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“Breast cancer is treatable if caught early, and often fatal if not. Mammograms are the best tool we have to find breast cancer before it spreads and becomes much more difficult to treat.”
-Dr. Debbie Saslow, American Cancer Society
WHAT IS BREAST CANCER?
Breast cancer is the disease that women in the United States fear the most, and for compelling reasons. It is the most common cancer in the U.S. for women, second only to lung cancer for cancer-related deaths among American women. Over 200,000 Americans are diagnosed with the disease every year, and roughly 40,000 lose their lives annually.
Coupled with Western ideals that equate breasts with sexuality and beauty, many women feel that having breast cancer and losing part or all of their breasts as a result, means a loss of their femininity. Almost everyone can name someone close to them that has suffered from this disease, yet so many still know little about breast cancer, including diagnosis, treatment options and ways of reducing their risks.
What is breast cancer exactly? In the most simple terms, it is when cells in your breast begin growing abnormally. The most common type of breast cancer begins in the ducts of the breast designed to carry milk; other types occur in the lobules, or sacs that produce milk. These cancerous cells form a malignant tumor, which can invade surrounding breast tissue and invade the lymph nodes, or collections of immune system cells that help fight infections.
Eighty percent of women diagnosed with breast cancer have no family history of the disease. About 5-10% actually inherit breast cancer, due to defects in one of two genes, dubbed BRCA 1 (Breast Cancer 1) or BRCA 2 (Breast Cancer 2). Both men and women can inherit these genes from either one of their parents.
EARLY DETECTION IS THE KEY TO SURVIVAL
While there is still no cure for the disease, the experts and leading organizations such as the American Cancer Society, Susan G. Komen Breast Cancer Foundation and Mayo Clinic all agree that early detection is the key to surviving breast cancer. If detection is delayed, the cancer tends to spread to distant organs and becomes very difficult, often impossible, to treat effectively. Too many women delay getting regular mammograms or are not aware that they need to and--if there is a tumor--they run the serious risk of enabling it to spread beyond the breasts.
WHAT ARE THE RISK FACTORS FOR BREAST CANCER?
The American Cancer Society estimates that 75 % of breast cancer cases occur in women with no known risk factors, other than sex and age. However, the following factors increase your risk:
Sex: Being a woman is your greatest risk factor. It should be noted that while it is rare for men to get breast cancer, approximately 1,300 men are afflicted with breast cancer each year. Risk factors for men include a family history, a genetic defect, exposure to radiation or having a disease related to high levels of estrogen in the body, like cirrhosis of the liver. For more information on male breast cancer, visit the National Cancer Institute's website, www.cancer.gov.
Age: One out of every eight women will be affected by breast cancer at some point in their lives, and your chances of developing breast cancer increase as you get older. Women under 30 are rarely (but sometimes) affected, whereas most breast cancers occur in women over age 50.
Family History of Breast Cancer: Women with a mother or sister with breast cancer have a higher chance of developing it themselves, and the more relatives you have with breast cancer who were premenopausal at their time of their diagnosis, the higher your own risk.
Personal History of Breast Cancer: If you've already been diagnosed with breast cancer in one breast, you are at an increased risk for developing cancer in the other breast. Additionally, radiation therapy to the chest before age 30 also puts you at higher risk for breast cancer.
Genetic Predisposition: Defects in the BRCA 1 or BRCA 2 genes put you at greater risk of developing the disease. Usually these genes help prevent cancer by making proteins to keep cells from growing abnormally, but if they are mutated, the genes aren't as effective. Women of Eastern European Jewish ancestry (called "Ashkenazi" Jews) are especially at risk.
Excess Weight: Although the relationship between breast cancer and excess weight is complex, in general, weighing more than you should, and especially carrying weight in your abdomen, puts you at greater risk for breast cancer. Women who have gained weight after menopause are also at higher risk.
Insufficient Exercise: Women who do not exercise regularly are more susceptible to weight gain, which is linked to a higher risk of breast cancer. Women who begin exercising in their teens can help delay the onset of menstruation, and by decreasing the amount of estrogen exposure, a woman can decrease her lifetime risk of developing breast cancer.
Exposure to Estrogen: If you have a late menopause, or began menstruating before age 12, you have a slightly higher risk of developing breast cancer. The same is true for women who have never had children, or waited until after age 30 to have children.
Race: Caucasian women are more likely to develop breast cancer than African American or Hispanic women, but minorities are more likely to die of the disease. They tend to be diagnosed at a later stage than white women, mostly due to lack of regular mammograms.
Hormone Therapy: Recent studies show that there are some health risks with hormone therapy, especially at higher doses and/or when taken for an extended time. Some menopausal women need and may benefit from hormone therapy due to difficult symptoms. Before starting, it is important to discuss your risk factors for breast cancer and other diseases with your doctor to determine whether hormone replacement is right for you - and, if so, in what doses, combinations and for what time period. According to the National Cancer Institute, women who take hormone therapy for five or more years after menopause seem to be at greater risk. Taking estrogen plus progesterone puts women at a slightly higher risk, and hormone therapy may make tumors harder to detect on mammograms. If you are on hormone therapy, it is important to let the doctor ordering your mammogram know as well as the radiologist, so that they will know that the test will be a bit less sensitive.
Birth Control Pills: The American Cancer Society says that women currently using the pill may have a slightly increased risk, whereas women who stopped using oral contraceptives 10 years ago probably don't have this risk. Most women who use oral contraceptives take them at a young age, when their risk of breast cancer is very low.
Exposure to Carcinogens: Polycyclic aromatic hydrocarbons (PAHs), chemicals found in cigarettes and charred meat, can increase your chances of developing breast cancer. Exposure to pesticides may also increase your risk.
At present, there is no evidence that residues of pesticides at the low doses found in foods increase the risks.
Excessive Consumption of Alcohol: Regular consumption of even a few drinks per week is associated with an increased risk of breast cancer in women.
Over-use of antibiotics: More studies need to be conducted to determine the reason why excessive antibiotic use may be associated with an increased risk of breast cancer. One theory, provided on the National Cancer Institute's website, is that antibiotics affect a body's immune function. It needs to be emphasized that antibiotics are an important weapon to combat bacterial infections, but gratuitous or excessive use may increase breast cancer risk as well as making a person potentially less responsive to antibiotic treatments in the future.
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