Breast Cancer: Know Your Risks and Take Action
October is Breast Cancer Awareness Month.
Breast cancer is the second most commonly diagnosed cancer among U.S. women, affecting one in eight women who live to age 80. Let’s not count out the male population! Men account for about 1 in 100 breast cancer cases diagnosed in the United States.
The disease forms when breast cells mutate (change) disabling specific functions that control cell growth and division. In many cases, these mutated cells die or are attacked by the immune system. But some cells may escape the immune system and grow unchecked, forming a tumor in the breast. If untreated, cancerous cells may spread to other parts of the body.
Women who have a family history of the disease, who are obese, or who have dense breasts have a higher risk of breast cancer. Breast cancer symptoms include a lump, skin changes, nipple discharge and pain.
Breast cancer risk factors
When it comes to breast cancer risk, there are factors you can’t change, like your age, race and genes. But there are others you do have control over, such as your exercise level, alcohol consumption and other lifestyle habits.
The key to lowering your risk for breast cancer is to focus most of your prevention efforts on those modifiable risk factors, and to be “hands-on” in various ways to monitor the ones you can’t change.
Life habits (risk factors) you can control
Alcohol use: Your risk for breast cancer may rise with every drink. Research suggests that women who drink one alcoholic beverage a day have a 7 to 10 percent increased risk for breast cancer compared with nondrinkers, and this number jumps to 20 percent for those who have two to three alcoholic drinks per day, according to the American Cancer Society.
Your weight: Breast cancer is on the list of diseases and conditions caused or worsened by being overweight or obese after menopause. Your ovaries stop making the female sex hormone estrogen after menopause, so most estrogen comes from fat tissue. The more fat you have, the more estrogen you make, and estrogen feeds some breast cancers, causing them to grow. Women who are overweight also may have higher blood insulin levels, which have been linked to breast cancer and diabetes, according to a large study in the Journal of the National Cancer Institute.
A sedentary lifestyle: The less you move, the higher your risk for breast cancer. Staying physically active may help decrease your chances of developing breast cancer, other diseases and aid in weight loss efforts. The American Cancer Society recommends that you aim for 150 to 300 minutes of moderate intensity exercise, such as brisk walking, or 75 to 150 minutes of more intense activity, like running, each week. The more physical activity you do, the greater the benefits. Get the all-clear from your doctor before making major changes to your exercise regimen.
Get Screened: getting screened for cancer as recommended by your healthcare provider can find cancer early, when it’s easiest to treat.
Risk factors to consider
Your reproductive history: Women who haven’t had children, or who had their first child after age 30, may have a slightly higher chance of developing breast cancer. That’s because breast tissue is exposed to more estrogen for longer periods of time. The risk of breast cancer declines for women who become pregnant at a younger age and those with a higher number of births.
What can you do?
Discuss your reproductive history with your doctor when considering your breast cancer screening and prevention plan.
Breastfeeding: If you breastfed, your risk of developing breast cancer may be reduced, especially if you did it for a year or longer. Breast cancer reduction is just one of many benefits associated with breastfeeding. The American Academy of Pediatrics recommends breastfeeding for about the first six months of life, then continuing to breastfeed, supplementing with appropriate foods, for one year or longer.
What can you do? Consider breastfeeding, if possible, as it also protects your baby from many diseases.
Hormone intake: Some birth control methods use hormones, which can up breast cancer risk. These may include:
Oral contraceptives
Birth control shot
Birth control implants
Intrauterine devices (IUDs)
Birth control skin patches
Vaginal rings
Using combined hormone therapy after menopause increases the risk of developing breast cancer. Combined HT also increases the likelihood that the cancer may be found at a more advanced stage.
What can you do?
Discuss concerns with your doctor and weigh all the risks and benefits to make the right decision about birth control or hormone replacement therapy.
Risk factors you can't control
Early menstruation/late menopause
If you started menstruating before you turned 12, you are at higher risk for breast cancer because of the increased number of years that your breast tissue has been exposed to estrogen. Entering menopause late (after age 55) also ups the risk, for similar reasons.
What can you do?
Discuss your menstrual history with your doctor when reviewing your breast cancer screening options.
Your gender
Breast cancer is most often found in women, but men can develop breast cancer too. About 1 out of every 100 breast cancers diagnosed in the United States is found in men. However, women are at much higher risk.
What can you do?
Focus on the risk factors that you can change, such as maintaining a healthy body weight and getting regular physical activity.
Your age
Breast cancer risk rises with advancing age. Most breast cancers are found in women aged 55 and older. What can you do? Regular breast cancer screening exams with mammography won’t prevent breast cancer, but they may find it earlier, when it’s more treatable.
