Noticing a lot more pink lately? That’s because it’s Breast Cancer Awareness Month. Each October, this international health campaign promotes awareness of the disease and raises funds for research into its cause, prevention, diagnosis, treatment, and cure.
With 1 in 8 American women diagnosed with breast cancer in their lifetime, it’s critical to continue sharing vital information about this disease. Over 3.3 million breast cancer survivors are proof that early detection and treatment can save lives.
In honor of Breast Cancer Awareness Month, we want to help you understand breast cancer risk factors, prevention, and early detection. Here are the answers to five questions we hear most often from our patients.
1. What is breast cancer?
Breast cancer is a disease that occurs when abnormal cells in the breast grow and invade healthy cells in the body. The cells begin in the breast but can spread (metastasize) to other areas of the body through blood or lymph vessels.
Many people assume there is only one kind of breast cancer. However, it depends on which cells in the breast turn into cancer. Breast cancer can begin in three areas:
- Lobules: Glands that produce milk
- Ducts: Tubes that carry milk to the nipple
- Connective tissue: Surrounds and holds everything together
Most breast cancers begin in the ducts or lobules. The most common kinds of breast cancer are:
- Invasive ductal carcinoma – Cancer cells grow outside the ducts into other parts of the breast tissue.
- Invasive lobular carcinoma – Cancer cells spread from the lobules to nearby breast tissues.
There are several other less common kinds of breast cancer, including Paget’s disease, medullary, mucinous, and inflammatory breast cancer. In addition, ductal carcinoma in situ (DCIS) is a breast disease that may lead to breast cancer.
2. What are the genetic risk factors for breast cancer?
There are still a lot of unknowns when it comes to breast cancer. Cancer grows when a cell’s DNA is damaged, but why or how it happens is still unclear. It could be genetic or environmental. In most cases, it’s a combination.
Let’s look at established genetic risk factors from the National Breast Cancer Foundation.
- Gender – Women have breast cancer nearly 100 times more often than men.
- Age – Two out of three women with invasive cancer are diagnosed after age 55.
- Race – Caucasian women are diagnosed with breast cancer more often than women of other races.
- Family history and genetics – If your mother, sister, father, or child has been diagnosed with breast or ovarian cancer, you have a higher risk. The risk increases if your relative was diagnosed before 50.
- Personal health history – If you’ve been diagnosed with breast cancer in one breast, there’s an increased risk for the other breast. Also, the risk increases if abnormal breast cells were detected before (such as atypical hyperplasia, lobular carcinoma in situ (LCIS) or ductal carcinoma in situ (DCIS)).
- Menstrual and reproductive history – If you had early menstruation (before age 12), late menopause (after 55), had your first child at an older age, or never gave birth, this can increase risk.
- Certain genome changes – Mutations in certain genes (such as BRCA1 and BRCA2) can increase your risk for breast cancer. You can determine this with a genetic test, which you may consider if you have a family history of breast cancer. These gene mutations can pass to your children.
- Dense breast tissue – Having dense breast tissue can increase your risk for breast cancer and make lumps harder to detect. Be sure to ask your physician if you have dense breasts and what the implications are.
3. What are the environmental risk factors for breast cancer?
There are also risk factors within your control. If you’re genetically predisposed to breast cancer, make sure you’re taking steps to reduce the effects of these lifestyle-related risks.
- Lack of physical activity – The more sedentary you are, the greater the risk.
- Poor diet – Particularly one high in saturated fat and lacking fruits and vegetables.
- Being overweight or obese – Your risk increases if you’ve gone through menopause.
- Frequent alcohol use – The more alcohol you consume, the greater the risk.
In addition, if you’ve had radiation to the chest before the age of 30 or take combined hormone replacement therapy (HRT), this can also increase your risk.
4. What can I do to prevent breast cancer?
As you can see from the environmental risks above, there’s plenty you can do to reduce your chances of developing breast cancer. The American Cancer Society recommends the following:
- Maintain a healthy weight – Increased body weight and weight gain as an adult increases the risk of breast cancer after menopause. Take measures to stay at a healthy weight throughout your life and avoid excess weight gain by balancing food intake with physical activity.
- Eat a healthy diet – The possible link between diet and breast cancer risk is not clear, but this doesn’t mean there’s no point in eating a healthy diet. A diet low in fat, low in processed and red meat, and high in fruits and vegetables can have other health benefits, including lowering the risk of some other cancers.
- Be physically active – Many studies have shown that physical activity is linked with lower breast cancer risk. Get at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity activity each week (or a combination), preferably spread throughout the week.
- Limit or avoid alcohol – Even low levels of alcohol intake can increase risk. It’s recommended to have no more than one alcoholic drink a day. A drink is 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof liquor.
And for those who can, women who choose to breastfeed for at least several months may also get an added benefit of reducing their breast cancer risk.
If you’re at especially high risk, your health provider can help you decide if you want to take additional steps, such as medicines or preventive surgery.
5. How can I ensure that breast cancer is detected early?
Breast cancer is sometimes found after symptoms appear, but many women with breast cancer have no symptoms. That’s why regular breast cancer screening is so important.
So, what types of screenings are effective and how often you get them? There are different recommendations depending on the organization, so it’s essential to have a one-on-one discussion with your health care provider to decide what’s best for you.
Let’s take a look at the American Cancer Society recommendations for the early detection of breast cancer. These are in contrast to the US Preventive Services Task Force, which has less stringent guidelines.
Average Risk Recommendations
A woman is considered to be at average risk if she doesn’t have a personal history of breast cancer, a strong family history of breast cancer, or a genetic mutation known to increase the risk (such as in a BRCA gene), and has not had chest radiation therapy before the age of 30.
- Women between 40 and 44 have the option to start screening with a mammogram every year.
- Women 45 to 54 should get mammograms every year.
- Women 55 and older can switch to a mammogram every other year, or they can choose to continue yearly mammograms. Screening should continue as long as a woman is in good health and expects to live 10 or more years longer.
Women who are at high risk for breast cancer should get an MRI and a mammogram every year, typically starting at age 30, based on her personal circumstances and preferences. This includes women who:
- Have a lifetime risk of breast cancer of about 20% to 25% or greater, according to risk assessment tools based mainly on family history
- Have a known BRCA1 or BRCA2 gene mutation (based on genetic testing)
- Have a first-degree relative (parent, brother, sister, or child) with a BRCA1 or BRCA2 gene mutation, and have not had genetic testing
- Had radiation therapy to the chest between the ages of 10 and 30 years
- Have Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or have first-degree relatives with one of these syndromes
If you have more questions about breast cancer screenings, our board-certified nurse practitioners provide a wide range of women’s health services, including clinical breast exams and mammogram referrals. You can schedule a well woman visit at one of our two locations in Midtown Manhattan or Washington Heights. Call 212-326-5705 or make an appointment directly through the website.