Breast cancer affects us all
The numbers are staggering. One in 8 (12.4 percent) U.S. women will develop breast cancer during her lifetime, according to the National Cancer Institute. The Susan G. Komen Breast Cancer Foundation estimates that approximately 255,000 people will be diagnosed with breast cancer in the U.S. this year alone, and more than 40,000 lives will be lost to this disease. These are numbers we feel every day, as most people, regardless of who they are or where they live, are impacted by breast cancer in some way, whether it be a family member, friend, or colleague who has or knows someone who has this disease. While there’s much left out of a woman’s control when it comes to getting breast cancer, especially considering most cases appear randomly and do not always run in families, there are several important steps that can reduce this risk substantially. In honor of Breast Cancer Awareness Month, doctors share the steps you can take every day, week, month and year to put your best foot forward towards lowering your risk. Find out the breast cancer symptoms you might ignore.
First things first: Know your family history
It’s standard procedure nowadays for nearly every type of doctor you see to inquire about your family history, as genetics have been proven to be a key contributor to an individual’s cancer risk—and it’s especially important when it comes to breast cancer. “Some women (and men) have an especially high risk of developing breast cancer related to inherited predisposition, history of radiation treatments to the chest wall during adolescence or early adulthood, or because of ‘overactive’ breast tissue that is sometimes detected on breast biopsies,” explains Lisa Newman MD, MPH, a member of Komen’s Scientific Advisory Board and director of the Breast Oncology Program for the Henry Ford Cancer Institute. Red flags that she says suggest possible inherited predisposition include having multiple relatives with breast or ovarian cancer, male relative(s) with breast cancer and relatives that were diagnosed with breast cancer at young ages. “Patients who are found to have an increased risk of breast cancer should then discuss risk-reducing options (such as medication or surgery) or more aggressive breast cancer screening options (such as mammograms starting at younger ages or a special breast imaging test called an MRI),” adds Dr. Newman. Find out six simple changes you can make to lower your breast cancer risk.
Perform self breast exams monthly
While the American Cancer Society recently revised its guidelines on self breast exams, noting that there’s not enough research to support their clear benefits, experts agree that they’re still important—and there’s absolutely no downside. “Knowing what your baseline ‘lumps’ are so you’ll be able to immediately recognize when something feels new or different is key,” says Phoebe Harvey, MD, chief of hematology/oncology for Kaiser Permanente Northwest in Portland, Oregon. “Women who have naturally lumpy breasts often say they find it hard to know what’s ‘normal.'” Her best advice is to pay attention to lumps that feel unlike the rest of your breast tissue, for example, that are harder or just seem out of place. These should be checked out by your provider. “There can also be visual clues as well, like a change in the size or shape of your breast, or dimpling of the skin,” she adds. And if you do find a lump, don’t freak out. Here are seven things that lump could be beside breast cancer.
Schedule yearly mammograms
Women who have an average risk of breast cancer should begin having annual mammograms, basic x-rays of the breast, according to the American Cancer Society. However, there’s been a great deal of controversy in recent years with regard to the age and frequency. Experts recommend discussing your risk factors with your doctor to determine if a mammography before the age of 40 is right for you. “Although getting screened for breast cancer does not reduce your risk, it can help identify the proper screening methods you should be using based on your risk factors and can help to identify cancer early when it is easiest to treat,” explains Jane Kakkis, MD, medical director of breast surgery at MemorialCare Breast Center at Orange Coast Medical Center in Fountain Valley, California. If you are old enough to have a screening mammogram, Dr. Kakkis recommend also asking your doctor whether or not you have dense breast tissue. “If you have dense breast tissue, then your risk of breast cancer is increased and, depending on other risk factors that you might have, your doctor may recommend supplementing your mammogram screening with ultrasound or MRI.” Find out how dense breasts affect your breast cancer risk.
