As Breast Cancer Awareness Month begins this week, we’ll start seeing pink awareness efforts everywhere. Pink products will line the shelves at stores, awareness and fundraising ads will showcase celebrities wearing pink ribbons, and high school, collegiate, and even professional athletes will adorn their uniforms with pink, some even articulating a specific person or family member affected by breast cancer for whom they’re dedicating their athletic efforts.
Raising awareness is a great thing. Throughout the year I’m asked to speak to community groups about cancer prevention, early detection, and the impact of heredity on cancer risk. The number of requests always escalates sharply in October. These programs provide an opportunity to help educate the public on the health impact of breast cancer, the importance of taking personal responsibility for health, and the new research studies that ultimately affect clinical practice.
- Breast cancer is a significant public health problem. About 252,710 new cases of invasive breast cancer will be diagnosed in women as well as 63,410 new cases of carcinoma in situ. And 2,470 men will be diagnosed with breast cancer.
- Breast cancer is the second leading cause of cancer death in women with 40,610 deaths; lung cancer is the leading cause of cancer death in women.
- Death rates from breast cancer dropped from 1989–2007. Since 2007, breast cancer death rates have remained steady in women 50 years or age or younger, but have continued to decrease in older women.
- More than 3.1 million breast cancer survivors are living in the United States.
Risk factors for breast cancer include being a woman and getting older. Women with a family history of breast, ovarian, melanoma, or pancreatic cancer may be at increased risk—especially women with a family member diagnosed before 50 years of age. Women cannot change their family history. However, they should make an effort to know that family history and talk with their healthcare providers about whether they should change their screening plans or seek evaluation with a credentialed genetics provider for possible genetic testing. Genetic testing and identification of hereditary risk combined with increased surveillance and risk reducing surgery can be lifesaving.
Women can do some things to reduce their risk of developing breast cancer. Lifestyle factors should not be ignored.
- Drinking alcohol is linked to an increased risk of breast cancer. The risk increases with the amount of alcohol consumed. Women who have two to three drinks a day have about a 20% higher risk compared to women who don’t drink alcohol. The American Cancer Society recommends that women who drink have no more than one drink a day.
- Being overweight after menopause increases breast cancer risk. Following menopause, most of a woman’s estrogen comes from fat tissue instead of the ovaries. Having more fat tissue after menopause can raise estrogen levels and increase the risk of breast cancer. Women who are overweight tend to have higher blood insulin levels, which have been linked to some cancers, including breast cancer. Women should try to achieve and maintain a healthy weight.
- Regular physical activity reduces breast cancer risk, especially after menopause. Exactly how physical activity might reduce breast cancer risk isn’t clear, but it may be because of its effects on body weight, inflammation, hormones, and energy balance. The American Cancer Society recommends that adults get at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity activity each week (or a combination of these), preferably spread throughout the week.
All women need to be aware of how their breasts normally look and feel—any change, no matter how trivial it seems, deserves further evaluation by a healthcare professional. Beginning at age 40, women of average risk need an annual mammogram. Mammograms should continue annually, as long as a woman has at least five years of life expectancy. The decrease in breast cancer deaths and increased number of cases of the highly treatable carcinoma in situ of the breast is directly related to regular mammography use that can detect a lump long before it would be palpable.
Genetics and Breast Cancer
Research continues to better understand the complex interaction between genes and environment in the development of breast cancer. A large, long-term study funded by the National Institute of Environmental Health Sciences is currently being conducted with the goal of understanding the causes of breast cancer. The Sister Study enrolled 50,000 women who have sisters with a diagnosis of breast cancer and is currently following these families for at least 10 years. A secondary study, the Two Sister Study, examines women with breast cancer diagnosed before age 50, with a sister, and their parents to further characterize possible causes of early-onset breast cancers. It also aims to provide valuable information about long-term survivors of breast cancer.
Breast cancer is a public health concern that’s a year-round issue, but it’s good to draw more attention to the issue from time to time. I’m glad to do a few extra educational programs in October, because women need to know that breast cancer is treatable when detected early, especially when based on the 3.1 million breast cancer survivors in the United States.
Mammography can be an effective screening tool, and women need to engage in regular screenings. They need to understand their risks and talk to their provider about an appropriate screening protocol. Some families will benefit immensely from genetic testing. All women can take some control of their risk by embracing a healthier lifestyle—it can make a difference. Much of the progress in breast cancer is because of ongoing research. Thanks should be given to all of the women who have participated in this research. Thank you to our athletes, celebrities, and everyone else who will make a little extra effort this October to raise awareness about breast cancer.