Breast Cancer Prevention - Women's Health

Here’s the bad news: One in eight women in the United States will develop breast cancer in her lifetime.

And I'm one of those women. I was diagnosed with breast cancer a few days after my 29th birthday, and as I write this, I am in the middle of my first cycle of chemotherapy.

Odds are good that you know someone like me. Breast cancer is the most common cancer among women. Worse, it is the leading cause of cancer-related death among young women. So, for ladies in our 20s, a breast cancer diagnosis can be a death sentence.  

While these terrifying statistics are not what the newly diagnosed patient wants to hear, I wanted to share them with you because in the three months since my diagnosis, I have never once been told that my prognosis was anything other than recovery. I don’t even need a mastectomy.   Why? Because of a combination of early detection and the giant leaps and bounds that we've made in the treatment of the disease in the past two decades.

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But, despite all this pink everywhere, there is still confusion about taking care of our breasts, especially among young women. So, what can you be doing, right now, to save your breasts? Read on.

Photo: Courtesy of Dena Stern

Get to know your girls (but don't worry about "monthly checks")
Because your breasts actually change all the time due to factors like your weight and hormones, and breast tissue is naturally a little lumpy in the first place, doing a real self exam can be both confusing and intimidating. The good news: You don’t have to do them. You and your doctor just want to know your breasts well enough for you to be aware if anything changes.   The National College of Obstetricians & Gynecologists, the American Cancer Society, and the National Comprehensive Cancer Network all endorse breast self awareness, which is defined as a woman’s awareness of the normal appearance and feel of her breasts.

Don’t let confusion or worry about “how to do it right” hold you back; just pay attention to how things feel while you are shaving your armpits or cleaning yourself in the shower. More than 70% of breast cancer in women under the age of 50 is self-detected, frequently by what the College of Obstetricians & Gynecologists refers to as "incidental finding.”

“Doing these formal breast exams is hard and confusing for most women. We know that, so all we ask is that you just get to know your breasts,” says Dr. Anne Ladenburger, an OBGYN resident at the University of Utah. “In fact, I found a small nodule while I was learning about doing breast checks in medical school. I got it biopsied and it ended up being nothing, but now I know it’s there and I can keep an eye on it."

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Get a doctor to check them out every one to three years
The American Cancer Society, the US Preventative Services Task Force, and the National Cancer institute all recommend that women between the ages of 20 and 39 go in at least once every three years for a clinical breast exam. According to Dr. Ladenburger, “The problem with self examination, the reason it is controversial right now, is that it is really hard to do. You’re just sort of feeling around and it can be hard to know if normal breast tissue irregularities are something to worry about. So, the best thing you can do is to know your breasts, check them occasionally for changes, and get someone else to check them, too. Someone who knows what they are looking for, like your doctor.”  

Don't be scared to ask your doctor about anything weird
Sure, lots of lumps that women find end up being nothing. Fibroadenomas (non-cancerous breast lumps) occur in about 10 percent of all women and are especially common in women in their 20s and 30s. In fact, they account for about half of the 1.6 million breast biopsies doctors perform each year in the U.S. But, your doctor would much rather you come in for nothing, than not come in at all. When breast cancer is caught early the survival rate is over 90 percent, but once it spreads to other parts of the body, the survival rate drops to less than 25 percent.

Finding a lump in your breast is a terrible, scary experience, but don’t let this fear keep you from going to your doctor and asking to have the lump checked out. “You’re never going to be completely sure unless you have a doctor check your breasts and follow up on any suspicious changes. You’ll feel much better knowing that it’s nothing,” Dr. Ladenburger says.  

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Keep your weight in check
The latest research suggests that there is a very real connection between being overweight and having an increased chance of getting breast (and other) cancer. According to the National Cancer Institute website, a projection of the future health and economic burden of obesity in 2030 found that if every adult reduced her BMI by one percent (weight loss of 2.2 lbs for an adult of average weight) it could actually result in the avoidance of about 100,000 new cases of cancer.  

“I tell people all day long that they need to lose weight or maintain a healthy weight for a whole bunch of reasons,” says Dr. Carla Fracchia, a Generalist OB/GYN at Kaiser San Francisco, who has been practicing for nearly 20 years. “Heart disease is way more common than breast cancer, and so that’s usually the reason that I use. But the message isn’t getting through in a big enough way.”

Doctors are still trying to understand the connection between being overweight and having an increased breast cancer risk, but researchers are exploring the idea that fat tissue produces excess amounts of estrogen, high levels of which have been associated with the risk of “gynecological” cancers including cancer in the breasts, ovaries, and uterus. Obesity is also linked to a higher cancer mortality rate. The American Cancer Society’s research suggests that one-third of the more than 572,000 deaths that occur from cancer in the United States each year can be attributed to diet and physical habits.  

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Exercise on the regular
If you needed another reason to drag your butt to the gym, here’s a really good one: According to the National Cancer Institute, exercising four or more hours a week may decrease hormone levels and help lower breast cancer risk. The link between exercise and reduced breast cancer risk is greater in premenopausal (young) women of normal or low weight. That means getting in a workout will have the largest impact for you, right now. “I can’t emphasize enough, for so many reasons, how good it is to get a little exercise every day,” says Dr. Fracchia. “It’s something I tell every single one of my patients to do."

American Cancer Society guidelines on nutrition and physical activity for cancer prevention recommend that adults engage in at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity activity each week, preferably spread throughout the week. That breaks down to just 20 minutes a day (like this quickie workout from Madonna’s trainer). 

Limit your drinks
To reduce your risk of breast cancer, many doctors recommend that you limit yourself to no more than seven drinks in a week. "It’s not dogma, but research is showing that drinking more than a drink a day has a marked increase on your risk of getting breast cancer. I’ve heard it enough times from people who know that I feel like I have to mention this one,” Dr. Fracchia says. “I’m not telling anyone not to drink at all, but the evidence is showing that if someone is drinking 10 or 20 drinks a week, they are going to have an increased risk of breast cancer – and that seems to me like a really good reason to try to drink in moderation.”

Photos: Courtesy of Dena Stern