Maintain a normal body weight
Among the laundry list of reasons why a healthy BMI (body mass index) is beneficial is that it has been known to significantly reduce your risk of cancer, as well as several other diseases including heart disease and diabetes. “One reason for this is that body fat produces estrogen, which increases the risk of developing breast cancer,” explains Dennis Holmes, MD, breast cancer surgeon and researcher and interim director of the Margie Petersen Breast Center at John Wayne Cancer Institute at Providence Saint John’s Health Center in Santa Monica, California. This is even more important as we get older, as Dr. Newman notes that women who are overweight or obese after menopause have a 30 to 60 percent higher breast cancer risk compared to those who are lean. Aim for a BMI that is between 18.5 to 24.9, as anything above is considered overweight and anything above 30 is considered obese. Find out how else BMI may affect your health.
Exercise several times a week
According to Marc Hurlbert, Ph.D, breast cancer specialist and chief mission officer for the Breast Cancer Research Foundation, physical activity may be the most potent lifestyle factor in reducing the risk of breast cancer, especially after menopause. “It not only helps in achieving and maintaining a healthy weight, but exercise also reduces the levels of metabolic hormones including insulin and leptin, and it reduces levels of estrogen, all of which promote tumor growth,” he says. “Exercise may be most beneficial in overweight women who may have high levels of insulin and estrogen.” The American Cancer Society recommends that adults get at least 150 minutes of moderate intensity, or 75 minutes of vigorous intensity, activity each week, preferably spread throughout the week. Find out 15 breast cancer myths you can safely ignore.
Watch your diet
When it comes to maintaining a healthy weight, diet goes hand-in-hand with exercise. “Changes to your body as you age, and especially after menopause, make it necessary to change lifestyle and eating habits to maintain a healthy weight,” Dr. Kakkis explains. She recommends the Mediterranean diet, which incorporates a lot of fresh vegetables, healthy sources of fats, lean protein sources, and whole grains. “All of these, especially when coupled together, benefit your cardiovascular system and lead to a substantial amount of health benefits.” She does note, however, that even with a healthy diet, portion sizes should be appropriate, with the largest food group in each meal being vegetables. Also, do your best to eliminate preservative-laden foods, especially nitrates, as well as hormone and pesticide additives. “Soy concentrated products should be avoided by high-risk persons or breast cancer survivors, (soy supplements, soy milk, etc.) and natural food sources of soy, such as tofu should be limited to three small servings per day,” she says. “Using proper oils for deep frying is important, as oils that are heated past their optimal temperature develop chemicals known to cause cancer to enter the food.” Peanut oil is an example of an oil that can be used for deep frying. Find out more easy ways to make your diet more Mediterranean.
Cut down on the cocktails
While it’s not exactly clear why, there is a growing body of evidence that suggests as little as one alcoholic beverage a day is enough to increase an individual’s risk of breast cancer. “Among other things, alcohol is thought to raise estrogen levels and can also contribute to weight gain,” explains Dr. Harvey. This can be a tough pill to swallow for those who enjoy a nightly cocktail or glass of wine, but Dr. Harvey urges that the correlation is strong enough. She advises people to strongly consider reducing their intake, especially since alcohol is a known risk factor for a number of other cancer types as well. Are you drinking too much? Find out here.
Quit smoking, stat
“Recent studies show that smoking, especially heavy smoking, may increase the risk of certain breast cancers,” says Dr. Hurlbert. “The effect may be stronger when a woman starts smoking before her first child.” Second-hand smoke plays a role in increasing a person’s risk too. “In animal studies, chemicals from first or second-hand smoke caused breast tumors and was found in the milk of nursing rodents,” he says. Bottom line: Smoking is terrible for your health and may be a catalyst for increasing your breast cancer risk. Quitting is your only option to reduce this risk. Here are the 23 best ways to quit smoking.
Take aspirin or ibuprofen regularly
Seriously! Research has found that women who take two or more tablets of aspirin or ibuprofen each week for at least five years have a 20 percent lower risk of developing breast cancer. “Taking these medications for more than 10 years lowers the risk even further,” notes Dr. Holmes. “Either mediation is capable of reducing chronic inflammation within the body, which can predispose some women to develop cancer.” While the ideal dose and frequency of use of aspirin or ibuprofen have not been determined, Dr. Holmes recommends women to consider taking a low dose of aspirin (81 mg) or ibuprofen (200 mg) twice a week if they’re not already doing so for other reasons.
