Breast cancer is one of the most common cancers affecting women today, second only to skin cancer. Currently, a woman born in the United States faces a one in eight risk of developing this disease during her lifetime, and chances are that every person reading this article has either faced the disease or knows more than one friend or family member who has.
Prior to 1970, the subject of breast cancer was taboo except in medical journals, but today breast cancer is a common topic of conversation, and that’s the first step in prevention activities. Let’s begin this discussion of breast cancer prevention by providing historical context and some good news.
First, since 1990, the mortality rate from breast cancer has decreased by two percent per year. Approximately half of that decline is attributable to screening mammography.
Although screening mammography leads to an earlier diagnosis of breast cancer among women of all ages, women screened between the ages of 50 and 69 derive the greatest benefit from this tool.
Second, after peaking in 1998, the incidence of breast cancer has steadily declined. One reason for this decline stems from the findings of the Women’s Health Initiative study. This report showed that women who take the combination of estrogen plus progestin menopausal hormone therapy have an increased incidence of breast cancer. As a result of this report, many menopausal women chose to stop taking hormone replacement therapy, and the incidence of breast cancer began to fall soon after the report was published.
Women can reduce their risk of breast cancer in several ways. For example, avoiding exposure to x-rays during puberty, engaging in regular exercise, drinking no more than one alcoholic beverage daily and maintaining normal weight after menopause. Breast feeding is associated with a decreased risk of breast cancer. Also, women who have had a hysterectomy can reduce their risk of breast cancer by taking an estrogen-only hormone replacement.
Today, we have several models for calculating a woman’s risk of developing breast cancer. Perhaps the most well-known is the Gail model which predicts risk based on age, race, a woman’s age at her first menstrual period, her age at her first live birth, the number of breast biopsies she undergoes, the presence of abnormal milk ducts (atypical ductal hyperplasia) in a biopsy, and the number of close relatives with breast cancer. Women who are found to have a high risk of developing breast cancer can reduce that risk by taking certain anti-hormone medications. However, before taking breast cancer prevention medications, a woman should consult a doctor as such medications have potential side effects.
Not all breast cancer can be prevented, but women can take steps to decrease their likelihood of getting this disease. An awareness of the risk factors related to lifestyle is the first step toward prevention. For more information on how one can prevent breast cancer visit http://www.cancer.gov/cancertopics/preventio n-genetics-causes/breast.
Dr. Barton Paschal is a graduate of Emory University School of Medicine and completed a fellowship in cancer medicine at Wake Forest University. He is certified by the American Board of Internal Medicine in the specialty of medical oncology. Dr. Paschal is a member of the staff at Haywood Cancer Center, 600 Hospital Drive, Suite 10 in Clyde; and Macon Cancer Center, 190 Riverview Street in Franklin. He can be reached at (828)456-5214 or (828)369-4257.