Must-Know Facts About Breast Cancer
It's More Common Than You Think
One in eight. That's the chance of a woman having invasive breast cancer some time during her life, making it the second most common cancer among women in the United States, after skin cancer. While women over 50 constitute 65 to 70 percent of breast cancer cases, one in 200 women will be diagnosed before their 40th birthday, according to the American Cancer Society (ACS). And for these women, the prognosis is often much worse. Why? Because breast cancer in younger women is more likely due to an abnormal genetic component and more often occurs in both breasts.
Young Black Women Are at Greater Risk
While the overall incidence of breast cancer is higher in white women, young black women are more likely to die from it and to have secondary cancer, says Abenaa Brewster, M.D., a medical oncologist in the Nellie B. Connally Breast Center at MD Anderson Cancer Center. This is because black women are three times more likely to develop an aggressive "triple negative tumor," compared to women of other racial backgrounds, according to a 2009 study from Boston University School of Medicine. A triple negative tumor is one of the most deadly types of breast cancer because it is resistant to most treatments.
Don't DIY Your DNA
At-home DNA testing kits are increasingly popular these days. But while they're great for finding out things like your ancestry and whether or not your pee will smell after you eat asparagus, they're not as good for testing for major health conditions, like breast cancer, says Dr. Brewster.
Still, understanding your genetic risks is extremely important: 55 to 85 percent of women with both BRCA1 and BRCA2 genes will go on to develop breast or ovarian cancer. But the risk is lower for those who only have one of the genes, says Elizabeth Chabner Thompson, M.D., founder of Best Friends for Life (BFFL) Co., a company dedicated to improving the breast cancer patient experience.
"If you have a strong family history of female cancers, talk to your doctor about getting a referral to a genetic counselor," says Dr. Brewster. "They will assess your risks and help you know which DNA tests are right for you and help you understand the results," she says. Online kits may be able to give you raw information but unless you're an expert in genetics you don't have the expertise needed to truly understand what they mean for your health, she says. (For example, this company offers genetic testing for breast cancer at home, but should you?)
"The worst case is when women see 'negative' for breast cancer on their DNA results and think they are safe," she adds. "But there are so many more genes involved in breast cancer than the two BRCA genes," so having an expert who can take a look at the bigger genetic picture is critical.
It's Not Just About Lumps
The latest science suggests that you don't have
to do monthly self-exams, but you should still be cognizant of the look and feel of your breasts on a regular basis. The point isn't to catch all cancers—less than half of women diagnosed with breast cancer went in because they felt a lump—but to know what is normal for your body so you can be aware if anything changes, says Dr. Brewster. "We actually call it 'breast awareness' these days as we are encouraging women to be mindful of their breasts and how they feel overall, not just looking for lumps," she explains. But, still "always call your doctor if you find any lump or feel a change in your breast tissue," she adds.
Yes, You Still Should Get Mammograms
Mammograms are still an important tool for catching breast cancer in its early stages—and the sooner the diagnosis, the better your chance of survival, says Dr. Brewster. Are they foolproof in finding cancer? Sadly, no, and there are many cases of false positives. Instead of seeing them as the definitive diagnostic tool, look at mammograms as more information that can help you decide whether or not you need to take extra precautions or get further testing. (A bit of good news: New technology is finally making these screenings less painful.)
As to how often and when to start getting mammograms, the recommendations vary. But for most women, you should have a baseline scan done at age 40 and then every one to two years after that unless your doctor tells you differently, says Dr. Brewster. But, there are many risk factors that indicate you shouldn't wait until age 40 for your first mammogram, such as if you have dense breasts, are African American or Ashkenazi Jewish, or have a strong family history of breast cancer. These same increased risk factors could make you a good candidate to get an ultrasound and/or an MRI done, in addition to the mammogram, says Dr. Brewster. (Related: 6 Women Share What It's Really Like to Get a Mammogram)
Asking the Right Questions Is Important
Whether or not you opt for DNA testing, don't underestimate the power of knowing your family history, says Dr. Thompson. "Having a first-degree relative, like a mother or sister, get breast or ovarian cancer at a young age ups your risk. And any ovarian cancer incidents in your family especially ups your risk."
Since detailed medical history isn't exactly dinner-table conversation, it's up to you to ask questions, says Dr. Thompson. "Sometimes families will say 'she died of female cancer' so you need to ask: 'What did she die of, exactly? How old was she when she died?'"
No family history of breast cancer? That's great news, but it doesn't give you a free pass on the disease, unfortunately. Surprisingly, 90 percent of women diagnosed with breast cancer don't have a family history, says Sean Fischer, M.D., a medical oncologist at Providence Saint John's Health Center in Santa Monica.
No Amount of Alcohol Is Safe
You may have heard that drinking a glass of wine a day can help reduce your risk of getting cancer, but that is a deadly myth based on old, faulty science, says Dr. Brewster. (The potential health benefits of risk associated with things like coffee and wine have long been conflicting, so it's understandable if you're unsure what's what.) "I'm amazed at how many of my patients don't know that even a few drinks increase their risk of breast cancer, and no level of alcohol is considered safe," she says. "It's not well publicized, yet it's one of the easiest risk factors to control." Actually, a study found that just one serving of alcohol a day can increase your risk for breast cancer.
