The hidden risk: understanding breast density and cancer

By Dr Susan Hawe12 June 20254 min read

Your Guide to understanding Breast Cancer and screening options.

By Dr Susan Hawes

How common is breast cancer?

Over 21,000 Australians will be diagnosed with breast cancer this year. Risk of breast cancer increases greatly after the age of 50. However, around 1,000 women aged under 40 are diagnosed with breast cancer each year. 1:7 women and 1:550 men are diagnosed with breast cancer in their lifetime.

I have felt a breast lump. Are most breast lumps cancerous?

No. Approximately 10% of breast lumps are cancers, and 90% are not cancer. It is important to have any new breast changes investigated with your doctor. This can include a new lump, dimpling of the skin, new onset redness, nipple changes such as crusting, ulceration, abnormal nipple discharge or new onset of nipple inversion.

Should I be checked out if I had a normal screening mammogram last year?

Yes. If a patient develops new breast symptoms these should be checked with a doctor. BreastScreen is a health initiative that aims to reduce illness and death from breast cancer. Women aged 50-74 are actively invited to free mammogram screening every 2 years. Women aged 40 to 49 or over 75 can also attend who do not have breast symptoms. Some women can also undergo breast checks and have breast imaging organised with their general practitioner.

Can women with breast implants have mammograms?

Yes. It is generally safe to have a mammogram with breast implants. However, it is important to advise the imaging company or BreastScreen beforehand so that the best images can be obtained.

What is breast density?

Breasts are made of a mixture of glandular tissue, fibrous connective tissue, and fatty breast tissue. It is not something that can be determined when breasts are examined. Only a radiologist looking at a mammogram can tell if a woman has dense breasts. Density describes the relative amount of these different types of breast tissue as seen on a mammogram. Dense breast tissue has relatively higher amounts of glandular and fibrous connective tissue and relatively low amounts of fatty breast tissue. Dense breast tissue can make mammograms more difficult to interpret because dense breast tissue and abnormal changes both appear white on mammograms whereas fatty tissue appears dark. This can result in women with dense breasts being called back for more follow-up testing to reduce risk of missing cancer. At present there is not enough evidence to recommend more testing in women with dense breasts; however, breast MRI, USS and contrast mammograms are tests that can give doctors more information to reduce the risk of missing cancer. You can discuss this with your GP or be referred to a breast specialist to discuss this further.

Are dense breasts common?

Yes, dense breasts are common. Nearly half of all women who are 40 and older who get mammograms are found to have dense breast tissue. Higher breast density can be hereditary, is associated with low body mass index and may be seen in women who use hormone replacement therapy for menopause symptoms. Lower breast density can be due to increasing age and having had children.

What is a strong family history?

Having 2 or more people in the family – particularly first- degree relatives (mother, sister or daughter) who meet any of the following criteria is classified as strong: • Breast cancer before age 40 • Triple negative breast cancer • First degree relatives with breast or ovarian cancer • Breast or ovarian cancer in the same woman • Male breast cancer • Breast cancer that occurs in both breasts • Ashkenazi Jewish history • Many people on the same side of the family affected by breast, ovarian, pancreatic, prostate cancer, sarcoma or melanoma. 95% of breast cancers have nothing to do with family history.

What tests will be performed if my doctor is suspicious of breast cancer?

After thorough history and clinical examination your doctor may order the following. Breast imaging such as mammogram and ultrasound and in some instances breast MRI. Diagnosis also requires taking some tissue with a biopsy which is usually performed by a radiologist and involves a fine needle biopsy or core biopsy. If you are diagnosed with breast cancer then you will be referred to a surgeon to discuss further treatment options.

What if I have breast cancer?

Many people diagnosed with breast cancer are successfully treated. Finding breast cancer early offers the best chance of successful treatment and recovery. The five-year survival rate for Stage 1 (early) breast cancer is, on average, 100% and Stage 2 is 95%. For locally advanced cancers (known as Stage 3) the survival rate is 81%, while the five-year survival rate for Stage 4 (metastatic breast cancer) is significantly lower at 32%.

Further information.

