South Florida Health and Wellness Magazine Health and Wellness Articles
Related Articles
By Paula Greene, A.R.N.P.-C, Palm Beach Breast Institute
Breast cancer is the most common form of cancer found among women in the United States. One in eight women, or 12.7%, will develop invasive breast cancer in her lifetime. Breast cancer is the leading cancer site among American women second only to lung cancer in regard to cancer deaths.
In 2011, an estimated 230,480 women and 2,140 men were diagnosed with invasive breast cancer and approximately 39,520 women and 450 men died of breast cancer in that year. The good news is, the number of these deaths is steadily decreasing. Medicine is making great strides against the disease thanks to early detection and better treatments. In 2011, there were 2.6 million breast cancer survivors in the United States.
ARE YOU AT RISK FOR DEELOPING BREAST CANCER?
Risk factors are anything that increases your risk for developing cancer. Having a risk factor does not mean that you will develop breast cancers, some women with one or more risk factors never develop breast cancer and most women who have been diagnosed with breast cancer have no apparent risk factors.
RISK FACTORS YOU CANNOT CONTROL:
- Gender – Women are 100 times more likely to develop breast cancer than men.
- Age – Two of three breast cancers are diagnosed after the age of 55.
- Genetics – Genetic mutations which include a BRCA1 and BRCA2 account for 5 to 10% of breast cancers.
- Family history – Having a first degree relative (mother, sister or daughter) doubles your risk for developing breast cancer.
- Personal history – Having a previous diagnosis of breast cancer increases your risk by three to four times.
- Radiation – to the chest for treatment of Hodgkin’s or non-Hodgkin’s lymphoma puts you at increased risk for developing breast cancer.
- Race – Caucasians are more likely to develop breast cancer than African American, Asian, Hispanic or Native Americans. African Americans develop more aggressive advanced stage breast cancer at a younger age.
Menstrual periods – If you start your periods before the age of 12 and do not go through menopause until after 55, you are at increased risk for developing breast cancer.
Dense breasts – Having dense breast tissue increases your risk and makes mammograms more difficult to read.
CONTROLABLE RISK FACTORS:
Being overweight increases your risk. There is a 4% increased risk for every 11 pounds gained after the age of 35.
Not having children or having them later in life, after the age of 30, increases your risk for developing breast cancer.
- Hormone replacement therapy – Estrogen exposure over long periods of time increases a woman’s risk for developing breast cancer.
- Alcohol – Two or more drinks per day will increase your risk for developing breast cancer.
- Diet – Diets high in saturated fat will increase your risk of developing breast cancer.
- Smoking – Smoking at an early age will increase your risk for breast cancer.
GENETIC RISK – WHO SHOULD BE TESTED?
Approximately 5 to 10% of breast cancers are thought to be hereditary or due directly from a mutation on a gene passed on from either your father or mother. Most inherited cases of breast cancer are associated with two abnormal genes: BRCA1 (BReast CAncer gene 1) and BRCA2 (BReast CAncer gene 2).
Everyone has BRCA1 and BRCA2 genes. The function of these genes is to repair cell damage and keep cells growing normally. When these genes contain abnormalities or mutations, they do not function normally and breast cancer risk increases. Abnormal BRCA1 and BRCA2 genes may account for up to 10% of all breast cancers, or one out of ten cases. Having an abnormal BRCA1 or BRCA2 gene does not mean you will be diagnosed with breast cancer, but you may be a higher breast cancer risk. Still, most people who develop breast cancer do not inherit an abnormal breast cancer gene and have no family history of the disease.
You may be at risk to have one of these mutations if you or a family member have:
- Ovarian cancer
- Breast cancer before the age of 50
- Bilateral breast cancer
- A male relative with breast cancer
- Ashkenazi Jewish ancestry
The average woman in the United States has a one in eight, or 12-13% risk of developing breast cancer in her lifetime. Women who have an abnormal BRCA1 or BRCA2 gene (or both) can have up to an 80% risk of being diagnosed with breast cancer during their lifetime.
Breast cancers that are associated with an abnormal BRCA1/BRCA2 gene tend to develop in younger women and occur more often in both breasts than cancers in women without these abnormal genes. Women with abnormal BRCA1/BRCA2 genes also have an increased risk for developing ovarian, colon, pancreatic and thyroid cancers, as well as melanoma.
Men who have an abnormal BRCA2 gene have a higher risk for breast cancer than men who do not…about 8% by the time they are 80 years old. This is about 80 times greater than average. They also have a higher risk for developing prostate cancer.
GENETIC TESTING
There are genetic tests available to determine if you have an abnormal BRCA1/BRCA2 gene. These are simple tests done via blood or other samples. Interpretation of these results and what they mean for your health can be very complex.
If you believe that breast or ovarian cancer runs in your family, you may want to contact your healthcare provider to determine your risk for hereditary cancer. Although they cannot tell you whether you will or will not get cancer, they can calculate a statistical range of your risk of certain cancers.
If you are at higher risk because of an abnormal breast cancer gene, you and your doctor will develop a screening plan tailored to your unique situation. You may start being screened earlier than 40. In addition to the recommended screening guidelines for women at average risk, a screening plan for a woman at high risk may include:
- Monthly self breast examination.
- Yearly breast examination by your doctor.
- Digital mammogram every six months or every year starting at the age of 30 or younger.
- Breast ultrasound every six months or every year.
- MRI breast screening every year.
Talk to your doctor, radiologist or genetic counselor about developing a specialized program for early detection that addresses your breast cancer risk, meets your individual needs and gives you peace of mind.
If you do have an abnormal gene, there are also lifestyle choices you can make to keep your risk as low as possible. These include:
- Maintaining a healthy weight.
- Exercising regularly.
- Limiting alcohol.
- Eating nutritious foods.
- Never smoking or quit if you do smoke.
These are just a few steps you can take. Along with these lifestyle choices, there are other risk reduction options for women at higher risk because of abnormal genes. Besides close surveillance, these include:
- Research trials.
- Medications.
- Prophylactic or preventative mastectomy or oophorectomy.
All women should follow the lifestyle choices for breast cancer risk reduction as well as the following: American Cancer Society Guidelines for Early Detection of Breast Cancer
- Yearly mammograms are recommended for most adults.
- Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health.
- Clinical breast examination every three years for women in their 20’s and 30’s and every year for women 40 and over.
- Women should know how they breasts normally feel and look and promptly report any changes to their healthcare provider. Self breast examinations are an option for women starting in their 20’s.
For further information regarding genetic testing and cancer risks, contact Palm Beach Breast Institute at (561)881-9100 or visit www.BreastQuestion.com.
