Breast Cancer Prevention and Detection

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According to the American Cancer Society, 1 in 8 women will develop breast cancer in their lifetime. Fortunately, thanks to increased awareness and promising new tests and treatments, survival rates are on the rise. The key is early detection, which leads to faster treatment. That can lead to better outcomes for you. Breast cancer often has no symptoms, so regular breast health checkups are important.

Breast Cancer Prevention

While there is no cure for breast cancer, there are some things you can do that may reduce your risk of developing this kind of cancer. Lifestyle changes, genetic testing and preventive measures can significantly affect your chance of developing breast cancer.

According to the American Cancer Society, when breast cancer is detected early and is in the localized stage, the five-year relative survival rate is 99%. Early detection includes doing monthly breast self-exams, and scheduling regular clinical breast exams and mammograms.

Lifestyle Changes

Diet and Nutrition

Preventing breast cancer begins with living a healthy lifestyle. While some risk factors, including a family history of breast cancer, cannot be changed, the following lifestyle changes can help reduce your risk.  

A diet that includes vegetables, fruit, calcium-rich dairy foods and lean protein may reduce your risk of breast cancer. Avoiding red meat and processed meat also may reduce your risk.

Physical Activity

Studies have shown that regular physical activity is linked to reduced risk of breast cancer death. Exercise has a beneficial effect on cancer rates as well as your overall health. Regular exercisers have lower blood pressure, improved sleep and lower resting heart rates. Studies recommend physical activity for at least 150 minutes per week at moderate intensity, or 60 to 75 minutes per week at vigorous intensity. You can meet this target with about 30 minutes per day, five days per week.

Alcohol Consumption

According to the American Cancer Society, alcohol use is one of the most preventable risk factors for cancer, along with tobacco use and excess body weight. Alcohol use accounts for about 6% of all cancers and 4% of all cancer deaths in the United States. For some types of cancer, most notably breast cancer, consuming even small amounts of alcohol can increase risk. Yet many people don’t know about the link between alcohol use and cancer.

Researchers don’t know exactly how alcohol affects your cancer risk, but some possible ways include:

  • Damage to cells
    • Alcohol is an irritant, and as your cells try to replace damaged cells, DNA can be replicated incorrectly, which can lead to cancer.
    • Damage from other harmful chemicals
      • It’s possible that alcohol allows harmful chemicals to enter the cells more easily.
    • Preventing cells from absorbing nutrients, such as folate, which cells need to stay healthy
    • Affecting weight
      • Alcohol has calories that may lead to excess body weight, which is linked to cancer.

Limit your alcohol intake to reduce your risk of breast cancer.

Weight Management

Being overweight increases your risk for breast cancer, as well as many other types of cancer. However, the risk is different before and after menopause. It starts with your body mass index (BMI), which is a calculation to see if you are underweight, normal weight, overweight or obese. Higher weight means higher risk for developing breast cancer after menopause.

After menopause, your breast cancer risk increases by about 12% for every 5 point increase on the BMI scale.

Extra body weight can affect breast cancer risk through:

  • Long-term hormone exposure
    • Estrogen and insulin are two important hormones that encourage cell growth and other functions related to weight. Higher-weight people have more hormones in their bodies for longer periods of time than lower-weight people. The more rapidly your cells grow and divide, the more likely something can go wrong — like cancer. Estrogen levels should decrease after menopause, but overweight and obese people who have gone through menopause still have higher levels of estrogen.
  • Inflammation
    • This happens when the body responds to an illness or injury. As it means more cells are made in the body, the risk for cancer increases.

It can be difficult to lose weight, but the benefits to your health are clear:

  • Reduced cardiovascular disease
  • Better sleep
  • Decreased inflammation
  • Improvements in insulin resistance
  • Lowered risk of certain types of cancer

Talk to your primary care provider about weight loss and recommendations for your unique situation.

Breast Self-exams

Importance

A breast self-exam is done by you at home. This helps you understand what your breasts typically look and feel like, so it’s easier to notice changes. It is not a replacement for an annual breast health screening by a doctor. However, about half of all cases of breast cancer in women 50 and older, and almost three-quarters of breast cancer cases in women under 50 are detected by women themselves, according to the American College of Obstetricians and Gynecologists.

When to do a breast self-exam depends on whether you have gone through menopause, but you should do one every month. Before menopause, do an exam about three to five days after your period starts. After menopause, do the exam on the same day of each month.

