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Catherine M. Porter, DO, Breast Surgery
Chester County Hospital; West Chester, PA

Published: September 8, 2014

With the approach of October and Breast Cancer Awareness Month, it's time to think about the risks of breast cancer and the measures taken to reduce that risk. Breast cancer is the leading cancer in women, and the second leading cause of death from cancer for women in the United States (lung cancer is number one). However, fewer women are dying today of breast cancer, a trend that has been observed since 1989 and thought to be due to increased awareness, earlier detection, better screening, and improved treatments.

The average woman in the United States has roughly a 12% risk (approximately 1 out of every 8 women) of developing breast cancer in her lifetime. Certain aspects of a woman's lifestyle can increase her risk of developing breast cancer, including the use of hormones, such hormone replacement therapy. Breasts that are constantly forced to be active, through our bodies' own natural hormones or artificial ones in the form of a pill, are thought to form cancer. Many studies have linked increased body weight and diets higher in saturated fats with an increased risk of developing breast cancer. Additionally, more than one alcohol drink a day elevates one's breast cancer risk 1.5 times.

Of course, doctors always say that a lack of exercise is the root of all evil, along with things that taste good, right? It turns out that fat cells in a body release a chemical similar to estrogen, the hormone that stimulates breast tissue to be active. Studies have shown that at least four hours of exercise a week lowers the risk of developing breast cancer. This exercise also lowers body fat, therefore decreasing breast cancer risk in postmenopausal women. Exercise and decreasing body fat are effective tools to enable breast cancer survivors to lower their risk of developing a recurrence as well.

There are, of course, some risk factors that can't be changed, such as family history. A woman with a first-degree relative (mother, sister, daughter) with breast cancer has an approximately 20% risk of developing breast cancer. Family histories with multiple generations of cancer that are not necessarily breast cancer are also worrisome. Recent advances in genetic research have identified genetic mutations that can cause cancer in organs in addition to the breast. Any family history with male breast cancer, ovarian cancer or breast cancer that presents at a young age is very concerning for a genetic mutation called BRCA. For these women, genetic counseling and testing is important, along with earlier and more frequent screening (i.e., mammograms recommended annually before age than 40). Annual MRI of the breasts is considered as well. Certainly, avoiding the modifiable risk factors, hormones use, increased body fat, a diet rich in saturated fats to name a few, is important for these women with an already elevated risk.

For a those women that have a significantly elevated risk, there are drastic but effective ways to try to prevent a cancer. Tamoxifen is an oral medication that blocks estrogen, thereby reducing the growth effect of estrogen in the breasts. Studies have shown that taking tamoxifen or similar estrogen-blocking pills for five years can lower a woman's risk of breast cancer over her lifetime by upwards of 60%. Alternatively, in women who have a known genetic mutation, prophylactic (preventive) mastectomies decrease the risk of developing breast cancer to less than 10%. Sadly, there is no way, as of yet, to completely eliminate the risk of developing breast cancer; until we can, vigilant surveillance will always be necessary.

So, as pink ribbons start to appear signifying breast cancer awareness month, let us not only think of the loved ones that we have lost to this disease, but to the survivors that continue their fight. By identifying risk factors for breast cancer, our goal is not only to identify high-risk individuals, but to make changes to prevent the next breast cancer from ever forming.



This article was published as part of the Daily Local News Medical Column series which appears every Monday. It has been reprinted by permission of the Daily Local News.


Related Breast Cancer Information from Chester County Hospital:

 

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