red Meat

For many years, the adage has spread that red meat is the inferior choice to white meat because red meat causes inflammation. Extensive cohort studies into breast cancer risk have found that while no difference in breast cancer risk was found between groups who ate a high amount of red meat versus a low amount, postmenopausal women did see a higher rate of breast cancer than premenopausal women when both cohorts consumed red meat.

The cause behind this difference is unclear and could range from the cooking method to the type of animal the meat came from.

While the connection between red meat and breast cancer may not be entirely clear, there are still benefits to limiting its consumption. On average, white meat is lower in fat, decreasing caloric consumption.

Other essential nutrients, such as zinc and B vitamins, can be found in white meat, so there is an incentive to add more of it to the diet.

Fiber in the Diet

A diet high in fiber is good for the body for many reasons, but reducing the incidence of breast cancer is one reason people may not be aware of. There are many mechanisms behind why fiber is associated with significantly lower breast cancer rates:

• Stable blood sugar – Cancer cells need energy to grow, and excess glucose (sugar) in the blood encourages cancer proliferation. Fiber stabilizes blood sugar.
• Lower free estrogen – Fiber can help to reduce excess estrogen, which slows the proliferation of breast cells that can become cancerous.
• Decreased appetite – Fiber helps people to feel full for longer after eating, which helps to avoid calorie overconsumption. Thus, those who incorporate fiber (especially fruits and vegetables) are less likely to face increased cancer risk from obesity.

Alcohol and the Cancer Connection

Many assume that a small drink here and there does not impact their health. Still, studies show that breast cancer risk increases by 7% to 10% for each alcoholic drink an individual consumes per day.

Researchers believe that ethanol, the alcohol found in drinks, is responsible for this increase in breast cancer risk (through its function of raising estrogen in the body); thus, it is likely that the type of alcohol does not matter as much as how often and how much an individual consumes.

Get Regular Breast Cancer Screenings

A person’s dietary choices have a role to play in their breast cancer risk, just as their genetics, family history, and other lifestyle factors do. By making minor adjustments to nutritional habits over time, an individual can boost their health in many ways and decrease their lifetime risk of breast cancer.

The professionals at Raleigh Gynecology and Wellness encourage all women to participate regularly in breast cancer screening through both mammography and self-exams at home.

Contact Raleigh Gynecology and Wellness to schedule your mammogram or learn more about how to keep your breasts healthy over the long term.

Generally, women should have a mammogram once per year starting at age 45, though the American Cancer Society recommends that women start getting mammograms at 40 if accessible. Those with higher risk factors, such as the BRCA gene, should begin screening sooner.

However, women with breast implants often believe that mammography cannot work for them. In reality, it is both possible and encouraged to get breast exams, including mammograms, whether or not you have breast implants! Getting a mammogram with breast implants is generally similar to the experience for individuals who do not have implants.

However, there are still a few things to keep in mind. Here is a guide on how mammograms are conducted on people with breast implants and any special considerations to keep in mind.

Can Mammograms Be Done With Implants?

In short—yes, mammograms can be done on patients who have had breast implants. It is best to entrust this service to a healthcare provider with experience doing breast exams and imaging for people who have implants, as the process can be slightly different than it is for individuals with only natural breast tissue. More provider experience means better pictures!

What to Expect During a Mammogram

Patients who have breast implants should plan to tell their doctor at the time they schedule the mammogram. This allows them to be paired with a technician who has the necessary experience and may require a longer appointment time since patients with implants usually need a few more pictures to be taken.

On the day of the appointment, women will prepare for the procedure as normal by avoiding lotions and creams in the torso area and then undressing in the exam room.

During the imaging process, the mammographer will use a skill called implant displacement, in which the implant is gently shifted back toward the chest wall and the breast tissue pulled forward to get the best images without the implant in the way.

Still, because of the implants, most mammographers will need to take a few additional pictures to capture as much of the breast tissue as possible. Thus, patients should expect to spend 10 to 15 extra minutes at most.

When the mammogram is complete, the patient can return to their normal daily activities. The breast implants will remain in their intended position, but patients should report any lingering discomfort to their doctor.

The Risks of Mammography With Implants

Mammography is a safe and effective method of detecting breast cancer in its earliest stages. However, there are still some minor risks for individuals with breast implants. These include:

• Rupture – While extremely rare, it is possible for the pressure exerted during a mammogram to rupture certain types of breast implants, including saline implants. The best way to reduce this risk is to work with a provider with experience providing mammography to implant patients.
• Capsular contracture – In some instances, tough, scar-like tissue forms around a breast implant after it has been placed. A mammogram can disrupt this tissue, leading to slight visual or textural changes to the breast anatomy.
• Radiation – Because women with breast implants usually need to have more imaging done to capture as much breast tissue as possible, they are exposed to slightly higher levels of radiation. However, this only amounts to a few more pictures and is still well within the safe bounds of what doctors recommend for patients.

