There is no surefire way to prevent breast cancer, the experts say, no magic bullet to keep it at bay. But there are steps women can take to minimize their risk. And if they get the disease, there are things they can do to keep it from becoming life-threatening and lessen its impact on their quality of life.
Knowing the risk factors is a good place to start. First on everyone?s list should be family history. If you have breast cancer in your family background ? particularly in a ?first degree? relative such as a mother or sister ? you?re at risk.
?About 70-75 percent of breast cancers occur sporadically, with no family history,? said Stephanie Hines, a doctor of internal medicine and assistant professor of medicine at Mayo Clinic. ?Probably 5 to 10 percent of all breast cancers are caused by some gene that is being inherited through the family that we can track.?
When family history suggests higher risk, the doctor may recommend that a woman undergo genetic testing. ?If the test comes back positive,? Hines said, ?it?s because of a gene mutation such as BRCA 1 or BRCA 2 and a known level of risk. And that?s when we tend to be more proactive in terms of screening and prevention.?
A negative result can still give important information to doctors. ?It means we don?t know why they developed breast cancer. The woman is still likely to be at higher risk because of family history.?
While there?s not much women can do about their family history, they can take control of their overall health to reduce their risk. ?One thing that has been linked to breast cancer is alcohol,? said Hines. ?There have been some studies that suggest that women who drink regularly may have a slightly higher risk of breast cancer than women who don?t.?
Some studies also show a correlation between excess weight and breast cancer. ?I usually discuss with patients the importance of healthy weight, exercising regularly, eating plenty of fruits and vegetables and minimizing alcohol,? Hines said.
A healthy lifestyle can help fend off cancer, she said. ?Some studies have found that women with breast cancer who eat lots of fruits and vegetables and exercise regularly have better survival outcomes than women who don?t.?
Regular mammograms, breast exams and breast self-awareness are very important to ensuring that if woman does get breast cancer, it is found early and treated. Troy Guthrie, Jr. medical director of the Baptist Cancer Institute, encourages women to follow the American Cancer Society?s guidelines, beginning annual mammograms at age 40.
?There?s no question that early detection saves lives,? he said. ?Early in my career, we mostly saw advanced breast cancer and most of those women were destined to ultimately die. Nowadays, we?re finding women who have smaller tumors and are being cured. Early detection doesn?t prevent breast cancer; it just finds it in an early stage where it is unlikely to do harm.?
Medication is also used in the fight against breast cancer in high-risk women or to prevent reoccurrence in women who have been treated for the disease. Tamoxifen for premenopausal women, and raloxifene or exemestane for postmenopausal women, when taken for a number of years, can reduce cancer risk significantly.
Some women who have been diagnosed with breast cancer opt for a surgical approach to reducing their risk. These women?s cancer is small enough to be treated with a lumpectomy, where just the malignancy and tissue around it is excised, but they instead choose a mastectomy, where the entire breast is removed.
?Sometimes young women want to do this for peace of mind,? Hines says. ?They?ll say, ?I?m more comfortable this way, because if I go back for another mammogram and something?s there and I need another biopsy, my nerves are not going to handle that very well. I?ll have better quality of life just knowing this has been done.???
Peace of mind is also often the goal of a woman who chooses a bilateral mastectomy, in which a healthy breast is removed in addition to the diseased one. Bilateral mastectomy ?reduces risk for women by 90 to 95 percent,? said Hines. ?And while it?s not 100 percent, it?s the most definitive thing we can do to reduce risk.?
However, bilateral mastectomies are not recommended lightly.
?Because this surgery is irreversible, and considering the psychological consequences of not having breasts and the surgical risks of infection and anesthesia, we reserve bilateral mastectomies for women who have cancer or those who have an extremely high risk, such as BRCA genetic mutations,? Hines said.
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