Women should be paying close attention to their breast health at all times, though October gives us an opportunity to remind them about this preventive care. Currently, 1 in 8 women will develop breast cancer in their lifetime. Women over the age of 40 are at the greatest risk, and 8 out of 10 cancer cases happen to women over the age of 50. We still don’t know how to prevent breast cancer, but we DO know how to detect it early and treat so it will hopefully not become a fatal disease. Early detection is our best defense against this disease, and we need to do a much better job of reaching young women with the education and information they need to know their breasts, do regular self-exams and receive annual clinical breast exams.
Women can do a number of things to detect breast cancer early:
• Start doing self-exams in their early 20’s every month, 1-2 weeks after their period
• Starting at age 20, receive an annual clinical breast exam at least every 3 years, and every year starting at age 40
• Report anything abnormal they find to their practitioner immediately
• Receive a baseline mammogram at age 40, or earlier depending on family history
• Receive a mammogram every two years up to age 50, and every year thereafter
 Women can also do certain things to lower their risk for breast cancer, including:
• Decrease caffeine intake
• Decrease dietary fat intake
• Eat 5 or more servings of fruits and vegetables each day
• Choose whole grains over processed or refined products
• Limit intake of red meat
• Limit alcohol consumption to 1 or less drinks per day
• Exercise as many days of the week as possible. Obesity makes it harder to detect breast lumps which could leader to later diagnosis and treatment.
There are many risk factors for breast cancer, although having a risk factor or even several does not mean you will get the disease. Most women who have one or more breast cancer risk factors never develop the disease, while many women with breast cancer have no apparent risk factors.
Risk factors for breast cancer include:
• Gender: Being a woman is your greatest risk factor. Your breasts are constantly exposed to the growth promoting effects of the female hormones estrogen and progesterone.
• Aging: 1 in 8 invasive breast cancers are found in women younger than 45, while 2 out of 3 invasive breast cancers are found in women age 55 or older.
• Genetics: 5-10% of cases are due to heredity, related directly from gene defects called mutations inherited from a parent.
• Family History: Having one first degree relative (mother, sister or daughter) with breast cancer approximately doubles a woman’s risk. Having 2 first degree relative increases her risk about 5- fold. There is also an increased risk if the woman has a family history of breast cancer in a father or brother. About 20-30% of women with breast cancer have a family member with this disease. This means that most (70-80%) of women who get breast cancer do not have a family history of this disease.
• Race and ethnicity: While white women are slightly more likely to develop breast cancer than are African-American women, African-American women are more likely to die of the cancer. Part of this seems to be that African-American women tend to have more aggressive tumors. Asian, Hispanic, and Native-American women have a lower risk of developing and dying from breast cancer.
• Dense Breast Tissue: Some women have more glandular tissue and less fatty tissue. Dense breast tissue can make it harder for providers to spot problems on mammograms and/or feel on exam.
• Breast Conditions: such as fibrocystic breast condition (FCC), mastitis, other benign tumors like fibroadenomas and papillomas or atypical hyperplasia.
• Menstrual periods: Women who have had more menstrual cycles because they started menstruating at an early age (before the age of 12) and or went through menopause at a later age (after the age of 55) have slightly higher risk of breast cancer. This may be related to a higher lifetime exposure to the hormones estrogen and progesterone and breast changes associated with that.
• Previous chest radiation
• DES exposure: In the 1940’s-1960’s some pregnant women were given this drug to lower their chance of miscarriage. Women who took this drug and or their female offspring are at a greater risk for breast cancer.
• Lifestyle risks include: not having children, or having them later in life (after the age of 30). Greater exposure to hormones, estrogen and progesterone. The fewer periods you have, the better!
• Breast Feeding: if you breast fed a child for at least 1.5-2 years there is slightly lower risk of breast cancer. (reduces the total number of lifetime menstrual cycles)
• Alcohol: risk increased with the amount of alcohol consumed. 2-5 drinks/day = 1.5 risk. American Cancer Society recommends that women limit their consumption of alcohol to no more than one drink a day.
• Being overweight or obese: Especially for women after menopause. Before menopause your ovaries produce estrogen, after menopause most of the estrogen comes from fat tissue. These rising estrogen levels increase the risk of breast cancer. Excess fat cells in the waist area may affect the risk more than the same amount of fat in the hips and thighs. Fat cells in various parts of the body have subtitle differences that may explain this.
• Lack of physical activity: The more exercise the better! The Women’s Health Initiative found that as little as 1.25-2.5 hours per week of brisk walking reduced a women’s risk by 18%. Walking 10hrs /wk reduced the risk even more. ACS recommends 45-60 minutes of intentional physical activity 5 or more days/wk.
And finally, to dispel the myths! The following factors have not been proven in any way to cause breast cancer:
• Antiperspirants: Parabens (used as a preservative in antiperspirants and other products) may have an estrogen like property. Very weak research to link this to increased risk.
• Bras: Possible risk due to obstruction of lymph flow. No good scientific basis. Women who do not wear bras regularly are more likely to be thinner.
• Induced Abortion: Several studies have provided very strong data that neither induced abortions nor spontaneous abortions increase risk.
• Breast Implants: Breast implants don’t cause cancer, however, silicone breast implants can cause scar tissue to form in the breast and make it harder to see breast tissue on a standard mammogram.
• Chemicals in the Environment: PCB, DDE, chemicals used in plastics, cosmetics and pesticides may have an estrogen like property. At this time research does not show a clear link between breast cancer risk and exposure to these substances.
• Tobacco smoke: Research show “suggestive but not sufficient” evidence that tobacco smoke, including second-hand smoke can cause breast cancer.
• Night Workers: studies looking at the change in melatonin, a hormone whose production is affected by the boy’s exposure to light.
Planned Parenthood will be holding free, one-hour long breast health education sessions for young women during the month of October. For more information including dates, times and locations please visit our Web site at www.ppsev.org.
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