What can you do?
Discuss the best schedule for your breast cancer screening with your doctor.
Your family history
You don’t need a family history to develop breast cancer. In fact, just 15 percent of patients have had a family member with this disease. That said, if you have first degree relatives with a history of cancer, you are considered at higher risk.
What can you do?
If your mother, sister or daughter has had breast cancer, your risk is almost doubled. With two first degree relatives with breast cancer, your risk increases about threefold. Having a dad or brother with breast cancer also increases your breast cancer risk. Make sure your family history is a factor in your breast cancer screening decisions. It may make sense for you to see a genetic counselor and get tested for known breast cancer genes.
Your genes
Up to 10 percent of breast cancers may be inherited via gene changes or mutations passed on from your parents, such as the BRCA1 and BRCA 2 mutations. Researchers are trying to uncover additional genes that may be involved in breast cancer risk.
What can you do?
Speak with a genetic counselor about whether to get tested for the known breast cancer genes. If you have these mutations, discuss medication or surgical options to reduce that risk. For example, a preventive bilateral mastectomy may reduce your chances of developing breast cancer by 90 percent or more, according to the American Cancer Society.
Your race and ethnicity
White and Black women have the highest risk of developing breast cancer in their lifetime. Asian/Pacific Islander and Hispanic/Latina women’s breast cancer rates fall in between two major groupings while American Indian and Alaska Native women are on the lowest end of risk.
While white women are more likely to develop breast cancer than Black women overall, they tend to be diagnosed at an older age (between 60 and 84). Black women have the highest breast cancer rates among women under age 40. Black women make up a higher percentage of triple negative breast cancer cases.
What can you do?
If your race or ethnicity places you at higher risk, make sure you follow all screening recommendations to improve your chances of catching cancer early.
Your breast density
Dense breasts have more glandular and fibrous tissue and less fatty tissue, and this is known to increase your chances of developing breast cancer. Dense breast tissue also may make it harder to visualize breast cancers on mammograms.
What can you do?
If you have dense breasts, which must be noted in your medical records, ask your doctor which screening options are most suited for you. This may include other imaging techniques along with mammograms.
Benign (non-cancerous) breast conditions
Certain noncancerous breast conditions may confer a higher risk of developing breast cancer. The list includes proliferative lesions without cell abnormalities such as usual ductal hyperplasia, fibroadenomas, sclerosing adenosis, several papilloma and radial scars. Proliferative lesions with cell abnormalities, including atypical ductal hyperplasia and atypical lobular hyperplasia, also increase risk.
What can you do?
Knowledge is power. If you have a history of any of these benign breast conditions, make sure your doctor is aware and that this information is considered when making decisions about how and when you should screen for breast cancer.
Your personal history of breast cancer
If you’ve been diagnosed with breast cancer in the past, you are more likely to develop a new cancer in the other breast or in another part of the same breast. This is not considered a recurrence but a new breast cancer.
What can you do?
Follow your cancer team’s instructions on monitoring to stay on top of this risk. Ask your doctor whether you should see a genetic counselor. Ask your cancer team to give you a cancer survivorship plan (prevention and screening road map) that you can use with your primary care doctor.
For more information about breast cancer and breast health from the CDC, go to https://www.cdc.gov/cancer/breast/bcam.htm.
Cancer Diagnosis? Our Cancer Patient Navigator Can Help
Planning for life after breast cancer: You might think that cancer survivorship begins after the treatment ends, but it actually begins with a diagnosis. Survivorship focuses on your overall health and well-being, and this includes everything from financial stability to emotional health.
Our patient navigator is here to help you through every stage of your cancer journey.
Life after breast cancer may be different than the life you had before, but that doesn’t mean you can’t enjoy the many things you’ve always loved. The sooner you discuss life after treatment with your care team, the better prepared you may be to face the physical and emotional challenges of survivorship.
Creating a survivorship plan: There’s no one-size-fits-all approach to life after breast cancer, which is why a customized survivorship plan may help. You can always adjust the plan as you go, but having the roadmap is a critical first step.
Your plan may include:
A list of potential late or long-term side effects and symptoms
Recommended follow-up tests and screenings
A diet and exercise plan
Health insurance for follow-up care
Fertility/pregnancy resources
Mental health support
Sex and intimacy support
A guide on discussing your survivorship with loved ones
Financial planning
For information regarding cancer patient navigation services, contact Ann Crispino, Cancer Patient Navigator, Healthy Acadia, at ann.crispino@healthyacadia.org or 207-255-3741 Ext. 103.