Breast cancer awareness month
Breast Cancer is the second leading cause of death among women. In India, one in 10 women develops breast cancer in their lifetime, with 1 in 15 women dying of breast cancer.
According to the World Health Organization (WHO), breast cancer is the most common cancer among women worldwide, claiming the lives of many women each year. “It is the second leading cause of death among women. In India, one in 10 women will develop breast cancer in their lifetime with 1 in 15 women dying of breast cancer,” says Dr. P, Vijay Karan Reddy, Consultant Oncologist, Apollo Cancer Institute, Apollo Hospitals.
These statistics suggest an urgent need for intervention. In light of October being breast cancer awareness month, it is an opportunity for all of us to get to know more about this disease in order to be able to face it and fight it better. We ought to know the risk factors of breast cancer, measures we can take to prevent it, and the ability to detect it early.
The risk factors of breast cancer are many, says Dr P.Vijay Karan Reddy. Some of these factors can be altered to decrease the risk, and some cannot. Some of the above are proven, and some are yet unclear/controversial.
Risk factors you CAN change –
- WEIGHT – Being overweight/obese is associated with an increased risk of breast cancer, especially for women who are post-menopausal.
Fat tissue is the body’s main source of estrogen after menopause. Having more fat tissue means having higher estrogen levels, which can increase breast cancer risk.
- DIET –
* Eat plenty of vegetables, and fruit.
* Try to limit saturated fat intake to less than 10% of total calories per day, and fat intake to about 30 grams per day.
* Eat foods high in omega-3 fatty acids (present in fish/fish oil)
* Avoid trans fats, processed meats, and charred or smoked foods.
- EXERCISE – The in increasing evidence to show that exercise can reduce the risk of breast cancer. The American Cancer Society recommends engaging in 45-60 minutes of physical exercise at least 3- 5 days a week.
- ALCOHOL CONSUMPTION – Studies have shown that breast cancer risk increases with alcohol consumption. Consuming high quantities of alcohol damages one’s liver, and can limit its ability to control blood levels of the hormone oestrogen. This, in turn may increase risk.
- SMOKING – Smoking is associated with a definite increase in breast cancer risk.
- EXPOSURE TO ESTROGEN – The female hormone oestrogen stimulates breast cell growth. Long exposure/utilization of oestrogen can increase the risk of breast cancer. Some of these can be controlled by the following –
* Taking combined hormone replacement therapy (oestrogen and progesterone; HRT)
for several years or more, or by taking oestrogen alone for more than 10 years
* Being overweight
* Regularly drinking alcohol
- RECENT ORAL CONTRACEPTIVE USE – Using oral contraceptives (birth control pills) may mildly increase a woman’s risk for breast cancer, but only for a limited period of time. Women who have stopped using oral contraceptives more than 10 years ago do not appear to have an increased risk of breast cancer.
Risk factors you CANNOT change –
- GENDER – Being a woman is the most significant risk factor for developing breast cancer. Although men can get breast cancer, women’s breast cells are constantly changing and growing, mainly due to the activity of the female hormones’ oestrogen and progesterone. This activity puts them at much greater risk for breast cancer.
- AGE – Simply growing older is the second biggest risk factor for breast cancer. You have the highest risk of getting breast cancer when you are 60yrs and older, and lowest below 40yrs.
- FAMILY HISTORY OF BREAST CANCER – If you have a first-degree relative (mother, daughter, sister) who has had breast cancer, or you have multiple relatives affected by breast or ovarian cancer (especially before they turned age 50), you could be at higher risk of getting breast cancer.
- PERSONAL HISTORY OF BREAST CANCER – If you have already been diagnosed with breast cancer, your risk of developing it again, either in the same breast or the other is higher than if you never had the disease.
- RACE – White women are slightly more likely to develop breast cancer than are non – white women such as African, Asian, Hispanic, and Native American. Non – white women have a lower risk of developing and dying from breast cancer. However, the incidence and mortality of breast cancer is on the rise in India (highest mortality compared to other cancers)
- RADIATION THERAPY TO THE CHEST – Having had radiation therapy to the chest area as a child or young adult as treatment for another cancer (most common – lymphoma) significantly increases breast cancer risk. The increase in risk seems to be highest if the radiation was given while the breasts were still developing (during the teen years).
- BREAST CELLULAR CHANGES – More than 70 percent of breast diseases are benign. These benign diseases can include overgrowth of cells (called hyperplasia) or abnormal (atypical) appearance. Atypical cells have a higher risk of developing into breast cancer.
- EXPOSURE TO OESTROGEN – As mentioned earlier, exposure to oestrogen over higher periods of time increases the risk of breast cancer. Some of these risk factors are not under your control, such as:
* Early Menarche – starting menstruation (monthly periods) at a young age (before age 12)
* Late Menopause – going through menopause (end of monthly cycles) at a late age (after 55)
* Exposure to oestrogen in the environment (such as hormones in meat or pesticides such as DDT, which produce oestrogen-like substances when broken down by the body)
- PREGNANCY AND BREASTFEEDING. Pregnancy and breastfeeding reduce the overall number of menstrual cycles in a woman’s lifetime, and this appears to reduce future breast cancer risk.
* Women who are nulliparous have an increased risk of breast cancer.
* Women who do not breastfeed have a slightly higher risk of breast cancer
* Multiparous women who breast feeding for longer terms (>1yr) have a reduced risk of breast cancer
- DES EXPOSURE – Women who took a medication called diethylstilbestrol (DES), used to prevent miscarriages from the 1940s through the 1960s, have a slightly increased risk of breast cancer. Women whose mothers took DES during pregnancy may have a higher risk of breast cancer as well.
Risk factors which are Disproven or untrue: Some of these are rumours, and spread through social media/internet. These are said to supposedly increase the risk of breast cancer but have scientifically been proven to be false:
- Using Antiperspirants
- Wearing a Bra
- Induced/ Spontaneous Abortion
- High sugar diet
- Spread from person to person by contact
What you need to do:
- Avoid and change the risk factors that is under your control
* Eat healthy
* Be physically active
* Maintain weight
* Reduce consumption of alcohol and smoking
* Have children before age of 30yrs and practice breast feeding
- Self-breast examination is the simplest and the most important practice you can do at home to help detect breast cancer early and can increase the chance of cure.
- Women with a family history of breast cancer should visit their nearest oncologist for genetic counselling and testing. There are various mathematical tools by your doctor can assess your risk and suggest further intervention accordingly. In general, the latest recommendation for familial breast cancer suggests breast cancer screening from the age of 40yrs with yearly mammogram.
Possible interventions for women at high risk include:
- Genetic testing (BRCA 1/2)
- Close monitoring to detect cancer early
- Medicines to reduce breast cancer risk (Tamoxifen/Aromatase Inhibitors)
- Prophylactic surgery (removal of breast/ovaries)
TOGETHER WE CAN AND WE WILL FIGHT BREAST CANCER