By Tammy Worth
Breast cancer is the second leading cause of cancer in U.S. women, with about one in eight developing it in their lives. It tends to be diagnosed in middle age, with the median time of diagnosis 63. It happens when cells in the breast divide and grow more rapidly than normal.
The good news is that breast cancer death rates in the United States have been dropping for decades. This is largely due to better, more personalized treatments and improved detection technology like 3D mammography.
Though you can’t completely reduce your risk of getting breast cancer, there are a lot of factors that cause it. And by understanding some of what puts you at higher risk, you can incorporate health and lifestyle changes to lower yours. Read on to find out the basics about early detection, risk factors and how to keep your breasts healthy throughout your lifetime.
The power of early detection
Catching breast cancer in its early stages is extremely important. The five-year survival rate when it hasn’t spread to other areas is about 99%. Detecting breast cancer early starts with a clinical breast exam with your doctor (which many providers will do at your annual checkup) and a mammogram.
The U.S. Preventive Services Task Force recommends that women begin getting mammograms at age 40 and get them every other year through age 74. The American Cancer Society recommends mammograms annually from ages 40 through age 54; then semiannually as long as a woman is expected to live 10 more years. These guidelines are for women at average risk of having breast cancer.
If you are at a higher risk for the condition, the American Cancer Society recommends getting a mammogram and breast MRI every year starting at age 30. You are at higher risk if you:
- Have the BRCA gene,
- Haven’t been tested, but have a close relative – like a parent, sister or child – with the BRCA gene,
- Have had radiation to the chest or face before the age of 30,
- Have or have first-degree relatives with i-Fraumeni syndrome, Cowden syndrome or Bannayan-Riley-Ruvalcaba syndrome.
Deciding when and how to screen for breast cancer is a personal decision. There may be other factors that put you at higher risk for the condition aside from those suggested by the American Cancer Society. Talk with your doctor about your options if you have other risk factors like:
- Having a close relative who had breast cancer,
- Having breast cancer that was removed,
- Being diagnosed with a benign breast condition like atypical ductal hyperplasia, lobular carcinoma in situ and proliferative lesions,
- Having dense breasts, especially if you have other risk factors.
The American College of Gynecology suggests that all women should be evaluated for their risk of breast cancer by age 25. Being proactive about your health and knowing your risks can help you create a screening plan that’s best for you.
Self-breast exam recommendation changes
Doctors used to suggest that women perform monthly self-exams to check for breast cancer. But that has changed for people who aren’t at high risk because self-exams weren’t shown to reduce breast cancer deaths. They may also increase the risk of unnecessary breast biopsies.
Instead, many organizations say it’s good to have breast self-awareness. If you know how your breasts normally look and feel, you are more likely to notice any changes that may indicate cancer. It’s also important to note that about 25% of women have reported finding breast cancer through a self-exam, not through a mammogram, so many healthcare organizations suggest performing them monthly.
Performing a breast self-exam isn’t difficult, but it can take some time. You should make sure to feel each area with light, medium and firm pressure to reach all levels of breast tissue. To do a self-exam:
- Look at your breasts in the mirror, first with your hands on your hips and then with your arms raised.
- Check for breast fluid coming from the nipples.
- Lie down and use your right hand to check your left breast and vice versa. Press in circles the size of a quarter. Check the entire breast from the collarbone to the top of abdomen and your armpits to your cleavage.
- Do another exam while standing or sitting. This is easiest to do in the shower when your skin is wet.
When doing a self-exam, you are feeling for a lump, knot or thick tissue that is different than the rest of the breast or isn’t on your other breast. Remember, most breast lumps you’ll find aren’t cancerous; they can be cysts, fibrous tissue or benign tumors.
Aside from lumps on the breasts and armpits, you should also be looking for:
- Changes in breast size or shape or a sudden asymmetry of the breasts,
- Swelling or shrinkage on all, or part of, the breast,
- Dimpling or puckering of the breast skin,
- Inverted nipple or nipple pain or discharge,
- Change in skin texture, a rash, scaly, red or swollen skin on breast or nipple,
- Swollen lymph nodes under the arm or near the collarbone.
Not everyone with breast cancer has symptoms. And symptoms can vary dramatically between people who have it. If you feel or see something that is concerning during your examination, don’t panic, but do talk to your doctor.
Lifestyle prevention tips
The exact cause of breast cancer isn’t known, but it’s likely a combination of genetics, family history and lifestyle factors. You can’t change your genes, but you can do some things every day to reduce your risk.
Start by adopting a healthy lifestyle that limits the use of tobacco and alcoholic beverages. If you smoke, stop. No amount of alcohol is safe, but if you do drink, women should have no more than one drink a day and fewer than seven drinks in a week.
To reduce your risk, you can also maintain a healthy weight (often measured as a body mass index of 18.5 to 24.9). To do this, eat plenty of fruits and vegetables, whole grains and lean proteins. Exercise may also help keep your weight in a healthy range. Most guidelines suggest 150 to 300 minutes of moderate-intensity physical activity or 75 minutes to 150 minutes of vigorous exercise each week.
If you have questions about ways to reduce your risk of breast cancer, or want to understand the best screenings for you, talk to your doctor. There’s no way to avoid getting cancer, but a healthy lifestyle and regular checkups can go a long way toward prevention. For more information, visit us at kp.org/sandiego.
