Breast Cancer:: Real Talk, Reducing Risk

Along with pumpkins, Halloween decorations and fall foliage, October brings a flurry of pink ribbons signifying Breast Cancer Awareness Month. Though breast cancer awareness remains one of the most successful health advocacy campaigns, many of us are not actively thinking about the choices we can make to decrease our risk. So let’s dive into some of the core facts about breast cancer and what we can each do to maintain our breast health::

Breast cancer cases are on the rise

Though the annual rate of new cases has been fairly stable in the 120s/100,000 women since the early 2000s, as our population continues to grow and age, the annual number of cases per year has grown by about 50,000 per year in the past two decades. In 2017, just over 250,000 cases were reported! So, despite how good it can feel to buy something festooned with a pink ribbon, there remains a lot of work to do.

Certain demographics are more at risk

Breast cancer is most common in White women {126 new cases/100,000 women in 2017}, followed very closely by Black women {121/100,000}. Asian and Latina women seem to have a somewhat lower risk, with roughly 95 new cases per 100,000 women. Risk goes up with age, peaking in the 70s. That said, young women can get breast cancer, even in our 20s and 30s, and that risk starts to pick up more rapidly once we hit 40 {which is why it’s time to get your mammogram once you hit that birthday!}. Every year, I work with women diagnosed with breast cancer prior to completing their family-building. There is almost always time to freeze eggs or embryos before starting chemotherapy, and many resources available to try to make it possible. If pregnancy remains unsafe even after treatment, the eventual embryos can be used with a gestational carrier. And, men can get breast cancer also! 

There are some clearly-defined risk factors

Some risk factors we don’t have much control over, like having a family history of breast or ovarian cancer, having gotten your period early {before 12}, experiencing a late menopause {after 55}, never having given birth or a later age at first childbirth, having dense breast tissue or carrying genetic mutations in the BRCA or other cancer-related genes. Newer data suggests that breast implants may raise the risk of a specific cancer called anaplastic large-cell lymphoma {the prevalence of this cancer is very low, but talk to your doctor if you’re worried!}. Other risk factors, however, are lifestyle factors – having a sedentary lifestyle, a diet high in saturated fat or low in fruits and vegetables, letting weight drift too high, or higher levels of alcohol consumption {the more we drink, the higher our risk}. Let these modifiable risk factors be another pre-holidays reminder to practice true self-care by eating well and staying physically active!

Thermograms don’t cut it

I can’t yet speak from experience, but I’ve heard it from enough women to know that, yes, mammograms aren’t super comfortable. Neither are Pap tests, but screening tests are important! I have many good friends and colleagues who specialize in breast imaging, and one of the things I hear most frequently is their frustration about women being misled about thermography. There is not scientific data to show thermography is equivalent to mammography in picking up cancer, so unless and until new research pops up, just plan for that mammogram every 1-2 years starting at 40! {Talk to your physician to figure out the exact interval and initiation for you – your personal or family history may necessitate earlier testing or other tests like breast ultrasound, etc.} 

Talk about breast cancer with your loved ones

1 in 8 women in the U.S. will receive a breast cancer diagnosis. It is almost a guarantee that someone in your life will be affected. I’m a huge proponent of sharing our health stories as a way of spreading awareness. If you’re going for your mammo, send out a blast to your friends, mom, sisters, social media followers encouraging them to do the same! If someone you love is diagnosed before her family is complete, make sure she’s received the fertility preservation information she needs {research shows that many women are not counseled on this topic despite guidelines supporting the need for fertility counseling!}.

For me, I know that sharing my first mammography experience will be part of my 40th birthday celebrations. That may not sound so festive, but it’s very personal. My mother-in-law was diagnosed with recurrent metastatic breast cancer shortly after my husband and I started dating, and her battle with the disease is what has defined our relationship and the early years of our marriage. Her passing continues to leave a hole in our family, especially as we watch our daughter grow, wishing she could have met her dadi {paternal grandmother}, for whom she carries her middle name, Meena. I want to do my best to prevent the disease from showing up anywhere else in our family, and I hope we each feel motivated to do the same!


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