Except for skin cancer, breast cancer is the most common cancer in American women. The risk of a U.S. woman developing breast cancer over her lifetime is approximately 12 percent — a 1 in 8 chance.
There are more than 3.1 million women with a history of breast cancer in the U.S. today. While this includes women being treated and women who have finished treatment, it is projected this year 252,710 new cases of invasive breast cancer n will be diagnosed along with 63,410 new cases of non-invasive (in situ) breast cancer. More often diagnosed in Caucasian women, breast cancer is more common in African-American women when comparing all women under the age of 45. African-American women overall have a 42 percent higher breast cancer death rate.
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Research shows from 1989 to 2015 the death rate from female breast cancer dropped 39 percent. It continues to drop. Today the chance that a woman will die from breast cancer is about 1 in 37 (or about 2.7 percent), thanks to new and improved early detection screenings and optical imaging tests, as well as numerous advances in support services and treatments. While female breast cancer is still the second leading cause of cancer death in women, information programs coupled with annual events like National Breast Cancer Awareness Month every October draw attention to breast cancer worldwide.
Women should start receiving mammograms around their 40th birthday and every year after that. A mammogram is an X-ray of the breast that can often detect tumors too small for you or your doctor to feel. Most mammograms are done digitally, so a record of images can be kept in an electronic file. The whole procedure takes about 20 minutes; the actual compression only lasts a few seconds. Some women choose to start receiving them at a younger age because of a personal or family history of breast cancer. Ultimately the best guide is your health-care provider.
Men impacted, too
While breast cancer occurs nearly 100 times more often in women than in men, about 2,470 new cases of invasive breast will be diagnosed in men this year. Although a man’s lifetime risk of breast cancer is about 1 in 1,000, research shows male breast cancer is like female breast cancer in that it spreads via lymphatics and blood stream. Probable contributors include radiation exposure, elevated levels of the hormone estrogen and family history of breast cancer, specially breast cancer that is related to the BRCA2 gene.
Although treatment outcomes are similar to women at the same stage of detection, a man diagnosed with breast cancer should see a genetics counselor for a consultation. If he tests positive for a defective gene this can lead to a future diagnosis of breast cancer and knowledge that his children have a 50 percent chance of carrying the gene. African-American men are hit harder by breast cancer than their white counterparts and after diagnosis, African-American men are three times more likely to die from breast cancer than white men. Overall, studies show male breast cancer is often diagnosed at an advanced stage, affecting survival rate percentage.
Risk factors
While the most significant risk factors for breast cancer are gender (being a woman) and age (two out of three women with invasive cancer are diagnosed after age 55), no one knows the exact causes. What scientists do know is that breast cancer is caused by damage to a cell’s DNA and that certain risk factors contribute to damaging a cell’s DNA. Having a risk factor does not mean someone will get breast cancer; most women who develop breast cancer have no obvious risk factors and no family history.
• Certain genome changes: The genes we’re born with may increase our risk for cancer. A new, state-of-the-art technology, multigene panel testing, simultaneously examines genes to look for potentially cancer-causing mutations. Panel testing provides time-based, integrated information, helping people to take action to prevent or stop cancer. Genetics counselors help interpret results and options. Studies show about 5 to 10 percent of breast cancers can be linked to gene mutations inherited from one’s mother or father.
• Family history: A woman’s risk of breast cancer nearly doubles if she has a first-degree relative (mother, sister, daughter) who has been diagnosed with breast cancer. If her mother, sister, father or child has been diagnosed with breast or ovarian cancer, she has a higher risk of being diagnosed with breast cancer—and her risk increases if a relative was diagnosed before the age of 50.
• Smoking: Accumulating research indicates that smoking may increase a woman’s breast cancer risk, particularly when it is long-term, heavy and among those who started before their first pregnancy.
• Overweight or obese: Being overweight or obese can increase risk for breast cancer, particularly if a woman has gone through menopause. The risk for breast cancer is about 1.5 times higher in overweight women, and two times higher in obese women than in lean women.
• Lack of physical activity: Growing evidence suggests that women who get regular physical activity have a 10 to 25 percent lower risk of breast cancer compared with women who are inactive; there is stronger evidence of this for postmenopausal than premenopausal women.
• Poor diet and alcohol consumption: A diet high in saturated fat and lacking fruits and vegetables can increase your risk for breast cancer. Numerous studies confirm on average alcohol consumption increases the risk of breast cancer in women by about 7 to 10 percent for each drink consumed. Women who have two to three alcoholic drinks a day have a 20 percent higher risk of breast cancer compared with non-drinkers.
• Personal health history: If a woman has been diagnosed with breast cancer in one breast, she has an increased risk of being diagnosed with breast cancer in the other breast. Her risk increases if abnormal breast cells have been detected before.
• Menstrual and reproductive history: Early menstruation (before age 12), late menopause (after 55), having first child at older age or never having given birth can be risk factors.
• Dense breast tissue: Having dense breast tissue can increase a woman’s risk for breast cancer and make lumps harder to detect. (Several states, including California, have laws requiring physicians to disclose if a woman’s mammogram indicates she has dense breasts.)
•Radiation to the chest: Having radiation therapy to the chest before the age of 30 can increase the risk for breast cancer.
• DES exposure: Women whose mother took a medication called diethylstilbestrol (DES) to prevent miscarriage from the 1940s through the ’60s, may have a higher risk of breast cancer. Data shows women who took the medication had an increased risk of breast cancer.
Myths debunked
There are many myths about breast cancer, and one of them is it is contagious. It is not. In addition, it is not caused by wearing underwire bras, implants, deodorants, antiperspirants, mammograms, caffeine, plastic food serving items, microwaves or cellphones. What is not a myth is the need for individuals to give themselves a breast self-exam once a month. Look for any changes in breast tissue, such as changes in size, feeling a palpable lump, dimpling or puckering of the breast, inversion of the nipple, redness or scaliness of the breast skin, redness or scaliness of the nipple/areola area, or discharge of secretions from the nipple.
Dr. Lizellen La Follette is a board-certified obstetrician and gynecologist in private practice in Greenbrae. She also sees patients in Sonoma Valley. Her “A Woman’s Perspective” column appears every fourth week.
