Guest Author - Dr. Denise Howard
Breast cancer is the most common malignancy in women. Approximately 1 of 9 women will develop breast cancer in her life time. Certain women are at higher risk than others. What are the factors that place some women at increased risk? Is there anything that can be done to prevent breast cancer? Risk factors for breast cancer are both genetic and environmental. The environmental factors can certainly be modified thereby potentially reducing the likelihood of developing cancer. Even though there arenít ways to modify genetic risk, there are ways to identify these risks. Treatment options are available to reduce the probability in high risk groups.
The risk of breast cancer increases with age. Women between 20-34 years of age have a 2% risk while those 35-44 have a 10% risk. It increases sharply after this with the highest risk being between ages 55-64 at 24%. The risk is 23% in the group beneath this and 20% in the group above. Combining age with other factors allows for a risk assessment. There are a number of models available to calculate an individualís risk. The assessment can be done for a 5 year period or the life time risk can be determined.
One most commonly used risk assessment tool is called the Gail Model. It combines information on age, age at menarche, age of first live birth, number of first degree relatives with breast cancer, race, the number of previous breast biopsies and other factors to determine a womanís risk. Once this is determined then an individualized screening and prevention plan can be developed. The screening may entail more frequent mammograms or ultrasounds but may also employ more complex imaging modalities such as magnetic resonance imaging. Of course in women at higher risk, there is a much lower threshold for evaluating abnormalities.
Modifiable risk factors are those that are not genetic and can potentially be changed. Obesity is one factor. Women with a body mass index greater than 30 are at higher risk. The use of exogenous estrogen, specifically the use of hormone replacement therapy for more than 5 years leads to an increased likelihood. Women who breast feed are at lower risk. In addition those with regular exercise and who consume higher amounts of fruits and vegetables are at lower risk. As with other medical conditions, smoking and excessive alcohol use can increase the risk of developing cancer.
So, even though you canít change your genes there are actions you can take to prevent breast cancer. These actions can have multiple benefits including decreasing your chance of developing other life threatening medical problems. If you are obese or overweight, get serious about reducing your weight. If you are normal weight, focus on preventing weight gain which occurs easily with aging. Regular exercise and consuming fresh fruits and vegetables are components of a weight loss program so you will be combating the risk on 3 fronts. Breast feeding for more than 6 months is beneficial to you in many ways and has lifelong benefits for your baby. Moderating your alcohol intake and smoking cessation are the smartest health decision you could ever make. Finally, if you donít need hormone replacement therapy then donít accept it and if you do try to wean off as soon as feasible.
A part of living is dying but it doesnít have to be premature and it should be high quality living. Your actions and decisions can affect your chance of developing breast cancer and other problems.
I hope this article has provided you with information that will help you make wise choices, so you may:
Live healthy, live well and live long!