Fight With Style: Your Breast Health Checklist
It's tricky to sift through all the information (and misinformation) out there about how to reduce your chances of getting breast cancer. You can't do anything about two of the biggest risk factors—being a woman and getting older. But you can take other steps, whatever your age. Here's a guide to what you can do:
1. Talk to Your Doctor!
Bright Pink—the only national nonprofit dedicated to breast and ovarian cancer prevention in young women—suggests you begin the conversation with your health care provider now. According to Bright Pink founder Lindsay Avner, here are the five questions you should start with:
* Based on my family history and lifestyle factors, what's my projected lifetime risk for developing breast cancer?
* What sort of breast cancer preventative plan do you recommend for me?
* What does this personalized breast/ovarian cancer preventative plan entail for me? What do I need to do annually, semi-annually or at a certain age?
* What lifestyle changes or other actions could I take to reduce my risk for breast cancer?
* Should I see any specialists to manage my risk, such as a genetic counselor or breast specialist? Do you have any you recommend and work with regularly?
2. Perform regular breast self-exams.
Doctors advise all women to start self-exams in their 20s. Do them once a month, the week after your period ends. You may feel awkward at first, but self-exams are worth it: Early detection of cancer is critical. "The earlier it's found, the higher the likelihood that you won't need chemotherapy. Your treatment will be less involved," says breast surgeon Jocelyn Dunn. For an in-depth video demonstration and downloadable, step-by-step instructions, click here—right now!
3. Follow your recommended mammogram schedule.
Some women get a "baseline" test at age 35, though that's not statistically necessary for everyone. (One out of eight invasive breast cancers is found in women younger than 45, though, so you're never too young to start thinking about this stuff.) But all women should get a mammogram once a year, beginning at age 40—even if there's no cancer in your family. "Most women with breast cancer don't have a family history," says Laura L. Kruper, M.D., assistant professor and breast-cancer surgeon at City of Hope. If your sister or mother had breast cancer before menopause, you should start mammography 10 years before that relative's age of diagnosis.
4. Explore genetic tests.
Scientists think only 5 to 10 percent of breast cancer cases are the result of gene mutations inherited from a parent. But if you are an Ashkenazi Jew, or if you have been diagnosed with breast cancer, you may want to take a test for the genetic mutations known as BRCA-1 and BRCA-2. (If male breast cancer runs in your family, you are also at higher risk for a BRCA mutation.) The test costs $3,400 and is not necessary for most women, but your insurance should cover it if you fall into an at-risk category. Bright Pink even has a program where you can ask a genetic counselor a question before you commit to the full counseling. And take note: A federal law called GINA (for Genetic Information Nondiscrimination Act) prevents discrimination against people because of differences in their DNA that may affect their health.
5. Use the Breast Cancer Risk Assessment Tool.
It's easy: plug in some key information and receive numbers for your five-year risk and lifetime risk. Asian, Hispanic and Native American women have a lower risk of developing and dying from breast cancer, as do women who were younger when they first gave birth. One first-degree relative (i.e., a parent, sibling or child) with breast cancer doubles your risk of getting the disease.
6. Avoid high doses of radiation when possible.
Women who were treated with radiation for Hodgkin's disease or non-Hodgkin's lymphoma or for acne are more likely than other women to get breast cancer. That's especially true if they were treated with the radiation as teens, when their breasts were still developing.
7. Breastfeed your baby.
It's not been proven, but some studies suggest breastfeeding may slightly lower risk, especially if you continue for one and a half to two years. The theory is that nursing reduces a woman's total number of menstrual cycles over her life. And it's good for your baby, too!
8. Maintain a healthy weight.
Though plenty of thin women get breast cancer, obesity is linked to the disease. "Breast cancer risk increases with your BMI," reports Kruper. One possible explanation: Estrogen is stored in fat, so more fat means more estrogen exposure.
9. Exercise, exercise, exercise.
Studies have suggested it may help, perhaps because it reduces circulating estrogens. "I tell my patients to aim for 30-40 minutes, four times per week," Kruper says. "You don't have to necessarily get to a gym; walking is great exercise. And it's never too late to start!" Studies show that exercise decreases a woman's chances of getting breast cancer—and for women who've had breast cancer, it decreases the chance of a recurrence.
10. Limit alcohol use.
Don't consume more than a couple of drinks per week. "Increasing alcohol use is associated with increasing risk of cancer, and we don't know how low a level to consider 'safe,'" says Kruper.
11. Eat a low-fat diet.
It's good for overall health and may help prevent breast cancer. Most studies have found that breast cancer is less common in countries with low-fat diets. (Yet other studies in the United States have not found a link to fat intake.) Still, it can't hurt to try a low-fat regimen. "It's certainly not bad for your breasts," says Dunn.
12. Continue eating soy if you like it.
Many people worry that plant-based estrogens, called phytoestrogens, may increase breast-cancer risk. But there's no proof. In fact, a 2009 study in the American Journal of Clinical Nutrition looked at 73,223 Chinese women who participated in the Shanghai Women's Health Study and found strong evidence of a protective effective of soy food intake against premenopausal breast cancer. (Food is fine, but skip soy supplements, advises Dunn.)
13. Consider buying organic...
...but know it may not make a difference. "I don't think drinking organic milk or shopping at Whole Foods or Trader Joe's is going to hurt you, and it may help you, but there's no proof," says Dunn.
14. Limit exposure to pesticides and chemicals.
It's not a sure thing, but it can't hurt. "Unfortunately, there's really no proven environmental thing you can eliminate [to lower your risk]," according to Dunn.
15. Look into a preventative prescription.
If your doctor feels you're at high risk, ask her whether you would benefit from the estrogen-blocking drug tamoxifen. If used for five years, it decreases risk by about 50 percent—but there can be serious side effects. Some high-risk women take the osteoporosis drug raloxifene.
16. Continue using antiperspirant and bras.
The American Cancer Society says studies do not support the Internet rumors that chemicals in underarm products cause tumors, or that bras cause breast cancer by obstructing lymph flow.
Be sure to check out our Fight With Style section for more Breast Cancer Awareness resources!