October is National Breast Cancer Awareness Month, and it is so much more than just wearing pink. It’s not enough to be aware – you must get educated! Breast cancer is a VERY common cancer. About 12% of American women face the disease at some point in their lives. And almost no family is untouched by this illness; every woman who is diagnosed is someone’s mother, daughter, sister, aunt, or cousin.
Recently, thanks in large measure to Angelina Jolie’s brave decision to go public with her preventative journey and her family history, there has been a lot of information in the press about the dangers of hereditary breast cancer. (Check out my blog on the BRCA gene.). Still, only 5% of breast cancers are from the BRCA 1 or 2 genes, and just 20% of all breast cancers are “familial.” That leaves 80% of breast cancers that are considered “sporadic,” meaning that those affected have no known family members with the disease. And breast cancer doesn’t discriminate; I have seen it in a 20- year-old and in a 90-year-old.
The message is we are all at risk.
My job as a gynecologist is to help <a href=”/integrative-medicine-program.shtml”>diagnosis breast cancer</a>. I do all I can to find malignancies when they are small and treatable, so my patients have a higher likelihood of surviving and thriving. And I always recommend that any woman with a strong family history of breast cancer should consider BRCA testing. Some additional tools that might be used to access risk for those with a hereditary link include:
- The Gail Risk Assessment Model is a statistical tool used to determine risk based on years of exposure to hormones and family history (“first degree” relatives like a mother or sister), and it takes less than five minutes to complete in the gynecologist’s office. Make sure that your doctor orders an MRI to go along with your annual mammogram if your lifetime risk is 20% or higher.
- The Tyrer-Cuzick Model takes into account extended family. The point of this approach is to determine if the risk is greater than 20% so again, an MRI might be in order along with your annual mammogram.
Even if you have no family history of breast cancer, I strongly recommend that you have an annual mammogram after the age of 40. Only 30% of women actually get one done, even though it’s prescribed and recommended yearly for women over 40. This can help diagnose the disease in the early stages.
If your mammogram reads dense breast, then you should talk to your physician about a supplemental breast ultrasound. Dense breasts mean that there is more breast tissue and less fatty tissue in the breast, and numerous studies now tell us that increased breast density is its own independent risk factor for breast cancer.
And there’s more: Studies have identified seven DNA markers that are associated with an increased risk of getting breast cancer, and a new test, marketed as BRVAGEN can identify these DNA markers in Caucasian women over the age of 35. This test combines your GAIL model history with your DNA (obtained from a cheek swab) and calculates your five-year and lifetime risk of breast cancer.
While all this testing is helpful, you can play an active role in helping prevent breast cancer. Here are some areas to consider:
- Fitness makes a difference. While you know being healthy and fit helps you with heart health, it’s also an important measure to help prevent breast cancer. Obesity increases the risk of breast cancer (twice the risk of cancer incidence, recurrence, and death from the disease), so aim to have a BMI that is under 25. And women that exercise three to four times per week at moderate to vigorous levels have a 30-40% lower incidence of breast cancer.
- Keep your vices in check! Alcohol increases the risk of breast cancer, so limit your alcohol intake— less than two drinks per day, and less than seven drinks per week. Smoking tobacco increases the risk of EVERY cancer so don’t smoke!
- Eat your vegetables (mom was right). The American Cancer Society recommends nine servings of fruits and vegetables per day. These healthy foods provide plenty of antioxidants, which are the precise chemicals that help us repair errors in our DNA and prevent runaway cells from proliferating. I recommend trying to avoid chemicals and pesticides as well, so do your best to buy organic fruits and vegetables.
- Keep your environment safe. Exposure to environmental factors may affect cancer risk, so avoid BPAs, and choose foods/animal products that do not have antibiotics or hormones injected into them. Limit stress, as it creates chronic inflammation – the preferred environment for cancer cells. As a way to combat stress, you can try meditation, keep a journal, get a massage, or take a hot bath. And get enough sleep.
- Give yourself regular breast self-exams. The best time is 3-5 days after your period starts, or if you’ve gone through menopause, the same time every month. Check out these instructions from the National Institute of Health for more details, or ask us to show you how to do a self exam.
- Consider medication. Ask your physician about the use of medications such as hormones (for contraception or menopause) or Selective Estrogen-Receptor Modulators (SERMs), such as Tamoxifen or Evista, as they may help lower the risk of breast cancer.
Together We’ll Find A Way
Now you are aware and educated about breast cancer! If you have questions, concerns, and/or a strong family history of breast cancer that you’d like to discuss, please contact Dr. Tina Koopersmith.