While it is true that mammography can pose some minor risks that occur rarely, patients with implants should not be dissuaded. The advantages of mammography for identifying breast cancer early are worth the risk, and many more patients will detect breast cancer than will experience any negative side effect.

Get Your Breast Exams Done Regularly

Mammography is essential in a patient’s toolkit for preserving their long-term health and staying safe from cancer. In fact, individuals who received mammograms on the recommended schedule were 41% less likely to die due to breast cancer and saw a 25% reduction in the severity of breast cancer if diagnosed.

Having breast implants should not discourage patients from seeking out regular screening, though the process may be slightly different compared to those who do not have implants.

If you are overdue for your next breast exam or mammogram, the best time to schedule is now! The professionals at Raleigh Gynecology and Wellness understand how to complete high-quality mammography in patients with breast implants. Contact Raleigh Gynecology and Wellness today to schedule your screening!

Breast cancer screening is an invaluable part of healthcare for women (and even men, sometimes!). A mammogram provides clarity into the state of the breast tissue, which can identify problems ranging from benign cysts to the development of cancer.

However, many people face challenges when considering scheduling a mammogram. While accessibility, cost, and awareness are all roadblocks to getting a mammogram as recommended, fewer people consider the psychology of breast cancer screening and how a person’s mentality can affect their exposure to mammograms.

From developing anxiety about the procedure before the mammogram is even scheduled to experiencing significant stress, depression, or even PTSD following a diagnosis, individuals can face severe psychological challenges related to breast health.

Preparing for the process ahead of time can ease these difficulties and make mammography a more seamless part of life that does not cause such distress.

Before the Mammogram

Before scheduling a mammogram, women may face psychological challenges that interfere with their ability or willingness to make an appointment at all.

Studies show that some individuals face severe anxiety about breast cancer screening—especially if they believe that they are especially susceptible to developing cancer (e.g., a family history) or they fear the severity, length, or cost of potential cancer treatments. This anxiety can cause defensive avoidance of screening, leaving women unwilling to schedule an appointment.

Those who do choose to schedule may continue to face anxiety, especially if the mammogram appointment they are attending is a follow-up to a previous abnormal report. This, too, can lead to avoidance, resulting in appointment cancellation.

After Breast Cancer Screening

For individuals who complete their breast cancer screening, psychological distress does not necessarily resolve. Studies indicate that conditions ranging from anxiety and depression to post-traumatic stress disorder (PTSD) can arise based on either the mammogram process itself or the results discovered therein.

Research following women after screening found that while a diagnosis of cancerous tissue resulted in increased anxiety, depression, and stress, so did heightened surveillance in non-confirmed diagnoses. In other words, women who were diagnosed with cancer through a mammogram screening were more anxious, depressed, and stressed.

However, those who did not have a cancer diagnosis but whose doctors scheduled them for follow-up screenings after finding “suspicious” tissue, as well as those whose medical professionals provided what patients perceived as “extra” guidance, also suffered from significant anxiety.

This may be caused by patients perceiving their doctors’ extra attention as suggesting something is wrong.

How to Prepare Mentally for Screening

Breast cancer screening can be intimidating, but when approached with preparation, individuals can replace their anxiety with confidence and reassurance. Understand that a mammogram aims to identify problematic cells as early as possible.

By getting mammograms regularly, patients can catch cancerous cells while they are still in the earliest phases—and sometimes before they have turned cancerous at all. Survival rates for a breast cancer diagnosis at this early stage are significantly higher, in some cases reaching nearly 100%.

Thus, mammography can ease patients’ worries by reassuring them that they are healthy and that any problematic cells are being attended to as soon as possible before any cancer can worsen. Other things that can help patients prepare include:

• Learning more about the mammography procedure – For patients nervous about the mammogram itself, watch videos or read step-by-step guides to help set expectations.
• Finding a doctor you can trust – Build rapport with a doctor in advance. This helps patients trust their recommendations rather than succumb to the anxiety associated with doctors who recommend follow-up care. Patients with a reliable medical team will trust their doctor to care for them properly, which can ease fears and reduce stress.
• Scheduling wisely – A mammogram can become more stressful when scheduled at an inconvenient time. Patients are more likely to cancel if they schedule their mammogram during the work day or when they must rush to the appointment. Choose a mammogram slot that fits into your day so you can feel confident and at ease.

