Breast Cancer: Early Detection is
Your BEST PROTECTION!

Breast Cancer. These two words can strike fear in our hearts because we know - even if we ignore the threat - it could happen to us. Among American women, breast cancer is by far the most common cancer, and it's the second leading cause of cancer death (behind lung cancer). Each year more than 190,000 American women develop breast cancer and almost 40,000 die from this disease.

If you have not already done so, it's time to stop avoiding the threat and start doing something to help yourself. Learn about your risks, do what you can to lower them and take advantage of screenings. Early detection is your best protection!

Certain factors can influence your risk

One woman in eight will develop breast cancer. Certain factors can increase the odds that this woman will be you. Remember, however, the primary risk factors for breast cancer are being a woman and age - your risk increases steadily as you grow older. Less than 25% of women with breast cancer have any other known risk factors. So even if none of the following applies to you, that does not mean you are immune, and not at risk

1.  FAMILY HISTORY:  Hereditary breast cancer occurs in only 5% - 10% of breast cancer patients.  If someone in your immediate family (children, parents, siblings) has been diagnosed with breast cancer, your risk of the disease is 2 to 3 times higher than average.  Your risk is 4 times higher if your mother had breast cancer before menopause.

 
In 1994, researchers discovered that one in 200 women in this country carry an irregular gene which is involved in the development of inherited breast and ovarian cancer. 10% of women are carriers of this gene. Women who carry this gene have a 50%-60% lifetime risk of breast cancer and also have an increased risk for developing cancer of the ovary. Females of Eastern and Central European Jewish population (Ashkenazi) are at increased risk. Genetic linkage testing can now be done to detect the gene. Testing for this gene may be done if there is family history. Some women at a very high risk of developing breast cancer may choose to have mastectomies to remove their breasts before cancer develops. These genetic mutations also increase ovarian cancer risk. Physicians may recommend removal of the ovaries after childbearing or after menopause as there are currently no reliable methods of screening for ovarian cancer.

DIET: Breast cancer rates are 4 to 7 times higher in the U.S. than in Asia. Yet, when Asian women move to this country their risk doubles over a decade, and equals U.S. rates after several generations. No one is sure why this happens, but consistent evidence points to a change in their diet. We don't know whether their risk is influenced by the increase in calories, high fat foods and meat or a decrease in fruits, vegetables, grains, soy or other foods. The results of many different studies are still inconclusive. However, we do know that eating less fat and more fruits, vegetables, beans and grains will help protect us against cancers of the lung, mouth, throat, stomach, and colon -- and possibly breast cancer.

OBESITY: Obesity has been suggested as a breast cancer risk in all studies, especially in postmenopausal women. More research is needed to better understand the impact of fat intake and body weight on breast cancer risk, but these factors have been shown to increase the risk of developing other types of cancer. The American Cancer Society recommends that everyone maintain a healthy weight and limit the intake of high-fat foods.

HORMONES AND PREGNANCIES: If you have a longer reproductive life (menstruation began before 12 and/or menopause occurred after age 55), you may have a greater risk of breast cancer. If you have never been pregnant, your risk is higher than if you have had one or more full-term pregnancies. In addition, if you delay childbearing until your 30's or 40's, your risk is higher than women who have had children in their teens or 20's. Although still under study, there's some evidence that breast-feeding may slightly lower breast cancer risk, especially if breast-feeding is continued for 1 1/2 to 2 years.

HORMONE REPLACEMENT THERAPY (HRT): Few studies have shown a very slight increase in the risk of breast cancer in women taking replacement hormones, while a number of other studies have found no increased risk and in some cases a lower rate of breast cancer. The American Cancer Society completed a study which suggests that women who use HRT are less likely to die from breast cancer than nonusers. Multiple studies have consistently shown that women on HRT live longer due to a potential decreased risk of heart attack and stroke, and a decrease of osteoporosis. HRT may even prolong life in women previously diagnosed with breast cancer who have been disease free for 5 years or more.

ORAL CONTRACEPTIVES "THE PILL": According to many studies, including the largest and most recent study from the Centers for Disease Control and Prevention, using the birth control pill does not increase your overall lifetime risk of breast cancer. Up until the age of 35, women who have taken "the pill" have a slightly increased risk of breast cancer compared to women who have never taken the pill. After age 35, women who used the pill (or who are still using the pill) do not have an increased risk of breast cancer, and after age 45, they may have a slightly decreased risk. Don't forget, the "the pill" also has many health benefits, like decreasing your risk of ovarian and uterine cancer and preventing pregnancy.

ALCOHOL: Drinking alcohol is clearly linked to increased risk of breast cancer. Compared with nondrinkers, women who drink one drink a day have a very small increase in risk. Women who drink 2 or more drinks a day have about 1 1/2 times the risk of women who drink no alcohol.

PREVIOUS CANCER(S): Previous cancer in one breast gives you the highest risk of developing cancer in the other breast. A personal history of uterine, ovarian or colon cancer also increases your risk of breast cancer.

Early detection is critical

There are two equally important things you can do to detect breast cancer in the early stages, when treatment is easier and more effective -- breast self-exams and mammograms. You need to do both!!

Physical Examination: Breast tumors are usually painless and are often detected by women themselves. Performing monthly self-exams is especially important between age 35 and 50 but should be started at an earlier age, 18 preferably, and should continue throughout the postmenopausal years. Breast tumors may grow faster in younger women because of higher levels of estrogen. A tumor may begin to develop right after you've had a mammogram and grow so quickly you can feel the lump before your next mammogram.

Regardless of your age, self-exams may help detect cancer earlier and improve your survival rate. Ideally, you should perform the exam at the end of each menstrual period, when your breasts are least affected by hormones. If you are post-menopausal, you should examine your breasts at the same time each month (i.e., the first of the month). A physician should perform a breast exam once a year during your routine visit, and immediately if you notice a change or lump in your breast.

Mammography and other imaging techniques: Mammography is a low dose x-ray used to image the breast tissue. Mammography detects 90-95% of all breast cancers, and can find tumors 1 1/2 to 2 years before they can be felt. Annual mammograms in women over 50 can reduce breast cancer deaths by 30%.

At The Adler Center for Women's Health we follow the American Cancer Society guidelines and recommend a baseline mammogram between age 35 and 40, and then every year from age 40. These recommendations may be different for you depending upon your risk factors.

Other diagnostic techniques include breast ultrasound studies and high resolution digital ultrasound with Doppler flow. These techniques can help distinguish between breast cysts and solid tumors. Special MRI studies and techniques using bioelectric field technology may provide more accurate and cost effective breast imaging in the future. Currently, mammography is still the best imaging technique.

Don't wait until it's too late