Take charge of your breast health

October 2, 2011 

There’s a new movement in breast cancer, and the focus is on survivorship.

“Our detection tools have gotten so good that many cases are being caught in the most treatable stages, so the survival rate is very high,” says Dr. Maura Dickler, assistant professor of medicine at Memorial Sloan-Kettering Cancer Center in New York City.

That’s big news -- and it’s partly thanks to the fact that experts understand more than ever before what raises your breast cancer risk and what all women can do to help beat the odds.

“Just knowing you have certain risk factors ups the chances of catching cancer early if you’re more vigilant about screenings,” says Dr. Therese Beavers, medical director of the Cancer Prevention Center at the M.D. Anderson Cancer Center in Houston. And there are risks you can control.

Here are a few tools to take charge of your breast health.

THINGS YOU SHOULD DO IN YOUR . . .

20s

n Exercise. A landmark study found that women who worked out as young adults had a 23 percent lower risk of breast cancer. Strenuous is best, but anything that makes you break a sweat helps.

n Limit your radiation exposure. Ask if you can get an MRI or ultrasound instead of an X-ray or CT scan, an X-ray technique that uses particularly high levels of radiation.

n Cut back on red meat. Eating three or more servings a week has been linked to an increased risk of breast cancer. Limit each serving to 4 ounces or less (about the size of your palm).

30s

n Breastfeed. You’re not producing as much estrogen, which reduces your risk, says Dr. Carolyn Runowicz, director of the Comprehensive Cancer Center at the University of Connecticut.

n Lose the baby weight. Women who gained more than 36 pounds while pregnant and didn’t lose it were 60 percent more likely to develop breast cancer after menopause, say researchers at Georgetown University.

n Don’t drink too much alcohol. Just 4 ounces a day (about half a glass) can raise your risk 9 percent. Cap it at three drinks a week; if you’re high-risk, ask your doctor if you should abstain altogether.

40s

n Go digital. Starting at 40, all women need a mammogram yearly. If you’re under 50 or have dense breasts, get a digital one if possible (it’s slightly more accurate than traditional X-rays).

n Keep moving. Studies show that women who exercise regularly throughout their lives lower their breast cancer risk. Exercise may help suppress excess estrogen, which can fuel tumor growth.

n Avoid pesticides. Some can mimic estrogen and you never know how much you absorb. Avoid herbicides when gardening. If you need an exterminator, pick one that uses all-natural products.

50s and 60s

n Watch the scale. Women who gained 22 pounds or more after menopause were about 20 percent more likely to develop breast cancer. Those who shed 22 pounds or more cut their risk by 57 percent.

n Skip hormone therapy if you’re 60 or over. While research suggests that brief stints on hormone therapy, or HT, to relieve menopausal symptoms are OK in younger women, it’s best to avoid it past age 60.

n Don’t miss a year of getting a mammogram. Risk goes up as you age -- more than 75 percent of breast cancers are diagnosed after age 50. Yet ironically, we tend to get less vigilant as we get older.

THINGS YOU MAY NOT KNOW

n Even if you have no family history, you can’t be complacent. “The fact is, only 10 percent of breast cancers are inherited,” Runowicz says.

n Oral contraceptives may slightly raise your risk of breast cancer, but they may protect against ovarian, endometrial and colorectal cancers. Any increased risk of breast cancer disappears within five years after you stop taking them.

n HT isn’t totally taboo. If women in their 40s and 50s have serious menopausal symptoms -- frequent hot flashes, insomnia -- that severely diminish their quality of life, they can consider using hormone therapy “at the minimum effective dose for the shortest duration,” says Dr. Debbie Saslow of the American Cancer Society.

For more tips, pick up the latest issue of Woman’s Day magazine or visit www.womansday.com.

YOU HAVE BREAST CANCER -- NOW WHAT?

If you’ve been recently diagnosed -- or if your mother, sister or friend has been -- then you might have questions about diagnosis, treatment and prognosis. Maybe you don’t even know where to begin.

Step 1

Scream, yell and vent. Feel free to cry, throw things, and tell everyone or no one about your diagnosis. But we recommend telling your spouse, mother and best friend as soon as possible -- you’re going to need their support.

Step 2

Call your insurance company. Ask them to go over your coverage. Are referrals required for all the doctors you’ll need to see? Will they pay for a second opinion? Do they offer any special services for people diagnosed with cancer?

Step 3

Do your homework. Yes, all the info can be overwhelming, but you’ll feel more in control once you know what’s out there. A good place to start: “What to Do Next,” an online brochure that you’ll find at bcaction.org (click on “Get Informed/Newly Diagnosed”). Other go-to sites for trustworthy info: the American Cancer Society (cancer.org), Dr. Susan Love Research Foundation (susanlovemd.com), Susan G. Komen for the Cure (komen.org) and CancerCare (cancercare.org). Just don’t do your research right before going to bed or you’ll never fall asleep!

Step 4

Get a copy of your pathology report. It contains key info about your breast cancer (the type, the size, the stage, etc.). That way you can do some research before meeting with a surgeon. To learn how to read yours, go to getbcfacts.com and click on “About Breast Cancer/Detection and Diagnosis/Understanding Your Pathology Report.”

Step 5

Find a breast surgeon. Ask your primary care doctor for referrals, or call a cancer center near you (find one at www.facs.org/cancerprogram/howto.html) and ask which doctors mainly focus on breast cancer surgery. You can also go to castleconnolly.com and search the database of cancer doctors. Choose one who’s board-certified in general surgery and has treated a large number of breast cancer cases.

Step 6

Get a second opinion. A second doctor may suggest different surgery or treatment options, or simply validate the first doctor’s opinion -- either way, it’s worthwhile. Don’t worry about offending anyone; it’s common practice, and health insurance usually covers it when cancer is suspected or diagnosed. Make sure the second doctor gets a copy of your lab reports, records and films before your visit.

Step 7

Ask lots of questions before making any big decisions. For help generating your list, go to cancer.net/patient and click on “Cancer Types/Breast Cancer/Questions to Ask the Doctor.”

Step 8

Talk to someone who’s been there. Check out the “Sound Off” message board at komen.org. It helps with questions about the strange taste in your mouth from chemo or how to deal with your hair falling out. To speak to a survivor on the phone, call the Breast Cancer Network of Strength (800-221-2141) or SHARE (866-891-2392).

Step 9

Get support. Not all support groups are about sitting around and commiserating: The Comprehensive Breast Center in New York, for example, offers group yoga and cooking programs. Ask at your hospital or contact Gilda’s Club (gildasclub.com or 888-GILDA-4-U). For a list of specialized support groups (for Jewish women, African-American women, etc.) visit womansday.com/cancersupport.

Financial help

CancerCare (cancercare.org or 800-813-HOPE) can help with some costs, including transportation, home care, child care and pain meds for those who qualify. And a new program helps people who are having trouble meeting insurance copayments for prescriptions (866-55-COPAY or cancercarecopay.org).

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