About 80% of all detected breast lumps are not cancerous and present no health risk. If you find a breast lump, contact your primary care physician or gynecologist for a complete evaluation.

How to Do a Breast Self-exam

A breast self-exam should take only a few minutes. First, you will look at yourself in the mirror with your shirt and bra off and your hands at your side.

  • Look for any breast change — size, shape or symmetry.
  • Check the skin for redness, soreness or itchiness, for puckering or dimpling of the skin, for the nipple pulled inward, and for nipple discharge or scabbing over the nipple.

Next, raise your arms over your head with your palms pressed together and look for the same things. Put your hands on your hips and flex your chest muscles and look again.

The next part can be done in the shower when the skin is slippery, or in front of the mirror. Use the pads of the middle three fingers of the left hand to check the right breast, and then vice versa. Use a circular motion about the size of a quarter, varying pressure to feel breast tissue at different depths. Take your time and make sure to check the entire breast. You are feeling for lumps, thick spots, pain or other changes.

Finally, check your breasts while you are lying down. With a pillow behind your right shoulder and your right arm behind your head, use your left hand to check your right breast. When you’re done, switch the pillow to your left shoulder and repeat the process with your left breast.

Genetic Screening

Genetic mutations happen when your cells divide and make new cells. During this process, cells write all the instructions for your body (eye color, height, skin color, and so on) by copying the original gene’s instructions. Mutations occur when there is an error in this copying process. If you have an error, your genetic instructions may not be readable by the cells. It may have missing parts or extra parts. All of this can mean that your cells can’t function as they normally should.

Some cancers such as breast cancer are caused by specific mutations. These can be discovered with genetic testing, which looks at a sample of your blood to check the DNA in your cells.

Genetic testing may be recommended if you have:

  • A strong family health history of breast and ovarian cancer
  • A moderate family health history of breast and ovarian cancer and are of Ashkenazi or Eastern European Jewish ancestry
  • A personal history of breast cancer and meet certain criteria (related to age of diagnosis, type of cancer, presence of certain other cancers or cancer in both breasts, ancestry and family health history)
  • A personal history of ovarian, fallopian tube or primary peritoneal cancer
  • A known BRCA1, BRCA2 or other inherited mutation in your family

Family history and genetic testing results do not mean you definitely will or will not develop breast cancer. Genetic testing can guide your decisions, and a genetic counselor will walk you through your test results and possible options.

Medications and Prophylactic Mastectomy

There are some medicines that may prevent breast cancer from developing. Tamoxifen and raloxifene are the only Food and Drug Administration-approved drugs for patients who are at a higher risk for breast cancer but who have not had breast cancer. These pills are not chemotherapy, although they can be used with other treatments, including chemotherapy.

Prophylactic (pro-fih-LAK’-tik) mastectomy (mass-TEK’-toh-mee) is a surgery to remove one or both breasts. It reduces your risk of developing breast cancer. This is also called a preventive mastectomy or risk-reducing mastectomy.

Your health care provider may recommend medications or a prophylactic mastectomy if you have a high risk of developing breast cancer.

Breast Cancer Detection

Mammograms

Role in Early Detection

A mammogram is an X-ray of your breasts. It shows the doctor a detailed look at your breast tissue and can detect cancer, sometimes up to three years before it can be felt with a manual exam. It’s important to have mammograms regularly so your    doctor can see any changes over time and catch cancer early and before it spreads. Because a mammogram can detect the disease in its early stages, it is your best defense against breast cancer.

Screening Guidelines

Health care is self-care, and scheduling a yearly mammogram is part of that care.

It is recommended that women who are 50 to 74 years old and are at average risk for breast cancer get a mammogram every two years.

Women who are 40 to 49 years old should talk to their doctor or other health care provider about when to start and how often to get a mammogram. Women should weigh the benefits and risks of screening tests when deciding whether to begin getting mammograms before age 50.

Additional Tests

Self-exams and mammograms are good tools for detecting cancer. Other tests include:

  • Breast ultrasound
  • Breast MRI scan
  • Breast biopsy
  • Immunohistochemistry test to check for hormone receptors 
  • Genetic tests to identify mutations that cause breast cancer

These tests may be used depending on your health history, age and other factors.

If you or a loved one has been diagnosed with breast cancer, it can feel overwhelming, but consider nearly 4 million Americans are breast cancer survivors. Overall, 91% of people with breast cancer were alive five years after diagnosis. Talk to your doctor about your risk for breast cancer and recommendations to reduce risk. Your health care team will be with you every step of the way, with specialists, new treatments and support.

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