Having a breast problem can be very stressful, particularly if you need lots of tests. Some women who receive the all-clear with their results may find it takes time to stop worrying. The best contact is initially your general practitioner to speak to about any breast concerns you have and they can refer you to a breast specialist if required. Talking with your partner, family or friends can be helpful, or you can call the Cancer Council Helpline on 13 11 20.

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Visceral Fat: The Fat You Can’t See – and Why It Matters

We tend to think of body fat as the soft layer we can see or pinch around our stomach, hips or thighs. But there’s another type of fat that deserves our attention – visceral fat. Unlike subcutaneous fat, which sits just beneath the skin, visceral fat is stored deep inside the abdomen, surrounding organs such as the liver, pancreas and intestines. You can’t see or pinch it and, perhaps surprisingly, you can carry higher levels even if you appear relatively slim. Why does visceral fat matter? Visceral fat isn’t simply stored energy. It is metabolically active, releasing hormones and inflammatory compounds that can affect how the body functions. Higher levels have been linked to insulin resistance, type 2 diabetes, heart disease, high blood pressure, fatty liver and metabolic syndrome. For women, age and hormonal changes can also play a role. As oestrogen levels fall through menopause, the body has a greater tendency to store fat around the abdomen – which may explain why your waistline can begin to change even when your lifestyle hasn’t dramatically altered. The encouraging news is that visceral fat responds well to relatively simple lifestyle changes and is often among the first fat to reduce when overall body fat decreases. Do you have too much? You don’t necessarily need a special scan to get an indication. Waist measurement is a useful and simple starting point. For women, a waist measurement over 80cm suggests an increased health risk, while over 88cm suggests a higher risk. Another easy guide is your waist-to-height ratio – ideally, your waist should measure less than half your height. These measurements are general guides rather than a diagnosis, so speak to your GP if you have concerns. Why does it build up? There’s rarely one single cause. Visceral fat can increase through a combination of consuming more energy than the body uses, highly processed foods, sugary drinks and alcohol, low physical activity, ageing, hormonal changes, poor sleep, chronic stress and genetics. While we can’t control every factor, there is plenty we can influence. How to reduce visceral fat Forget endless sit-ups – unfortunately, we can’t choose where our body loses fat. Instead, focus on reducing overall body fat and building healthier habits. Eat well: Base meals around vegetables, lean protein, fibre-rich carbohydrates and healthy fats, while reducing highly processed foods, refined carbohydrates and sugary snacks. Combine strength and cardio: Brisk walking, cycling, jogging or interval training can help burn energy, while strength training builds and maintains muscle and supports metabolism. Cut back on alcohol: Alcohol can add significant extra energy and is associated with fat storage around the middle. Prioritise sleep: Aim for around seven to nine hours. Poor sleep can disrupt hormones involved in appetite and fat storage. Manage stress: Chronic stress raises cortisol, which can encourage abdominal fat storage and increase cravings. Walking, time outdoors, gentle exercise and simply making time to unwind can all help. Small changes count Reducing visceral fat doesn’t require extreme diets or punishing workouts. Consistency is far more important. Eating well, moving regularly, including strength training, getting enough sleep, managing stress and moderating alcohol can all make a difference – not simply to your waistline, but to your long-term health. And that makes visceral fat worth paying attention to, even if you can’t see it.

