Having dense breasts is a clear risk factor for breast cancer. It can also make cancers hard to spot on mammograms.

Yet you might not be aware you have dense breasts, even after mammographic screening.

In Australia, advice for women with dense breasts and their health-care professionals can be inconsistent and confusing.

This is because there’s not currently consensus on whether women who have dense breasts, but no symptoms, benefit from further imaging such as ultrasounds. Concerns include potential cost of these tests and the risk they can produce false positives.

What is breast density?

Breasts are made up of fatty tissue and fibroglandular tissue (including glands that make milk, held together by fibrous tissue).

On a mammogram – an x-ray of the breast – fibroglandular tissue appears white and fatty tissue appears dark. The white areas are referred to as breast density.

A higher proportion of fibroglandular tissue means your breasts are dense.

There are four categories to classify breast density:

• A: almost entirely fatty
• B: scattered areas of fibroglandular density
• C: heterogeneously or consistently dense
• D: extremely dense.

Breast density is very common. Around 40% of women aged 40–74 are estimated to have “dense breasts”, meaning they fall in category C or D.

What’s the link to cancer?

Breast density is associated with the risk of breast cancer in two ways.

First, breast density usually decreases with age. But if a woman has high breast density for her age, it increases her likelihood of breast cancer.

One study looked at the risk of breast cancer over the age of 50. It found there was a 6.2% risk for the one-third of women with the lowest density. For the 5% with the highest density, the risk was 14.7%.

Second, breast density “masks” cancers if they develop. Both cancers and breast density appear white on a mammogram, making cancers very hard to see.

Breast cancer screening saves lives through early detection and improved treatment options. But we don’t yet know if telling women about their breast density leads to earlier cancer detection, or lives saved.

In Australia, screening mammography is free for all women* aged 40 and older. This is run through BreastScreen Australia, a joint national, state and territory initiative. Those aged 50-74 are invited to have a mammogram, but it’s available for free without a referral from age 40.

However, the messages Australian women currently receive about breast density – and whether it’s recorded – depends on where they live.

What does the advice say?

In 2023, the Royal Australian and New Zealand College of Radiologists updated its position statement to recommend breast density is recorded during screening and diagnostic tests in Australia and New Zealand.

Meanwhile BreastScreen Australia says it “should not routinely record breast density or provide supplemental testing for women with dense breasts”. However this position statement is from 2020 and is currently under review.

Some state and territory BreastScreen programs, including in Western Australia, South Australia and soon Victoria, notify women if they have dense breasts. Victoria is currently at an early stage of its roll-out.

While the messaging regarding breast density differs by state, none currently recommend further imaging for women with dense breasts without speaking to a doctor about individual risk.

What are the issues?

Providing recommendations for women with dense breasts is difficult.

The European Society of Breast Imaging recommends women with extremely dense breasts aged 50–70 receive an MRI every two to four years, in addition to screening mammography. This is based on a large randomised controlled trial from the Netherlands.

But the Royal Australian and New Zealand College of Radiologists describes this recommendation as “aspirational”, acknowledging cost, staffing and accessibility as challenges.

That is, it is not feasible to provide a supplemental MRI for everyone in the screening population in category D with extremely dense breasts (around 10%).

Further, there is no consensus on appropriate screening recommendations for women in the category C (heterogeneous density).

We need a national approach to breast density reporting in Australia and to do better at identifying who is most likely to benefit from further testing.

BreastScreen Australia is currently undergoing a review of its policy and funding.

One of its goals is to enable a nationally consistent approach to breast screening practices. Hopefully breast density reporting, including funding to support national implementation, will be a priority.

*This includes those recorded female at birth and who are gender diverse.

Jennifer Stone, Principal Research Fellow, School of Population and Global Health, The University of Western Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

“Fart walks” have become a cultural phenomenon, after a woman named Mairlyn Smith posted online a now-viral video about how she and her husband go on walks about 60 minutes after dinner and release their gas.

Smith, known on TikTok as @mairlynthequeenoffibre and @mairlynsmith on Instagram, has since appeared on myriad TV and press interviews extolling the benefits of a fart walk. Countless TikTok and Instagram users and have now shared their own experiences of feeling better after taking up the #fartwalk habit.

So what’s the evidence behind the fart walk? And what’s the best way to do it?

Exercise can help get the gas out

We know exercise can help relieve bloating by getting gas moving and out of our bodies.

Researchers from Barcelona, Spain in 2006 asked eight patients complaining of bloating, seven of whom had irritable bowel syndrome, to avoid “gassy” foods such as beans for two days and to fast for eight hours before their study.

Each patient was asked to sit in an armchair, in order to avoid any effects of body position on the movement of gas. Gas was pumped directly into their small bowel via a thin plastic tube that went down their mouth, and the gas expelled from the body was collected into a bag via a tube placed in the rectum. This way, the researchers could determine how much gas was retained in the gut.

The patients were then asked to pedal on a modified exercise bike while remaining seated in their armchairs.

The researchers found that much less gas was retained in the patients’ gut when they exercised. They determined exercise probably helped the movement and release of intestinal gas.

Walking may have another bonus; it may trigger a nerve reflex that helps propel foods and gas contents through the gut.

Walking can also increase internal abdominal pressure as you use your abdominal muscles to stay upright and balance as you walk. This pressure on the colon helps to push intestinal gas out.

Proper fart walk technique

One study from Iran studied the effects of walking in 94 individuals with bloating.

They asked participants to carry out ten to 15 minutes of slow walking (about 1,000 steps) after eating lunch and dinner. They filled out gut symptom questionnaires before starting the program and again at the end of the four week program.

The researchers found walking after meals resulted in improvements to gut symptoms such as belching, farting, bloating and abdominal discomfort.

Now for the crucial part: in the Iranian study, there was a particular way in which participants were advised to walk. They were asked to clasp hands together behind their back and to flex their neck forward.

The clasped hands posture leads to more internal abdominal pressure and therefore more gentle squeezing out of gas from the colon. The flexed neck posture decreases the swallowing of air during walking.

This therefore is the proper fart walk technique, based on science.

What about constipation?

A fart walk can help with constipation.

One study involved middle aged inactive patients with chronic constipation, who did a 12 week program of brisk walking at least 30 minutes a day – combined with 11 minutes of strength and flexibility exercises.

This program, the researchers found, improved constipation symptoms through reduced straining, less hard stools and more complete evacuation.

It also appears that the more you walk the better the benefits for gut symptoms.

In patients with irritable bowel syndrome, one study increasing the daily step count to 9,500 steps from 4,000 steps led to a 50% reduction in the severity of their symptoms.

And just 30 minutes of a fart walk has been shown to improve blood sugar levels after eating.

What if I can’t get outside the house?

If getting outside the house after dinner is impossible, could you try walking slowly on a treadmill or around the house for 1,000 steps?

If not, perhaps you could borrow an idea from the Barcelona research: sit back in an armchair and pedal using a modified exercise bike. Any type of exercise is better than none.

Whatever you do, don’t be a couch potato! Research has found more leisure screen time is linked to a greater risk of developing gut diseases.

We also know physical inactivity during leisure time and eating irregular meals are linked to a higher risk of abdominal pain, bloating and altered bowel motions.

Try the fart walk today

It may not be for everyone but this simple physical activity does have good evidence behind it. A fart walk can improve common symptoms such as bloating, abdominal discomfort and constipation.

It can even help lower blood sugar levels after eating.

Will you be trying a fart walk today?

Vincent Ho, Associate Professor and clinical academic gastroenterologist, Western Sydney University

This article is republished from The Conversation under a Creative Commons license. Read the original article.