ancer EpidemiolBreast cancer. These words make every woman shudder, and with good reason! It is estimated that in the United States alone, one in every eight women born today are at a risk of contracting said disease and chances are that you know someone who suffers from the same; it’s a long and painful struggle that you would not wish upon anyone. The scariest thing about breast cancer is that much of what causes breast cancer is not in the control of the woman, and that’s a difficult thing to digest about something that kills over 500,000 women a year, worldwide. Cancer is understood to be a disease of the developed world, but recent studies have shown that over 50% of the cases are from countries that are developing, and their death rate is higher as well- mostly due to lack of access to good healthcare and poor medical facilities.
However, there is light at the end of this tunnel; thanks to research and studies that have been conducted over the years, there are steps that can be taken by every woman- regardless of where she is- to reduce her chances of having breast cancer. These are what doctors call ‘modifiable’ risk factors; by making a few changes to your lifestyle, you can reduce the chances. And while not all of them are easy enough to incorporate into your daily life, all of them are doable, and are widely encouraged by doctors the world over.
- Understand your breasts: Always know what you’re dealing with, and in this case, that means understanding your breasts properly; more specifically, know whether you have dense breasts or not. When you have more tissue than fat in your breasts -which is common in younger women-it makes cancer harder to detect on a mammogram; both tumors and breast tissue show up white, while fat looks dark. Even more important to know- having dense breasts makes your cancer risk up to 6 times higher. While doctors and researchers aren’t really sure why that’s the case, one possibility is that due to the lack of standardisation for measurement of breast density, the doctor’s scores are subjective. When you go in for your mammogram, ask your radiologist whether your breasts are dense; if your density is low, you will still need regular checkups and if it’s high, there’s nothing you can do to lower it -though breast density does tend to decrease with age. That being said, you can protect yourself by asking your doctor about adding MRI or ultrasound to your screening regimen, or switching from traditional mammography to digital, which is higher in contrast, thereby making it easier to see abnormalities in dense breast tissue.
- Maintain your BMI: Fat cells make estrogen; the more fat you carry, the higher your estrogen levels. And the higher your estrogen levels, the higher your risk, especially in women who gain extra weight post-menopause. Before menopause, most of a woman’s estrogen is produced by her ovaries; after menopause however, when the ovaries stop producing the hormone, most of the estrogen comes from fat tissue- the more fat in a woman’s body, the more estrogen. Of course, losing weight is easier said than done. But it’s worth it, especially over a lifetime; experts say that it’s the long exposure to moderately high levels of estrogen that’s bad for you. So it is advised that you keep tabs on your body, and make sure that it stays below 25.
- Stay active: Research shows that women who exercise regularly have a 25 percent lower risk of developing breast cancer compared to women that don’t work out. The American Cancer Society recommends that adults do moderate-intensity exercise at least 150 minutes a week, less than three hours a week! It doesn’t have to be high intensity either; in fact, studies have found that women who engage in nothing more strenuous than regular walks, have as much as a 14% less chance of having breast cancer. And that’s not all; according to a study that was recently published in the journal Cancer Epidemiology, Biomarkers and Prevention found that among women who exercise, the ratio of good estrogens to bad estrogens (that damage DNA and increase chances of breast cancer) improved roughly by 25%. Past research has also shown that the greater the ratio, the lower a woman’s breast cancer risk. Staying active- and 150 minutes a week is hardly a lot- is a good way to prevent other cancers as well, so break out those running shoes!
- Control your diet: You are what you eat, and research continues to produce evidence that points to the fact that what you eat can affect your risk. Researchers recently found that women who had the highest carotenoid levels in their blood had a 19% lower risk of breast cancer than those with the lowest levels; carotenoids are found in fruits and vegetables such as leafy greens, carrots, and red peppers. The American Cancer Society recommends eating five or more servings of fruits and veggies a day, limiting processed and red meats, and choosing whole grains to help reduce risks of all types of cancer. For example, women who eat a Mediterranean diet supplemented with extra-virgin olive oil and mixed nuts might have a reduced risk of breast cancer; the Mediterranean diet focuses on mostly on plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts.