Health and Wellness

Women who golf

Golf might once have had a reputation as a sport for retirees with plenty of time on their hands, but those days are well and truly behind us. Women of all ages are discovering that a round of golf delivers much more than a little friendly competition. In fact, golf has quietly become part of the health and wellbeing conversation, combining exercise, fresh air, mental stimulation and social connection – without necessarily feeling like exercise at all. At Southport Golf Club, that growing interest is easy to see. The club has welcomed 84 new women members over the past two years, all of whom have continued their membership, joining an existing community of around 170 women. Exercise Without the Gym An 18-hole round can clock up more than 10,000 steps and burn around 900 calories. But unlike pounding away on a treadmill, you’re usually far too busy thinking about your next shot, chatting with your playing partners and enjoying the surroundings to notice just how active you’ve been. Walking the course also helps strengthen and tone muscles, while providing regular moderate exercise that can contribute to better cardiovascular health. Good for the Mind, Too There’s something to be said for spending a few hours outdoors. Fresh air, green spaces and physical activity can help reduce stress, improve mood and boost self-esteem, while the release of endorphins can leave you feeling happier, more relaxed and even sleeping better. Regular physical activity can also help reduce the risk of conditions including heart disease, high cholesterol and dementia, supporting our health as we age. Keep Learning Golf is one of those wonderful games you never completely master – which might occasionally be infuriating, but it’s also part of the appeal. Learning new skills, setting goals and challenging yourself keeps the brain engaged and provides a real sense of achievement. Friends, Fun and Connection Perhaps one of golf’s greatest benefits is its social side. It creates opportunities to meet new people, strengthen friendships and enjoy time with family – with plenty of conversation along the way. And you don’t need to be super fit, young or particularly sporty to start. The handicap system allows different abilities to play together, while choosing between nine or 18 holes means golf can fit into busy lives. Exercise, friendship, fresh air and a little healthy competition? Perhaps golf really is onto something.

Health and Wellness

The Rise and Rise of Hypnotherapy

You’ve probably slipped into a hypnotic state today. You just didn’t call it that. Have you ever driven somewhere familiar and suddenly realised you have no memory of the last few kilometres? You weren’t asleep, your attention simply wandered while your brain handled it automatically. We all experience periods of absorbed attention, which can also feel like daydreaming. Hypnotherapy uses that same state, guided deliberately toward a therapeutic goal. You may have heard of the lovely story about a man who asked his gardener what made his plants grow so beautifully. The gardener replied: “I don’t force them to grow. I remove what stops them. I pull out the weeds that are strangling their growth, clear the space around them, and position healthy plants to better receive the sunlight they need.” That is how I think about hypnotherapy. Sometimes old patterns, beliefs and emotional responses have shaped the way we think, feel and behave for years. We may consciously know we want something different, yet still find ourselves responding in the same familiar way. Hypnotherapy aims to explore what’s underneath those patterns, and may help loosen what’s no longer serving us, making room for new ways of thinking, feeling and doing. So, what does hypnotherapy actually feel like? You remain awake and aware. You can hear, speak, think and open your eyes at any time. For many people, hypnosis is experienced as deeply relaxing and focused. The outside world may feel less important as attention becomes absorbed in the therapist’s voice and suggestions. Depending on the goal, hypnosis might involve exploring a different perspective, rehearsing a new response, strengthening confidence or working with an unwanted habit or emotional pattern. But isn’t that just meditation? Not quite. Meditation helps us become still. Hypnotherapy uses that same focused, relaxed state and gives it direction and purpose. Meditation generally aims to cultivate awareness, presence and calm. Hypnotherapy uses focused attention and suggestion towards a specific therapeutic goal, working with thoughts, feelings, behaviours and patterns. What might people seek it for? Stress, anxiety, sleep difficulties, pain management, confidence, self-esteem, unwanted habits and phobias, such as a fear of flying or emetophobia (a fear of being sick), are among the reasons people may explore hypnotherapy. For an HSC student, that might mean a calmer relationship with exams, or reduced performance anxiety. Hypnotherapy isn’t a one-size-fits-all intervention, and no ethical practitioner should promise a particular outcome. What does the science say? For years, some dismissed hypnosis as a parlour trick. Modern neuroscience has given researchers a new way to investigate what actually happens. In a Stanford University study published in Cerebral Cortex, researchers used functional MRI to examine brain activity and connectivity during hypnosis. They observed changes involving networks associated with attention, cognitive control and self-awareness in highly hypnotisable participants. The research doesn’t suggest hypnosis is a magic switch, or that everyone responds the same way. But it does add to growing evidence that something measurable is happening in the brain during hypnosis. From athletes to celebrities and royalty Hypnosis has moved a long way from its stage-show associations. Athletes have explored hypnosis, visualisation and mental rehearsal as part of performance preparation. Dual Olympian Jodi Winter has spoken about her own experience of hypnotherapy, describing coming away feeling “deeply relaxed, clearer and lighter”, and the easing of anxiety she had carried for much of her life as “incredibly freeing.” Catherine, Princess of Wales, has spoken about using hypnobirthing techniques to help her cope with hyperemesis gravidarum, a severe pregnancy sickness condition, as well as during the birth of her three children. Perhaps high performers understand something the rest of us are increasingly recognising: the mind isn’t separate from performance. It is part of it. So why is hypnotherapy rising now? We’re surrounded by notifications, screens and constant demands for our attention, yet many struggle to switch off, sleep, feel confident or simply feel like themselves. Hypnotherapy offers something increasingly precious: deep, focused attention. For many women juggling work, family and everyone else’s needs, that kind of undivided attention on themselves is rare, and it can feel like coming up for air. In a world of surface-level, instant dopamine hits, depth is becoming essential. If that’s something you’re drawn to exploring, who you choose to guide you there matters. Choosing a hypnotherapist When choosing a hypnotherapist, know that the profession, like counselling, is unregulated. Look for the title ‘Clinical Hypnotherapist,’ and as a benchmark, ideally one who is a member of the Australian Society of Clinical Hypnotherapists (ASCH) or the Australian Hypnotherapists Association (AHA), both of which ensure high educational standards, ongoing supervision and continued training. With the right support, there’s a chance to learn something wonderfully new. Disclaimer: This article is for general information only and is not intended to replace medical advice, diagnosis or treatment. If you have a mental health concern, speak with your GP or another appropriately qualified healthcare professional. About the author Justine Williams Founder of The Feel Good Studio and Hyp Little Fairy Tales® Affectionately known as The Fairy Godmother for her work supporting children, parents and families. A highly regarded Clinical Hypnotherapist, speaker and multi-award-winning author. Website Email

