Sunday, August 29, 2010

Breast cancer risk indicators

Wouldn't it be great if doctors had a way to determine our individual risk factors for breast cancer? Then armed with this knowledge we could take specific steps or treatments to prevent the disease? Now you might be thinking, well, there's the mammogram, which has become the gold standard for breast cancer screening. There's also the breast MRI and ultrasound, and let's not forget the clinical or self breast exam. As important and useful as these tools are, they are not about the prevention of breast cancer. The focus of these tests is on detection not prevention, and these are two totally different things.

The National Cancer Institute (NCI) defines cancer prevention as an "action taken to lower the chance of getting cancer". When it comes to disease, prevention really is the best cure. Yet, compared to screening information, not much discussion about prevention is offered to women. 

There are three approaches to disease prevention one can take: reducing risk factors, increasing protective factors or doing both.  Risk factors are defined as anything that increases the chances of getting a disease. Protective factors are anything that helps to reduce the chances of getting a disease. Some risk factors for disease can be avoided and others cannot. For example, tobacco smoking, poor nutrition or lack of exercise can be changed, but a genetic tendency toward cancer cannot. Reducing risk factors and increasing protective factors can help lower the risk of getting cancer, but this doesn't guarantee you won't ever get it either. 

What are the risk factors for breast cancer? According to the NCI, studies have shown the following risk factors:
  • Age
  • Personal history of breast cancer
  • Family history of breast cancer
  • Certain breast changes
  • Genetic alterations
  • Menstrual history
  • Race/ethnicity
  • Radiation therapy to the chest
  • Breast density
  • DES (diethylstilbestrol) exposure
  • Reproductive history
  • Hormone use
  • Obesity after menopause
  • Physical inactivity
  • Alcoholic beverage intake

The good news is that "most women who have these risk factors do not get breast cancer" (NCI). If you're interested in learning more about each of the risk factors listed above you can view more detailed information here. The National Cancer Institute also has an excellent resource called the Breast Cancer Risk Assessment Tool which you can access here. This tool helps estimate a woman's individual risk of developing invasive breast cancer. The NCI points out that no risk assessment tool is 100% accurate and that the tool does have limitations, but it is useful for providing insight into the factors that increase each individual woman's risk for breast cancer. Armed with this knowledge, it can then provide a jumping off point for discussion of an action plan for breast cancer prevention with a health care provider.

If you're considering a breast cancer prevention action plan, experts suggest beginning with specific lifestyle changes to increase the protective factors against developing breast cancer. There are several nutrition and exercise steps you can take, such as limiting alcohol, staying physically active, maintaining a healthy weight, watching the type of fat consumed in your diet (see previous post on understanding the omegas) and eating a diet that is rich in fruits and vegetables. Also, other lifestyle changes like limiting chemical exposure and avoiding antibiotics and hormones found in food can be protective as well (Mayo Clinic and Linus Pauling Institute).

Many of the posts in this blog are focused on providing more information about each of these protective factors against cancer. I believe that when it comes to our health, knowledge is power. It's easy for medical misinformation to result. For example, a news story might have misinterpreted the findings from a research study, or the story that is reported may be a small portion of the bigger picture. In addition to confusing information, medical terminology, data and statistics can often seem overwhelming and frightening.

Rather than living in the shadow of fear that can be created by misinformation and technicality, we can attempt to become empowered by educating ourselves. We can learn more about our own health, beginning with knowing our own realistic level of breast cancer risk. Armed with this knowledge, we can then talk to our medical professional about ways to reduce the risk factors and increase the protective factors that are within our control.  That old saying really is true - an ounce of prevention is worth a pound of cure.

National Cancer Institute -
Breast Cancer Risk Assessment:
MRI and ultrasound:
Risk factors:
Science Daily -

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