Have children earlier in life (if possible)
While the reasons aren’t totally clear, research suggests that women who conceive children earlier in life have a lower risk of breast cancer. The Nurses’ Health Study, for one, shows that women who give birth in their 20s compared to those who give birth in their 30s or later, have a reduced risk of breast cancer. “It is believed that the hormonal and other cellular effects of pregnancy influence the breast tissue positively and is protective against cancerous transformation,” explains Jack Jacoub, MD, medical oncologist and medical director of MemorialCare Cancer Institute at Orange Coast Medical Center in Fountain Valley, California. Additionally, women who have multiple children see a decreased risk. One reason for this, notes Dr. Jacoub, is that pregnancy limits the periods of “incessant ovulation” over a woman’s lifetime. “This is when ovaries are functional and producing high levels of sex hormones, namely estrogen.”
Breastfeed your baby
While this isn’t always easy, or feasible, for all women, research shows that women who breastfeed, when compared to those who don’t, have a modestly decreased risk of breast cancer. “The effect is greatest in women who breastfeed for one and a half to two years,” notes Dr. Hurlbert. “Breastfeeding delays the return of menses after childbirth and this lowers the lifetime exposure to estrogen.” He also notes that total exposure to estrogen over a lifetime can increase the risk of breast cancer after menopause. “That’s one reason why having children is also protective, as a woman’s estrogen levels drop during pregnancy.”
Limit oral contraceptive use
“Following on the discussion about exposure to estrogen, oral contraceptives increase this exposure,” says Dr. Hurlbert. In other words, women who use oral contraceptive have a slightly higher risk of breast cancer compared to those that don’t. “The risk decreases over time after stopping contraceptive use and women who have not taken contraceptives for more than ten years are no longer at increased risk from contraceptive use.” He recommends that women discuss their use of hormone-based contraception with their doctors to determine what is best for their particular health concerns and situation.
Quit menopausal hormone use
The practice of using menopausal hormone therapy (MHT) to relieve symptoms of menopause, such as hot flashes and sleep disturbances, has been used for more than a century, but recently it’s been linked to an increase in breast cancer risk. “The combination of estrogen plus progestin for several years increases the likelihood of developing breast cancer and can make mammograms more difficult to interpret,” explains Dr. Newman. “You can reverse some of this risk by discontinuing these hormones.” She recommends talking with your doctor about safe alternatives to control menopausal symptoms. Try these natural remedies for menopause symptoms.
Although all women are at risk of developing breast cancer, some women are at particularly high risk because of personal health factors and family history. These “high risk” women, many of which are carriers of the BRCA 1 or BRCA 2 genetic mutations, should consider taking preventative action, which often involves surgery, to dramatically reduce their risk of breast cancer. “If you have a strong family history of breast cancer, genetic testing is highly recommended so you can better understand your options,” says Nikita Shah, MD, breast cancer specialist at the Breast Care Center at Orlando Health UF Health Cancer Center. If someone in your family has been diagnosed with breast cancer, especially before age 40, ask your doctor about getting tested for the BRCA gene. In some cases, your doctor may recommend you go ahead with a preventative surgery, such as removal of the breasts, ovaries, and Fallopian tubes, to reduce your risk of getting cancer.
Understand how your community and identity can affect your risk
Research suggests that those with certain ethnic and socioeconomic backgrounds may be at a predisposition to be diagnosed with breast cancer, for example, Ashkenazi Jewish families have a significantly higher risk of carrying mutations or abnormalities, Dr. Newman notes. “We also know that breast cancer mortality and death rates are significantly higher among African American compared to white American women.” She explains that this disparity is related to socioeconomic disadvantages and healthcare access barriers that are more prevalent in the African American community, but it has also been shown that a biologically more aggressive pattern of breast cancer (triple negative breast cancer) is twice as common among African American compared to White American women. Breast health awareness and early detection or screening programs, as well as research, are essential to address and eliminate these disparities, so use what is available to you and use it wisely. Find out 12 things your mom’s health may reveal about yours.