By Justine Williams

Health and Wellness

A House in the Making – A Scent of things to come

For Paul James Graham, ‘Spencer Rambo’ represents the culmination of more than two decades immersed in hair, fashion and creative direction — and the beginning of something much larger. An award-winning hairdresser, educator, creative director and brand ambassador, Graham’s career has extended beyond the salon into education, editorial, competitions, judging, campaigns and major hair productions. That experience – and a reputation built over many years – now forms part of the foundation of Spencer Rambo. But Graham is not building it alone. His husband and long-time partner, Paul Dumenil, brings a different perspective. Where Graham’s career increasingly carried him beyond the salon, Dumenil remained deeply immersed within it – connected to the client, the craft and the everyday reality of creating beautiful hair. Their strengths are different, but complementary. Somewhere between Graham’s broader industry experience and Dumenil’s intimate understanding of the salon, Spencer Rambo began to take shape. Not simply as another name in haircare, but as a house – with its own point of view on beauty, fragrance, design and luxury. Its first expression is fragrance. CADENCE; In Perfect Time and ICON; Be Remembered are Spencer Rambo’s inaugural Hair & Body Perfumes. Designed to be worn through the hair and across the body, both feature an impressive 25% perfume concentrate, alongside Sodium Acetylated Hyaluronate – an advanced form of hyaluronic acid chosen for its moisture-binding properties and affinity with the hair. The fragrances themselves are deliberately distinct. CADENCE opens with aldehydes and jasmine, moving through clove, orange blossom and jasmine before settling into marine notes, amber and musk – polished, atmospheric and sensual. ICON moves differently: floral notes and vanilla give way to amber and matcha, grounded by musk, ambergris and sandalwood for warmth, depth and lingering sophistication. They are, perhaps, best understood as perfumes that happen to understand hair. CADENCE and ICON are only the first glimpse inside the house Graham and Dumenil are building. What comes next is being kept deliberately close. For now, the clues are in the legacy of their hairdressing careers – a world beginning to reveal itself. CADENCE and ICON are the invitation. Behind them, the doors to Spencer Rambo are only beginning to open. “As professional hairdressers, we never take for granted the trust someone places in us when they invest their time and money in something we create for them. we want them to feel that same genuine value when they choose Spencer Rambo – in the quality, the formulation and the experience. Luxury can be beautiful and aspirational, but above all, it should be truthful — Paul & Paul