Obesity Significantly Ups Your Risk of Breast Cancer
As the rates of obesity go up in the United States, so do the rates of breast cancer—and that's no coincidence, says Dr. Brewster. Being overweight or obese increases your risk for many cancers, not just breast cancer, she says. The relationship between weight and cancer is complicated, but post-menopausal women who are obese have up to a 40 percent higher risk of getting breast cancer than their healthy-weight peers, according to the American Association for Cancer Research.
Thankfully, this is one scary stat you can do something about. "Maintaining a healthy BMI between 18 and 25 is one of the best things you can do for your health," she explains. However, we know that BMI isn't always the clearest indicator of health, as it doesn't take into account body composition. If you are carrying around some extra, unhealthy weight, though, know that "even losing just 5 to 10 percent of your weight has been shown to reduce your cancer risk," says Dr. Brewster.
Healthy Eating and Exercise Are Strong Cancer Prevention
Approximately one-third of all cancer deaths can be attributed to poor diet and inactivity, according to ACS. This means that no matter what you weigh, eating healthy and exercise makes a difference in your overall cancer risk.
The good news is that you don't have to be a total gym rat to reap the rewards. Even mild physical activity can reduce your breast cancer risk, according to a study published in Cancer
. Women who exercised 10 to 19 hours per week experienced the greatest benefit with an approximate 30 percent risk reduction. Intensity level didn't matter—a brisk walk is just as worthwhile as a spinning class that leaves you drenched in sweat.
In addition, current research says that eating a healthy diet full of fresh fruits and veggies, whole grains, healthy fats, and protein can also reduce your risk, according to ACS.
Be Choosy About Birth Control
Because breast cancer is hormone-sensitive, certain types of hormonal birth control can increase your risk for breast cancer. Progesterone-only contraceptives like the Depo-Provera shot double your risk when used for a year or longer, according to a study published in Cancer Research. The increased risk does dissipate within just a few months of quitting the shot.
The risk may extend to hormonal birth control pills, too. While research on the subject isn't conclusive, experts say "those with a family history of breast cancer related to mutations in the BRCA genes should use caution before taking birth control pills." (Related: Is Your Birth Control Pill to Blame for Your Crappy Vision?)
If you're worried about your cancer risk, discuss your concerns with your doctor right away, as there are several very effective nonhormonal options, like the Paragard IUD, says Dr. Brewster.
A Lot Has Changed In Breast Cancer Treatment
It might sound shocking, but "breast cancer is not usually an emergency," says Stephen Marcus, M.D., cancer researcher and author of Complications of Cancer. "Less-experienced doctors will try to rush you into something, but it's about finding the right treatment, not the fastest treatment," says Dr. Marcus. This means you likely have time to explore all your medical and surgical options. (Related: This Viral Photo of Lemons Is Helping Women Detect Breast Cancer)
The last few years have seen amazing new treatments developed for breast cancers, especially metastatic cancers, says Dr. Brewster. "We now have targeted therapies that work better than chemotherapy and are tolerated much better," she explains. In addition, new guidelines for mastectomies and radiation have been issued in the past two years, according to BreastCancer.org.
Choosing the Right Doc Matters
If you do find a lump or any irregularity, finding the right doctor with training and experience in treating early breast cancer is key, Dr. Marcus says. "Board-certified radiologists or surgeons, especially those who have had extra training in the treatment of breast cancer, have special expertise in performing the tests, like the less invasive needle biopsies, that can effectively make the diagnosis and guide treatment."
To find the best doctor for you, Dr. Marcus recommends looking at nearby teaching hospitals and cancer centers, as they will usually have the most cutting-edge equipment and be on top of the most recent research.
Be Cautious About Alternative Therapies
More and more women are delaying medical treatment for their breast cancer and first trying alternative therapies such as supplements, cleanses, or diets, according to a study published in JAMA Oncology
. This can have tragic results, says lead researcher Heather Greenlee, Ph.D., an assistant professor of epidemiology at Columbia University's Mailman School of Public Health. When it comes to breast cancer, early intervention is best, and timely initiation of breast cancer chemotherapy is associated with better breast cancer survival, she explains.
It's true that you have time to weigh your options, so you don't have to act immediately. But you shouldn't delay treatment unnecessarily, especially to try out unproven or risky alternative therapies. Talk to your doctor about what types of alternative therapies you can use to help support your medical treatment, not replace it.
There's an App for That
Keeping track of all the latest research, your family history, and lifestyle factors like alcohol use, smoking, weight gain, and exercise is enough to make some women leave their future to fate. Fortunately, there's an online app that can help. The National Institute of Health's breast cancer risk calculator can help you track everything and determine your real risk.
The B4BC app gives you tips and reminders for self-checks and doctor's exams, in addition to news and recent research about breast cancer.
Recently got a diagnosis? The Breast Cancer Healthline app gives you tools and information about diagnosis, treatment, and recovery while also providing support groups and discussion boards for real-world and online help.