- Limit alcohol intake: There is a clear link between alcohol intake and breast cancer, and it is a line that everyone must tread carefully. Women who drink alcohol have higher levels of estrogen, and while the process is not exactly clear, it is known that alcohol gets converted to cholesterol, which later gets converted to estrogen. Alcohol has some pretty severe consequences on a growing body; compared to women who don’t drink at all, women who have three alcoholic drinks per week have a 15% higher risk of breast cancer and research estimates that the risk of breast cancer goes up another 10% for each additional drink women regularly have each day. Furthermore, girls aged 9 to 15 who drink three to five drinks a week have three times the risk of developing benign breast lumps. While alcohol is considered good for health among people that are older, you should be careful about the amount that you drink during your developing years, and try to limit it to one a day, if you must.
- Don’t smoke: Smoking causes a number of diseases and is linked to a higher risk of breast cancer in younger, pre-menopausal women. Research also has shown that there may be link between very heavy second-hand smoke exposure and breast cancer risk in postmenopausal women. Smoking also can increase complications from breast cancer treatment, including: damage to lungs from radiation therapy, difficulty in healing and breast reconstruction, and higher risk of blood clots while taking hormone therapy.
- Breastfeeding is good for you: It’s good for your baby, and your breast health. The more months you breastfeed, the lower your likelihood of developing breast cancer; women who consistently breast-feed for the first 6 months have a 10% reduced risk of death from cancer, compared with those who don’t. There are a variety of reasons for this, but it all boils down to one thing; less exposure to estrogen. The longer a woman is breastfeeding, the less menstrual cycles that she has to go through. Furthermore, starting periods later, ending periods sooner, and having fewer periods because you’ve been breastfeeding or exercising a lot all reduce your risk. Giving birth to your first child at a younger age also decreases the likelihood of developing breast cancer, though no one knows why; some researchers are of the opinion that with the first pregnancy, the breast undergoes an irreversible change that makes it less sensitive to carcinogens. It might also be related to the milk-producing hormone- prolactin.
- Keep Hormone Therapy short: The Women’s Health Initiative study showed that a combination of estrogen and progesterone increased the risk of breast cancer by 24%. If you and your doctor feel that you absolutely need hormone-replacement therapy to manage menopausal symptoms, take the lowest possible dose for the shortest possible time. If you’re on birth control, keep in mind that taking the pill slightly increases your risk, especially after the age of 35 – but it seems to go back to normal over time once you stop taking the pill. Women with a significantly high risk of breast cancer should avoid taking it at all, if possible unless they’ve had their ovaries removed and are going through surgical menopause. There are other ways to deal with the symptoms of menopause, and talking to your doctor about your options is definitely advised.
- Get regular mammograms: Yes they tend to be painful, but chances are that this could save your life.While mammograms don’t prevent cancer, they make a cure more possible. Early detection is key, and if caught in the initial stages, the prognosis is excellent: breast cancer is curable in 90 percent of stage one cases, 80 percent of stage two cases, and 60 percent of stage three cases. If you fall in the age groups mentioned below, you should consider making mammograms a required part of your health check:
- 40-44: Yearly mammograms are advised. You should consult with a doctor and talk about the risks and benefits of the same.
- 45-54: You should definitely get a mammogram every year.
- 55 and over: Mammograms are recommended every other year (you can choose to continue to have them every year.) Clinical breast exams and self-exams are not recommended as a self diagnosis might do more harm than good. That being said, you should definitely be familiar with your breasts and consult a doctor right away if you notice any changes in how your breasts look or feel.
- Know your family history: About 5 to 10% of breast cancer is hereditary, and is passed from one generation to the next via a variety of mutated genes. And even though you might be up to date on illness from your mother’s family, remember that your father’s family counts too! And look at your family’s history of other kinds of cancer, too. Men can carry some of the same aberrant genes, such as BRCA1 and 2, that up the risk of not only breast cancer but also ovarian cancer in women, pancreatic cancer in men and women, and early prostate and testicular cancers in men. Check if any family members have a history of breast and ovarian cancer – and, remember, even men can get breast cancer. If you’re related to a carrier of an inherited mutation -known as BRCA1 and BRCA2- make sure to get tested.