October is Breast Cancer Awareness Month. Many women today live in fear of breast cancer. If you worried about a breast cancer diagnosis the number one thing you can do is understand the facts instead of living in fear.
It’s important to know that even though breast cancer affects approximately one in eight woman in this country, the number of people diagnosed has been increasing because of more screening and awareness. Fortunately, the majority of breast cancers are diagnosed very early, so most people diagnosed today do not die from breast cancer. While breast cancer in the 1970s and 1980s killed 30% of people diagnosed, now that rate is down to 3%. This progress is due in part to better treatments, increased awareness and earlier detection.
Misconceptions about breast cancer increase fear and confusion for many people. One of the most common misconceptions is that a family history of breast cancer is present in the majority of patients diagnosed. In fact, only 15% of people diagnosed with breast cancer have a family history. It’s important to note that mammograms do not prevent cancer – they diagnose it early. People get very concerned about the radiation dose from mammograms but it is very low. It’s best to listen to your doctor for the latest news and advice on breast cancer. While we know that increased estrogen exposure increases the possibility of breast cancer it appears that the low-dose oral contraceptive pills available today likely do not increase the risk of breast cancer. Short-term estrogen therapy in menopause may be safe without a personal history of breast cancer but it is very important to individualize your exact treatment.
Today we know that breast cancer is not just one disease but probably over a thousand different kinds of diseases. This is why individualized treatment using a multidisciplinary approach is important. The main methods to treat breast cancer are surgery, radiation, and chemotherapy in the form of anti-estrogen pills or intravenous (IV) medications. The majority of breast cancer patients do not need intravenous chemotherapy. We look at each individual and their specific tumor biology to determine who needs what treatment. In addition, the majority of women today do not need a mastectomy. Partial mastectomy (formerly known as lumpectomy) used with radiation has the same recurrence and death rate as a full mastectomy.
Mammograms are the most important way to detect breast cancer. While there’s been a lot of controversy about whether mammographic screening should start at age 40, 45 or 50, we encourage women to listen to their doctor’s advice on when they should begin screening. Having a medical practitioner examine your breasts once a year is also a good idea.
How can you help prevent breast cancer? The number one thing you can do is lose weight, especially in the abdomen area. While we do not understand completely the biological mechanism, we do know that maintaining a normal body weight reduces your risk of getting breast cancer. People who eat a diet high in fiber (greater than 25 to 35 grams of fiber each day) also have a lower risk of breast cancer. In addition, people who exercise at least 20 to 30 minutes a day just by walking also have a lower chance of getting breast cancer. For those considering hormone replacement therapy you should limit any intake of extra estrogen (bioidentical or medications) to less than two years. You should never take extra estrogen if you have a personal history of breast cancer.
While you can do everything right and still get breast cancer, keep in mind that most women will survive this disease. So eat healthy and exercise, get your screenings, and try not to worry too much about breast cancer.
Written by Dr. Kerry G. Bennett, author of the “The Little Pink Book: What I say every day to my patients” and “Stress Less.” She is a surgeon, genetics of cancer specialist, and specialist in breast health and cancer and surgery. She works at Reliant Medical Group in Worcester.