Cancer is cell growth
gone out of control. But
that doesn’t mean you
have no control over
whether or not you get
cancer.
According to the
American College of Ob-
stetricians and Gynecol-
ogists, close to half of
all cancer deaths could
be prevented if everyone
adopted healthy behav-
iors, such as eating a
nutritious diet, getting
regular exercise and
not smoking.
When the topic nar-
rows to breast cancer,
Debbie Saslow, PhD, an
expert on the disease,
prefers not to use the
word prevention.
There aren’t specifc
actions you can take
that will prevent you
from getting breast can-
cer, she explains.
However, you can
take steps to reduce
your risk for develop-
ing the disease, says
Dr. Saslow, who is the
director of Breast and
Gynecologic Cancer for
the American Cancer
Society.
What increases
your risk?
Some things raise your
likelihood of developing
breast cancer.
Older age is one.
The federal Offce on
Women’s Health (OWH)
calls this the strongest
risk factor and notes
that most women who
develop the disease are
older than 50.
Other factors that
increase your risk for
breast cancer include:
■
■
Having certain
mutations of the genes
BRCA1 or BRCA2.
■
■
Having a family his-
tory of breast cancer,
especially in close rela-
tives like a mom, sister
or daughter.
■
■
Being overweight or
obese.
■
■
Not having children
or having your frst child
after age 30.
■
■
Beginning puberty
before age 12.
■
■
Going through meno-
pause after age 55.
If you see yourself
somewhere on that
list, don’t be alarmed.
Having a risk factor
doesn’t mean that you’ll
get breast cancer. In
fact, many women with
one or more risk factors
never develop the dis-
ease, notes the OWH.
How can you
lower your risk?
Dr. Saslow, the Ameri-
can Institute for Cancer
Research and other
experts say you can re-
duce your risk for breast
cancer if you:
Exercise. Regular
physical activity can
lower your risk for get-
ting breast cancer. In
women who have had
breast cancer, exercise
reduces the risk for a
recurrence, Dr. Saslow
says. “We know that
exercise during ado-
lescent and teen years
also is important,” she
adds. One reason: It
infuences how breasts
develop over the years.
Avoid weight gain.
Increased levels of
estrogen are linked to
breast cancer. Excess
fat during menopause
can keep hormone lev-
els higher longer, adding
to risk.
Breastfeed your
baby. Women who
breastfeed have a lower
incidence of breast can-
cer compared to women
who don’t.
Women who are at
particularly high risk for
breast cancer may want
to talk with their doctor
about additional steps
they can take to lower
their risk. For example,
tamoxifen is a drug used
to treat breast cancer.
But it also can be pre-
scribed to help women
at high risk avoid the
disease.
Women who suspect
or know they carry a
BRCA gene mutation
may want to discuss
their options with a
genetic counselor.
Today, thanks to better screening and earlier detec-
tion, women frequently have the option of removing the
tumor with a lumpectomy. “In these cases, life expectancy
is identical, whether you choose mastectomy or lumpec-
tomy,” Dr. Saslow says. “Te survival rates are the same.”
Yet the number of mastectomies is on the rise.
According to Dr. Saslow, there may be several forces
at work, including:
●
●
Access to radiation treatment. “A lumpectomy is
almost always followed by radiation,” she says. Not one
treatment, but a series of treatments. Tat can make
lumpectomy a difcult, and expensive, option when the
nearest treatment facility is far away.
●
●
Fear of recurrence. “If you choose to save the breast
with a lumpectomy, there is a slightly higher risk of
getting a second tumor,” Dr. Saslow says. It’s almost
never fatal, she adds, but instead is found quickly on
follow-up mammograms and successfully treated. Still,
“it’s understandable that some women want to avoid that
possibility,” she says. “It isn’t always a lack of knowledge
that is causing more mastectomies. Instead, it’s women
making personal choices for their own lives.”
7
THE IMPORTANCE OF SCREENING
According to
the Centers for Disease Control and Prevention, mam-
mograms remain the best way for breast cancer to be
found early, when it’s most easily treated.
Today’s technology can fnd a tumor up to three years
before it can be felt—which usually doesn’t happen until
it’s about the size of a pea.
Te ACS recommends women keep the following
schedules for mammograms and clinical breast exams:
●
●
At age 20, begin having your breasts examined by a
medical professional at least every three years.
●
●
At age 40, begin having a screening mammogram and
a clinical breast exam every year.
Can you lower your risk for breast cancer?
Depending on your personal risk factors, your doctor
might suggest earlier or more frequent screenings.
8
A POSITIVE PROGNOSIS
Tere’s been a lot of
progress made in diagnosing and treating breast cancer
over the years, Dr. Saslow says.
Terapies like Herceptin and tamoxifen represent big
steps forward. Research continues to fnd that women can
survive with less radical surgery. A recent study found
that many women could avoid the sometimes-debilitating
efects of mass lymph node removal without afecting
their survival.
“We only look at fve-year survival rates for breast
cancer because treatment keeps improving,” Dr. Saslow
says. “Since the 1990s, mortality has improved about
2 percent every year.
“Te prognosis for breast cancer just keeps getting
better.”
F A L L 2 0 1 1
5
C M H H E A L T H S C E N E