September 28, 2016 // Uncategorized

Reducing your risk of breast cancer

By Dr. David Kaminskas

The incidence of breast cancer has risen dramatically over the past 40 years and could be classified as a modern-day epidemic. It is the leading cause of cancer deaths in women and is the most common cancer diagnosed in women. In 1970 there were approximately 68,000 new cases of female breast cancer in the U.S. By 2014 there was a 242 percent increase to 232,600 new cases of breast cancer. From birth to death, breast cancer affects one in eight women in the USA. This article will discuss both modifiable and non-modifiable risk factors. There is little question that woman can significantly reduce their risk of breast cancer if they pay close attention to prevention. October is Breast Cancer Awareness Month, and that has motivated me to present this article now.

There are certain risk factors that you cannot do anything about. If you are a white woman, your risk of breast cancer is higher than other ethnic groups. Believe it or not, tall women have an increased risk, and cancer researchers have no clue why. Having dense breast tissue, defined as dense tissue comprising greater than 75 percent of the breast by mammography, increases the risk of breast cancer by four to five times. Later menopause or earlier menarche is linked to a higher risk. A family history of breast cancer, especially in first-degree relatives significantly increases your probability. If you have one affected first-degree relative your risk goes up twofold. If you have two — mom and sister — your risk goes up threefold.

There are inherited genetic mutations that predispose to breast cancer that amount to about 5 percent of the total cases. Probably the most famous mutation is the BRCA1 that Angelina Jolie Pitt discovered she had when she did genetic testing. This gave her a reported 87 percent chance of developing breast cancer. She opted to have bilateral mastectomies to remove her risk.

Nulliparous women — females that have never given birth— have an estimated 1.5 times increased risk as compared to parous women. During the first full term pregnancy, breast lobules become mature and actually develop a resistance to cancer. By the second trimester, the breast contains approximately 70 percent cancer resistant lobules and only 30 percent cancer susceptible lobules (Breast Cancer Prevention Institute 2007). By full term, 85 percent of the breast consists of cancer resistant lobules. This is one of nature’s ways of protecting women from breast cancer. This is the likely reason that multiple studies show the increased risk of breast cancer in those women who have had abortions.

In the Nurses’ Health Study it was proven that women who became pregnant later in life had an increased risk of breast cancer compared to women who deliver their first child at a young age. “Women having their first child when aged under 18 years had only about one-third the breast cancer risk of those whose first birth is delayed until the age of 35 years or more” (MacMahon et al. 1970).

Let’s move on to the more modifiable risk factors. Breastfeeding reduces your chances of breast cancer. In fact, the longer you breastfeed your children the less your risk. So you moms out there who continue to offer the health advantages of mother’s milk to your 1, 2 or 3 year-olds are encouraged to do so by this doctor.

Obesity after menopause increases the risk of breast cancer. Physical activity lowers it. A recent review comparing inactive women to physically active women showed that breast cancer was reduced by 25 percent in those that exercise regularly. Smoking increases the risk of breast cancer, and this is true for most cancers as well. Breast exposure to radiation increases the risk of cancer. This is mostly true for women at age 45 or younger and especially true in the teenage years. Don’t let your doctor do X-rays or especially CT scans unless it is absolutely necessary at a young age.

Most of us would agree that working nights just can’t be healthy. A risk factor that even surprised me was found in a 2012 nurse’s study. Nurses who worked shifts after midnight had about twice the risk of breast cancer as day workers. This is believed to be related to light exposure and the suppression of nocturnal melatonin production by the pineal gland in the brain. (This may be exceeding even my pay grade!)  Hormone replacement therapy has been strongly linked to increased breast cancer risk as well as uterine cancer risk, and its use has dramatically declined because of this finding. Oral contraceptives increase the risk of breast cancer, especially those that contain high-dose estrogen. The earlier and the longer you take them, the higher the risk.

There are also diets that appear to reduce the risk of breast cancer. The Mediterranean diet, characterized by an abundance of seafood, plant foods, olive oil and nuts, proved to lower the risk. Although somewhat inconclusive, reduction in fat intake and red meat were favorable in several studies.

If you are one of the few men who read the title and still read this article, let it be known that you are not immune to breast cancer. It is uncommon, but not rare, in men. I have personally seen several cases in the past decade. Whether you are a woman or a man, a lump in your breast tissue should be promptly evaluated.

There have been recent advances in breast imaging for cancer detection. This includes using 3D imaging rather than 2D, which has been the standard till recently. Accuracy in diagnosing breast cancer is increased by 10-30 percent with the 3-D technique. Almost as important, it reduces callbacks, which cause so much mental distress after receiving that anxiety-provoking phone call. Insist on the best and ask for 3-D Mammography when you get your mammogram. The beautiful St. Agatha of Sicily is the patron saint of breast cancer. Her life story is quite inspiring. She was tortured to death, and her reported last words as she gave up her life were: “Oh Lord Jesus Christ, good Master, I give You thanks that You granted me victory over the executioners’ tortures. Grant now that I may happily dwell in Your never ending glory.”

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