Your Risk of Breast Cancer
October is breast cancer awareness month. Although breast cancer continues to be a major health concern, much is being accomplished. At San Juan Regional Medical Center, a new cancer center, due to open in December will offer more services than ever, including complementary alternative therapies. With better imaging, better self-detection and more education, women have more tools than ever before to decrease their risk of breast cancer and to improve their outcomes if diagnosed. Here's what you need to know about
Your Risk of Breast Cancer
About a decade ago, a women’s health newsletter concluded that “unfortunately, there is little we can do to reduce our risk of breast cancer.” Fortunately, that has changed. Not only are there specific things women can do to lower their risk, but there are clear indications that significant numbers are doing them.
Breast cancer is the most commonly diagnosed cancer in women and, after lung cancer, the one most likely to lead to death. The death rate from breast cancer has fallen since 1990, however, and more tumors are being found at an earlier stage.
AGE, FAMILY HISTORY:The number one risk factor for breast cancer is age. If you’re 40, your risk of developing breast cancer in the next 10 years is 1 in 48. If you’re 60, that risk has jumped to 1 in 26. Family history is also important. If your mother, sister or daughter has breast cancer, your risk is double that of other women. In a few cases, family history is associated with a gene mutation such as BRCA1 or BRCA2 that substantially increases risk.
While you can’t change your age, genetics or family history, you can use these risk factors to guide your decisions concerning screening. For women of average risk, the American Cancer Society recommends regular mammograms starting at age 40 and continuing as long as a woman is in good health.
At any age, of course, a woman should learn about breast self examination. Clinical examinations in a doctor’s office are advised once every three years before age 40 and yearly after that time.
BREAST DENSITY: Two recent studies indicated that breast density may be one of the most important risk factors for breast cancer. Dense breasts have less fat and more glandular material. Young women, who have a low risk, tend to have denser breasts, but so do some older women, particularly those who take hormone replacement therapy or have a genetic tendency. Early tumors are also more difficult to detect in dense breast tissue. While you have no control over whether your breasts are dense, you can be more vigilant if they are and consider asking your doctor about screening with digital mammography, MRI or ultrasound.
WEIGHT GAIN is a risk factor that you can control. A weight gain of 20 to 30 pounds after age 18 is associated with a 40 percent increased risk compared to a weight gain of five pounds or less. The theory is that fat cells stimulate production of estrogen, keeping the hormone in circulation even after menopause.
PHYSICAL ACTIVITY: Getting regular exercise is one of the best ways of avoiding weight gain. It also helps regulate hormones that have been linked to the growth of cancer cells. Studies have found that women who engage in moderately intense or vigorous exercise at least three or four hours a week are 20 to 30 percent less likely to develop breast cancer. The American Cancer Society recommends 45 to 60 minutes at least five days a week–a step up from what is generally recommended for good health.
FOLIC ACID, ALCOHOL: Women who have more than one drink a day of alcohol have an increased risk of breast cancer, but only if they fail to get adequate quantities (at least 500 micrograms a day) of folic acid, a B vitamin.
VITAMIN D: Sun exposure triggers vitamin D production in the body, and there is considerable evidence that vitamin D offers protection against breast and a number of other cancers. Experts now realize that the recommended level of vitamin D (400 IU) is too low; 800 to 1,000 IU is best. Since dietary sources are limited, some of this must come from supplements or sun exposure.
HORMONES: Women taking birth control pills have a slightly increased risk that disappears within 10 years after stopping use, according to data from the Nurses’ Health Study. Long-term use of combined hormone replacement therapy has a similar effect that drops back to normal within five years, according to the Women’s Health Initiative.
Taking a preventive approach to breast cancer has its frustrations. About three quarters of breast cancers occur in persons with no known risk factors. If you know your personal risks, there’s no reason for either anxiety or self assurance. With exercise, weight control, healthy habits and regular screening, you can improve your odds.