Get Breast Cancer Screening to Ease Anxieties

Breast cancer screening through mammography is an irreplaceable tool for keeping patients safe from the risks of breast cancer. It can be used alongside self-examination at home and clinical exams by your doctor to catch problems in their earliest stages when the tissue is still most responsive to treatment.

However, patients face numerous psychological barriers to breast cancer screening. Preparing for the appointment the right way can remove some of these challenges.

The professional team at Raleigh Gynecology and Wellness strives to make your mammogram as simple, seamless, and accessible as possible so you can schedule with confidence.

Contact Raleigh Gynecology and Wellness to select a slot for your mammogram appointment.

Breast cancer screening, including mammograms and breast exams with a gynecologist, is an essential part of good healthcare for adults of all backgrounds. However, not everyone attends their regular screenings as recommended by their doctor.

Many factors influence whether someone can undergo regular screening, from financial opportunity to awareness of mammography services in their area.

When an individual cannot access the cancer screening they need, they face an increased risk of more severe types of cancer due to the failure to detect precancerous development early.

This can result in poorer long-term outcomes, greater financial costs, and other negative consequences. If you are facing barriers to breast cancer screening, there are options to help you get the testing you need.

The Problem: Healthcare Coverage

The Affordable Care Act mandated that mammography screening be included with no co-payment; however, not everyone has health insurance.

Data indicate that less than 50% of those who did not have health insurance had a screening mammogram done within the previous two years. This number was slightly higher for those with private health insurance at 80%, but many patients are still not being screened.

The Solution

Patients who lack healthcare coverage have multiple options. The ACA may provide one alternative: subsidies for low-income individuals could cover the cost of nominal health insurance, either in part or in full. Alternatively, some individuals or families may qualify for Medicaid, which typically covers one mammogram per year for those over the age of 40.

The Problem: Awareness

Even among those who have insurance, many do not get regular breast cancer screening because they are not aware of its importance or what role it can play in their health.

Some may assume that breast cancer will show symptoms and that they do not need to worry before then; others (especially men or those with small breasts) may believe that breast cancer is not really a risk for them.

Those who know about breast cancer and the options for screening for it may still lack awareness of local resources that can help.

The Solution

Increasing education for all patients is the first step toward greater awareness of the importance of screening. From quick notes from a primary care doctor to informational pamphlets available at pharmacies, many resources may be available to help people better understand the need for breast cancer screening.

The Problem: Access

Some patients may have the knowledge to understand why screening is important, and it may even be covered by their insurance—but without proper access to screening facilities, these elements do not matter. A person who cannot find public transportation to a clinic or does not have enough sick leave from work might not be able to access screening services, even if they want to.

The Solution

Patients having trouble getting to a screening center might benefit from contacting volunteer organizations in their community. Churches, cancer treatment volunteer groups, and others may be able to provide temporary transportation for those who do not have another option.

In some cases coordinating your mammogram appointment with your routine doctor visit can reduce time away from work and transportation costs. As another line of defense, patients can learn how to do breast self-exams at home.

The Problem: Cultural Differences

America is a melting pot, with an increasing number of residents identifying as belonging to more than one culture. When these other cultures are at odds with how the American medical system conducts screenings, patients may not receive the necessary services.

The most common challenge is language barriers. Patients may not receive helpful education or understand their doctor’s recommendations if they do not share a connection via language—and in some cases, patients struggle to make an appointment at all. In other instances, cultural or religious pressures could prevent patients from seeking medical care from certain providers or offices.

The Solution

Utilize state-provided translation services that are available at many doctors’ offices or research volunteer or non-profit organizations that can provide translation.

Choose medical offices with friendly staff who demonstrate a commitment to patient comfort, including making important information available in a way that makes sense for patients.

Offices with online portals can be beneficial, as they allow patients to review documents in their own time and with the assistance of translation services, knowledgeable family members, and more.

Get Your Breast Cancer Screening as Scheduled to Protect Your Health

Breast cancer screening is an essential service, but many patients do not receive it due to factors ranging from cultural differences to lack of access to being unaware.

Both patients and doctor’s offices can work together to bridge these gaps and make cancer screening accessible for everyone.

The team at Raleigh Gynecology and Wellness champions patient comfort, and we truly strive to get to know all of our patients so that we can communicate with them clearly and completely. Contact Raleigh Gynecology and Wellness to schedule your breast cancer screening.