(The information contained in this article does not constitute medical advice; please consult a physician if you have questions about breast health issues raised in this article.)
The primary, if not number one, concern of American women is that they will develop breast cancer. At least that was the biggest fear of those who answered a government survey in 2005. Dread of the disease lurks in the hearts of those who have witnessed their friends and relatives die of it. Adverse breast health also has a psychosocial component, fueled by fears of loss of femininity, beauty, youthful appearance, sex appeal, marital intimacy and other factors valued in Western culture.
Women need not fear the disease as they have in the past. I had it at 43, and again at 52. Now at 56 I am cancer free, living a full life. Not only do I garden, enjoy my sons, and write, but I also volunteer for the American Cancer Society and the National Lymphedema Network, an organization dedicated to helping people with lymphedema, a swelling that can be caused by cancer surgery or radiation. Helping others takes my mind off my plight.
While in 2009 new cases of invasive breast cancer in the U.S. are predicted by the American Cancer Society to be 192,370 and deaths 40,170, the good news is that fewer women are dying of the disease than in prior years. New treatments have revolutionized patient care, the result of multiple clinical trials testing new chemo regimens and targeted therapies such as Herceptin, Tykerb, Avastin, and aromatase inhibitors. Early detection also plays a role: the sooner the disease is found, the sooner it can be treated before it spreads. Mammograms, clinical checkups, and self-exams are important prevention tools, especially starting at age 40 if no other risks exist.
A closer look at breast health reveals that while some risk factors can’t be changed, including age, genetics, race, and family history, some lifestyle choices can reduce the risk of receiving a breast cancer diagnosis. One proven factor appears to be obesity. If a woman falls within that category (a body-mass index (BMI) of 30 or more), she should try to lose weight. Another factor in the breast-cancer-risk equation is exercise: swimming, walking, climbing and jogging exemplify the kind of aerobic activities that are beneficial to breast health.
Women who never bore children, and those who gave birth to their first child after 30, face a slightly higher risk of breast cancer. Being pregnant multiple times in her twenties improves breast health for women, perhaps because pregnancy reduces the total number of lifetime menstrual cycles.
Those using birth control pills have a slightly greater risk of breast cancer than women who never used them. A doctor can elaborate on the risks and benefits of birth control pills.
Another factor shown to increase the risk of breast cancer is long-term use of progesterone hormone therapy (PHT) or estrogen replacement therapy (ERT). Again, a knowledgeable physician should be able to discuss the pros and cons of using these types of hormone therapies. One suggestion might be to use the lowest effective dose for the shortest period of time necessary.
Breast-feeding may slightly lower breast cancer risk, particularly if it lasts 1½ to 2 years. This could be because breast-feeding lowers a woman’s total number of menstrual periods, as does pregnancy.
Studies have shown that use of alcohol increases the risk of being diagnosed with breast cancer. Women who consume two to five drinks daily have about 1½ times the risk of women who don’t drink. For optimum breast health experts suggest limiting drinks to one a day, preferably only two to three times a week.
If a close family member had breast cancer, the woman should make sure she is monitored more closely, and ask her doctor if she should be checked for the BRCA-1 or -2 gene and if she is a good candidate for daily tamoxifen or some other preventative drug, or even for preventative surgery.
It is important to remember that while breast health should be monitored regularly, there is no need to obsess over it or fear it to the point that activities like work and parenting get shoved aside. In other words, we should enjoy life! A breast cancer diagnosis is not the end of the world.
Women are encouraged to take charge of their lives and dispel the myths that might be keeping them paralyzed in fear of their breast health going awry.
A former attorney, Jan Hasak authored Mourning Has Broken: Reflections on Surviving Cancer (Xulon Press 2008). In this memoir she shares her long journey through two bouts with breast cancer.