Tuesday, November 22, 2016

What Can I Do to Reduce My Odds of Being Diagnosed with Breast Cancer?

By: Jennifer Harvey, MD, FSBI

Breast cancer is common in the United States and other developed countries, with one in eight women being diagnosed during their lifetime.  The most common breast cancer risk factors are related to estrogen exposure over the course of our lifetime. A Western lifestyle increases these risk factors. Here is my best advice for optimizing your odds against this common disease.

  • Breastfeeding matures the cells that produce milk, reducing risk. This is a cumulative process so nursing three children for three months is similar to nursing one child for nine months. The more the better!

  • Minimize use of hormone therapy for treatment of menopausal symptoms. Hormone use in perimenopause can improve sleep, hot flashes and mood, but use the lowest dose possible to manage symptoms and for the shortest duration needed. Many women can taper off hormone use within a few years of menopause without significant lifestyle disruption.

  • Maintain a healthy body weight. This is especially important after menopause. Fatty tissue actually produces estrogen. After menopause, our hormone levels are typically very low but are much higher in women who are overweight or obese.

  • Avoid or minimize alcohol use. Alcohol and estrogen are both metabolized in the liver. An occasional beverage will not likely increase risk, but even one drink per day can increase risk of breast cancer by about 30%. And, unfortunately, it is dose related, so higher use results in higher risk.

  • Exercise really is the fountain of youth! Women who are more active also have lower estrogen levels, independent of body weight. Thirty minutes of activity at least three to four days per week can have a significant impact on reducing risk of breast cancer at all ages.

  • Maintain a healthy diet. Higher intake of saturated fats, such as animal and dairy fats, increases risk of many cancers. Likewise, increasing intake of anti-oxidant rich foods, such as berries and flax, may decrease risk of cancer. 

Following the above advice can reduce your risk of breast cancer. However, most of us will remain susceptible to this disease. Most women who are diagnosed with breast cancer have no substantial risk factors. I cannot tell you how many patients I have had who tell me, “This can’t be breast cancer. I exercise every day. I eat really healthy and I have no family history of cancer. This can’t happen to me. I do everything right.” And yet they ARE diagnosed anyway.

Our BEST defense is a good offense. Since breast cancer is so very common, our best strategy is to minimize the impact if and when we are diagnosed with this common disease. Anyone who treats breast cancer can tell you that the earlier the diagnosis, the more likely and easier it is to cure.

  • Mammography is the only proven way to reduce breast cancer deaths. My opinion is that all women in their 40s should undergo mammograms EVERY year. The absolute risk of having breast cancer that young is very small, but women who are diagnosed with breast cancer in their 40s make up almost a third of breast cancer deaths because cancers tend to be more aggressive in young women.

  • Having a mammogram every year results in the fewest breast cancer deaths at all ages. Some women may consider choosing to have a mammogram every other year after age 55. If you have dense breast tissue or any family history of breast cancer, you should still have a mammogram EVERY year because your risk is higher than average of having breast cancer.

  • If you have dense breast tissue, which appears white on the mammogram, you are more likely than the average woman to be diagnosed with breast cancer. In addition, that white tissue can make it harder to see cancers on mammography. Tomosynthesis (“3D” mammography) appears to find cancer better than regular mammography in women with dense breasts. Many women choose to have ultrasound of the breasts in addition to mammography to check for breast cancer. This can result in more benign biopsies, though, so not all women choose to have this done. At a minimum, if you have dense breast tissue, please get a mammogram every year.

Bottom line – yes, there are many things that we can do to reduce our risk of being diagnosed with breast cancer. And I would highly recommend these changes as they will help you feel healthier. Yet, we all remain vulnerable to this common disease. Optimize your ability to beat this disease by getting a mammogram every year beginning at age 40. Although some women will chose to have less frequent mammograms as they get older, women with any family history of breast cancer, prior biopsies with abnormal cells or dense tissue should continue to get a mammogram EVERY year. Women with dense tissue can also consider getting tomosynthesis and an ultrasound to help finding cancers earlier. Help us help you!

Dr. Jennifer A. Harvey is a Professor of Radiology and Medical Imaging; Co-Director, UVA Breast Care Program; Division Director, Breast Imaging

Author: SuperUser121

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The Society of Breast Imaging‘s goal for its initiative End the Confusion is to provide evidence based information on breast cancer screening. We will continue to provide information and resources as well as our views on the latest breast cancer screening news so we encourage you to regularly visit the website, like us on Facebook and follow us on Twitter (@BreastImaging). Hopefully we have addressed and will continue to address any and all confusion you experience when it comes to breast cancer screening. 

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