Almost everyone living in Anguilla knows someone who has breast cancer, whether it is our mother, sister, relative or friend. There has been several advances in the treatment and management of breast cancer in Anguilla, with many survivors now living longer than before and many more in remission. Despite this, many individuals still present to their doctors in the late stages of the disease, and some do not take advantage of the various screening tests that allow for early detection of the disease, and some also fail to seek treatment.
Can breast cancer be prevented?
At this time there is no sure way to prevent breast cancer but there are things you can do, that might lower your risk, such as changing risk factors that are under your control. Several clinical studies have confirmed that reducing certain risk factors for breast cancer can help reduce the incidence of breast cancer.
It should be pointed out that many women get breast cancer and do not have any significant risk factors. Others might have several risk factors and also do not get breast cancer. Much more research is needed in these areas.
There are several risk factors for breast cancer, some we do not have any control of but there are others we can influence. Those that we can influence include the following:
Drinking alcohol
The use of alcohol is clearly linked to an increased risk of developing breast cancer. The risk increases with the amount of alcohol consumed. Compared with non-drinkers, women who consume 1 alcoholic drink a day have a very small increase in risk. Those who have 2 to 5 drinks daily have about 1½ times the risk of women who do not drink alcohol. Excessive alcohol consumption is also known to increase the risk of developing several other types of cancer.
Being overweight or obese
Being overweight or obese after menopause increases breast cancer risk. The connection between weight and breast cancer risk is complex. For example, the risk appears to be increased for women who gained weight as an adult but may not be increased among those who have been overweight since childhood. Also, excess fat in the waist area may affect risk more than the same amount of fat in the hips and thighs. Researchers believe that fat cells in various parts of the body have subtle differences that may explain this.
Blood insulin levels
Higher insulin levels have also been linked to some cancers, including breast cancer.
Physical activity
Evidence is growing that physical activity in the form of exercise reduces breast cancer risk. The main question is how much exercise is needed. In one study, from the Women’s Health Initiative, as little as 1.25 to 2.5 hours per week of brisk walking reduced a woman’s risk by 18%. Walking 10 hours a week reduced the risk a little more.
Other risk factors for breast cancer
There are other risk factors for breast cancer that we do not have any control over. These include:
Gender
Simply being a woman is the main risk factor for developing breast cancer. Men can develop breast cancer but this disease is about 100 times more common among women than men.
Aging
Your risk of developing breast cancer increases as you get older. About 1 out of 8 invasive breast cancers are found in women younger than 45, while about 2 of 3 invasive breast cancers are found in women age 55 or older.
Genetic risk factors
About 5% to 10% of breast cancer cases are thought to be hereditary, meaning that they result directly from gene defects (called mutations) inherited from a parent.
Family history of breast cancer
Breast cancer risk is higher among women whose close blood relatives have this disease.
Having one first-degree relative (mother, sister, or daughter) with breast cancer approximately doubles a woman’s risk. Having 2 first-degree relatives increases her risk about 3-fold.
The exact risk is not known, but women with a family history of breast cancer in a father or brother also have an increased risk of breast cancer. Altogether, less than 15% of women with breast cancer have a family member with this disease. This means that most (over 85%) women who get breast cancer do not have a family history of this disease.
Early detection of breast cancer
It has been shown that the earlier breast cancer is diagnosed and treated, the better is the prognosis. There is still much debate regarding the best ways to detect breast cancer very early.
Breast self-exam (BSE) is an option for women starting in their 20s. Women should be told about the benefits and limitations of BSE. Women should report any breast changes to their health professional right away.
Mammograms-There are several benefits in having a mammogram. Individuals should discuss with their doctor when they should start having a mammogram and how often. Mammograms also have limitations. A mammogram can miss some cancers, and it may lead to follow up of findings that are not cancer. Women should be told about the benefits and limitations linked with yearly mammograms. Despite their limitations, mammograms are still a very effective and valuable tool for decreasing suffering and death from breast cancer.
Mammograms should be continued regardless of a woman’s age as long as she does not have serious, chronic health problems. Age alone should not be the reason to stop having regular mammograms. Women with serious health problems, or short life expectancies, should discuss with their doctors whether to continue having mammograms.
Other investigations-There are other investigations that your doctor might recommend such as ultrasound scans and MRI. Women who are at high risk for breast cancer, based on certain factors, should get an MRI and a mammogram regularly.
Regular medical check-ups. Individuals are encouraged to visit their doctor and have regular check-ups even if they do not have any signs and symptoms suggestive of breast disease. If you think you are at higher risk for developing breast cancer, talk to your doctor about what is known about the various screening tests and their potential benefits, limitations and harms. Then decide together what is best for you.
Conclusion
If you are concerned about breast cancer, you may be wondering if there is anything you can take toward breast cancer prevention. Some risk factors, such as family history and age, cannot be changed. However, there are lifestyle changes you can make to lower your risk. Limiting alcohol and staying physically active can go a long way in reducing your risk of developing breast cancer. Controlling your weight is also important. Being overweight or obese increases the risk of breast cancer. This is especially true if obesity occurs later in life, particularly after menopause. If you are concerned about breast cancer talk to your healthcare provider today.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB, BS, DGO, MRCOG, is an Obstetrician/Gynaecologist and Family Doctor who has over thirty two years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
