Women who detect breast cancer early become survivors.
It is generally recognized that living a healthy lifestyle, including regular exercise and maintenance of appropriate weight helps to reduce cancer risk. However, with breast cancer, early detection is most important.
Breast cancer statistics:
- 1/8 women will develop breast cancer. That’s over 250,000 women yearly who develop the disease.
- Over 40,000 women die yearly of breast cancer. Almost all of those women were diagnosed after the tumor had already spread.
- Breast cancer is ALMOST NEVER DEADLY when diagnosed early, when the tumor is small and localized.
Breast cancer screening is not one size fits all.
Many women are not doing all they can to stay healthy. Those women with greater than 20% lifetime risk of developing breast cancer are considered “high risk” and should strongly consider yearly breast MRI in addition to yearly mammography and breast ultrasound. Think being high risk is rare? Think again! Take our Risk Assessment now to find out your exact risk.
Breast Cancer Screening Guidelines
Have you received conflicting advice regarding when to start breast cancer screening? You’re not alone! Much of the confusion stems from the fact that the medical community has not come to one consensus on this topic. Recommendations vary from starting at age 40 to holding off until you are 50 if you’re not high risk. We think there is very clear evidence that lives are saved when all women start regular mammography screening no later than the age of 40.
If it’s so clear then why do some medical authorities suggest holding off until you are older? That’s because they are taking into account other factors which may not be so important to you. Such factors include cost to the healthcare system and false positive rates. As for cost, health insurers typically cover screening mammography starting at age 40 as a preventive health item, so there should be no cost to you for that.
As for false positives, this is an issue. Younger women tend to have more dense breasts with normal lumps and bumps that make mammography more challenging. If a radiologist isn’t certain about exactly what they are seeing they may recommend further imaging and / or biopsy. This all can create anxiety and cost. However, if you are worried about breast cancer and really want to be sure you catch it early and survive then you need to walk into that mammography center emboldened, ready for whatever they tell you, willing to accept a few false positives because they will make sure you stay alive!
Societal Guidelines for Breast Cancer Screening
American College of Ob/Gyn
U.S. Preventive Task Force
American Cancer Society
American Society of Breast Surgeons
Reducing Your Chances of Developing Breast Cancer
You can’t change your genes, but you can take steps to reduce your risk. Slimming down to those skinnier jeans really does make a difference for your overall heath and reduces your chances of developing breast and other cancers. Being at a healthy weight throughout your life, but especially during menopause has been linked to serious cancer risk reduction. Additionally, regular cardiovascular exercise is linked to additional risk-reduction regardless of your weight. Some studies also show a separate additional benefit to a diet full of fruits and vegetables. There’s no such thing as a super-food and no one vegetable or vitamin can really be linked to cancer-prevention. A good plan is to eat a variety of fruits and vegetables daily. And no… you can’t eat like crap and then take a vitamin. That doesn’t work!
There are other factors that may slightly alter your breast cancer risk.
- Having children younger (especially under age 30) and breastfeeding for a few months or longer seems to be somewhat preventative (but please don’t rush on the family thing and wait until you’re truly ready).
- Many of us love a cocktail here and there but ‘rose all day’ is not a motto you should live by. Daily consumption of more than one drink poses some serious health risks, breast cancer being only one of them.
- Birth control pills, shots, implants and hormone-containing IUDs have all been linked to potential slight increases in breast cancer risk. The jury is still out on this one and more studies are needed to truly understand the potential cause and effect. However, it is very clear that birth control pills are incredible at lowering your ovarian cancer risk by as much as 80% after 5 years of use (a risk-reduction that continues even when you get older and are off the pill). Plus there’s the obvious advantage of prevention of unintended pregnancy, prevention of ovarian cysts, improvement in PMS symptoms and other benefits. So don’t take yourself off the pill just because of this potential modest risk increase.
- HRT (hormone therapy after menopause) - There’s a lot of debate about this one. What’s clear is that women who have no uterus and use estrogen-alone hormone therapy seem to be in the clear. Most women have a uterus and therefore need both the hormones estrogen and progesterone when receiving hormone therapy (estrogen alone would increase their risk of uterine cancer). Some studies suggest a link between this type of hormone therapy (greater than 5 years of use) and a very modest increase in risk of breast cancer. More studies are needed to see if this link is real. Additionally, other studies show that women who have used HRT and develop breast cancer actually have a better prognosis so don’t count out HRT just because of this questionable link. Carefully weight any potential risks and benefits with the help of a knowledgeable physician.
- Breast implants can make it a little harder for a radiologist to see fine details in your mammogram and you may be required to have additional / different types of imaging. Recent reports also site an increase risk of a rare type of breast cancer (anaplastic large cell lymphoma) but only with a type of textured implant which was not used often. The up side is that implants can actually push out your existing breast tissue and in some studies have been shown to help improve detection of breast masses on self-examination.
- Plastic bottles are no good! There are many compounds in the environment that have estrogen-like properties and are being studied for their potential effects on breast tissue and breast cancer risk. For example, substances found in some plastics, certain cosmetics and personal care products, pesticides, and PCBs (polychlorinated biphenyls) seem to have such properties. In theory, these could affect breast cancer risk, but further studies are needed. In the meantime, why pollute the environment with something that may be killing you anyway?
- Smoking cigarettes - Do you really need another reason not to smoke? Yah, if you don’t get lung cancer first, smoking seems to increase risk of breast cancer. Second hand smoke has also been linked to cancer so don’t feel bad telling people not to smoke anywhere near you or in your home. There’s really no good data on vaping but let’s just go with common sense and not do that either.
- Stress is bad so let’s all get rid of it. Stress increases our cortisol levels and changes many hormones in our bodies. The end result may be weight gain, reduction in our immune system and an increased risk of many cancers. Working too much and stressing too much can do serious harm to our bodies. So take a little “me time” and try not to take on too much (way easier said than done).
Women at High Risk
Besides increased surveillance with mammography, breast ultrasound, breast MRI, clinical breast exams by experienced clinician and breast self-examinations / breast awareness, there are other options you should discuss with your physician if you are high risk for breast cancer.
- Medications- Several medications in the family of SERMS (selective estrogen receptor modulators) have been shown to reduce your chances of breast cancer by at least 1/3 (probably way more). These drugs are Tamoxifen and Reloxifene. They are effective but they come with their own baggage… potential hot flashes, night sweats, increased risk of dangerous blood clots. So not a slam dunk, but definitely worth speaking with your physician about this. Aromatase inhibitors are another class of drugs that help lower estrogen levels in postmenopausal women and seem to reduce breast cancer risk, but they aren’t approved for this indication in the US (doesn’t mean you can’t use them for this after speaking to your doctor).
- Prophylactic mastectomy. This is typically reserved for women at very high risk, such as those carrying a genetic mutation in the BRCA gene. While this is a big surgery and should not be taken lightly, you may be shocked to find out how quickly most healthy women recover and that most women are very happy with the aesthetic outcomes of the surgery.