October Is Breast Cancer Awareness Month
By Denise Monahan, MD, breast surgery, Northwestern Medical GroupCancer Care/Oncology October 28, 2018
It’s that time of year again where everywhere we look we can find a pink ribbon. October is an annual reminder for women to think about their personal risk for breast cancer.
Who is at risk for developing breast cancer?
Of course the biggest risk factor is being female. Breast cancer effects about 1 in 8 women. Risk also increases with age. Most women who are newly diagnosed with breast cancer do not have a family history, but if you do have a sister, mother or daughter with breast cancer than your risk is increased. If you have had a breast biopsy before that was abnormal then your risk is elevated compared to the average woman.
What does breast density mean?
Density refers to the ratio of fat to the glandular and supportive tissue seen on a mammogram. It is a normal finding and about 50% of women have breasts that are classified as dense on mammogram. Not only can dense breast tissue make interpreting a mammogram more difficult but we are learning that dense breast tissue also seems to be associated with an increased risk of developing breast cancer. Sometimes we recommend additional screening with whole breast ultrasound for women with dense breasts. There should be a comment regarding breast density on your mammogram report so you can know if this affects you.
What symptoms should prompt a woman to see her doctor?
If a woman finds a new breast mass
If one breast is enlarging, becoming red or swollen, or other skin changes such as flaking or crusting around the nipple
Nipple discharge that drains on its own, without squeezing, then she should have that evaluated
Sometimes women are discouraged from seeing their doctor about one of these issues if they recently had a normal screening mammogram, but any of the above findings should prompt an evaluation and may need further workup depending on the scenario.
What actions can you take to help reduce your risk for developing breast cancer?
Sometimes I think that people get discouraged when thinking about their breast cancer risk because it seems like there are so many risk factors we can’t control. While that may be true for our genes, our family history and some of the factors related to our lifetime exposure to hormones (such as age of first pregnancy or age at menopause), there are several things we can do to decrease our risk.
Maintaining a healthy body weight. Several studies have shown obesity in postmenopausal women is linked to a higher risk of breast cancer.
Stay active. The American Cancer Society recommends getting at least 150 minutes of moderate intensity or 75 minutes of vigorous activity per week.
Abstain or limit alcohol. There is a growing body of literature that demonstrates increased breast cancer risk relative to alcohol consumed.
Avoid long-term hormone replacement therapy with the combination of progesterone and estrogen if you can. Sometimes these medications are prescribed to combat a particular medical issue and may provide some health benefits. However, we know that the combination of estrogen and progesterone can increase the risk of developing breast cancer and therefore in general the recommendation is the lowest dose for the shortest duration of time. The relationship between hormones and breast cancer risk is quite complex and should be discussed with your doctor.
Breastfeed if you can. Some studies have indicated that breastfeeding is associated with decreasing a woman’s risk of developing breast cancer.