Breast cancer awareness guide

McClatchy-Tribune Information ServicesOctober 2, 2011 

Since the advent of the pink ribbon, health experts have been working hard to educate women about breast cancer. While we’ve come a long way, continuing to spread the right information is crucial. We asked top experts to dispel common myths and misinformation and clarify how women can protect themselves now.

A BETTER WAY TO EXAMINE YOUR BREASTS

For years women have been told to check their breasts for lumps by using a circular motion. But more and more doctors are now recommending a different technique known as the vertical strips method. “It provides more thorough coverage of the breast, including under the arm,” says Debbie Saslow, Ph.D., director of breast and gynecologic cancers at the American Cancer Society, which now recommends this method for women who do breast self exams. And according to Harvard researchers, the technique has a better track record of detecting smaller lumps than the circular exam.

n Imagine a grid drawn horizontally from your armpit to your breastbone, and vertically from your collarbone to just under your breast.

n Using the pads -- not the tips -- of your three middle fingers, move in tiny circles and apply varying degrees of pressure, starting under the armpit. Move your fingers down to the next square and repeat. Continue these vertical strips until you’ve covered the entire grid.

n A thorough exam of both breasts should take at least 10 minutes. At your next checkup, ask your doctor to review the vertical strips technique with you.

What really affects your cancer risk

Myths and misinformation are rampant when it comes to risk factors and causes of breast cancer. Here’s what you need to be concerned about and what you don’t.

Is it true that ...

Wearing antiperspirants and underwire bras can lead to breast cancer?

No. Several studies have found no link between these products and breast cancer risk, says Dr. Victoria Seewaldt, director of the breast cancer prevention program at Duke University. One theory was that using antiperspirants or wearing certain types of bras would impede lymphatic flow through the breast, causing cancer-causing toxins to build up, but that’s just not true, says Dr. Virginia Kaklamani, assistant professor of oncology at Northwestern Memorial Hospital in Chicago.

You’re destined to get the disease if you have a family history of it?

No. “Most people who have a mother who developed breast cancer after menopause only have a modest increase in risk compared to the general population,” says Dr. Claudine Isaacs, clinical director of the breast cancer program at the Georgetown University Medical Center.

Plus, there’s a difference between having a family history of the disease and having a genetic predisposition. If a close relative is diagnosed with the disease (including on your father’s side), you have a family history. Carrying a mutation in one of the so-called breast cancer genes BRCA I or II indicates a genetic predisposition, which raises your lifetime risk of developing the disease 40 to 80 percent, Isaacs explains. That may sound high, but it still doesn’t mean you will definitely get breast cancer, Isaacs says. “There are many lifestyle factors that come into play, including whether you exercise and are at a healthy weight, that can mitigate your risk,” she says.

Plus, if you have a BRCA I or II mutation, you can take measures to lower your odds. For example, removing the ovaries before menopause reduces breast cancer risk by 50 percent. That’s why it’s important to discuss your family history -- and your options -- with your doctor.

Having more than one drink daily increases your risk?

Yes. Women who have two to five drinks daily increase their breast cancer risk 50 percent compared to those who abstain from alcohol, according to the American Cancer Society. The theory is that the way alcohol is metabolized leads to higher estrogen levels in the bloodstream, which ups your odds of developing the disease. “Women should have less than a drink a day,” Seewaldt says. One drink is a 10-ounce beer, a 4-ounce glass of wine or one shot of hard liquor.

Being overweight is a risk factor?

Yes. “Overweight or obese women do have an increased risk for developing breast cancer in their postmenopausal years,” says Dr. Anne McTiernan, director of the prevention center at the Fred Hutchinson Cancer Research Center in Seattle. “We think it’s because these women have high levels of estrogens, testosterone and inflammatory markers such as C-reactive protein and insulin -- all of which can cause breast cells to grow excessively.”

THE NO. 1 HABIT THAT LOWERS YOUR RISK

Exercise. “We think that physical activity reduces your risk by lowering levels of estrogen and other hormones, in large part by reducing body fat,” McTiernan says. You don’t have to sweat it out for hours on end to reap the benefit: A landmark study involving more than 74,000 women found that those who walked briskly for an hour and a half to two and a half hours weekly cut their risk of breast cancer by 18 percent.

Staying active can also help you maintain a healthy weight, which lowers your risk of the disease. One study found that women who gained 21 to 30 pounds after age 18 had a 40 percent higher risk, compared with women who kept their weight within 5 pounds.

If you do see the number on the scale creep up, bringing it down can be protective: Data from the ongoing Nurses’ Health study found that women who shed 22 pounds after menopause reduced their risk by 57 percent.

Mammograms

n The good news: 91 percent of women who are 40 and older have had a mammogram and nearly 75 percent of women are getting one annually.

n A study showed that rates at which women are getting mammograms have gone down. We learned that 15 percent of women think it costs too much, 12 percent think it’s too painful, and 10 percent are worried that the doctor will find something.

n Ninety percent of women age 40 and over who hadn’t yet had a mammogram said they didn’t think they needed one yet. Wrong! Getting a mammogram annually starting at age 40 is the best way to catch the disease in its earliest, most treatable stage.

How to help a friend

It’s hard to know what to do when someone you know is hit with a breast cancer diagnosis. Remember that your friend is in a whirlwind and may not know yet how you can help, or she might be uncomfortable asking. Instead of saying, “Let me know if you need anything” or asking “What can I do?” here are a few things you can do that will definitely be of help:

n Hire a cleaning service for your friend, or come over and do chores yourself. While it’s never fun, housekeeping becomes a huge burden when you’re exhausted from chemo.

n If she’s a close friend, offer to serve as her information distribution contact. She may grow tired of explaining her diagnosis and progress repeatedly, and it can be overwhelming coming out of surgery and treatment while simultaneously keeping family and friends updated. If you offer to send out group emails and answer questions post-first surgery or chemo, friends will quickly learn to look to you, rather than her, for information, thereby taking a burden off of her.

n Offer to go for walks or exercise with her. Some light exercise is often recommended during chemo. Don’t push it, but she may enjoy the company on

days when she’s up to it.

n Baby-sit or take her kids for a day.

n Offer to drive and/or accompany her to and from chemo treatment and doctor’s appointments.

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