Before COVID, breast cancer seemed like the most well-publicized disease in the U.S. But even with all of this publicity, women still do not know what they need to know to maximize their chances of finding early, curable breast cancer.
The best starting point for being your own breast health advocate is to know your risk factors for breast cancer.
A risk factor is a characteristic, condition, or behavior that increases the likelihood of getting breast cancer.
What are the chances of getting breast cancer in the US? Unfortunately, it's pretty common. In the U.S,1 in 8 women will develop breast cancer during their lifetime. But if you find it early, breast cancer is over 95% curable* – that’s pretty incredible.
The number one risk factor for developing breast cancer is just being a woman! Women often think they aren’t at risk for breast cancer if it doesn’t run in their family, but actually, over 75% of women diagnosed have no family history. And many women have other risk factors, too.
After being a woman, dense breast tissue is the most common risk factor for breast cancer.
Dense tissue means that you have more connective or fibroglandular tissue than fatty tissue in your breasts. Dense tissue (or fibroglandular density) is normal and usually diminishes with age. However, dense tissue makes it about 25% more likely that you will get breast cancer during your lifetime.
Dense tissue affects 40-50% of women in the United States – which is a lot. The most important thing to know about dense breasts is that cancers are harder to see in dense tissue with a mammogram alone. If you have dense tissue (which you can only determine by having your first mammogram), you will likely need other essential screenings in addition to your mammogram. These screenings include ultrasound and in some cases, for extremely dense breast tissue, MRI.
If other family members have had breast or ovarian cancer, it may make it more likely that you could develop breast cancer as well. Start asking your family members whether anyone in the family has ever had breast or ovarian cancer. If they have, you should inquire how old they were and whether there were others.
If the person who had breast or ovarian cancer is a first-degree relative (i.e., mother, sister, grandmother) you should start screening for breast cancer ten years before the age that she was diagnosed. If she is a second-degree relative, you should talk to your doctor about when is the best time to start screening and what technologies are right for you.
Some people with strong family histories of breast cancer also carry genetic mutations. The most common mutation associated with breast cancer is the BRCA mutation, but there are others that carry a high risk for breast cancer, as well.
As geneticists and physicians learn more about breast cancer and its relationship to genetic mutations, they discover more mutations that were previously unknown. If you have a strong family history (i.e. anyone diagnosed before age 50 and/or multiple family members with breast or ovarian cancer), be sure to talk to your primary care provider or gynecologist about whether genetic testing is right for you. If you come from a male-heavy family, you may have to dig deeper to find out whether breast or ovarian cancer runs in your family. Don’t be scared to ask!
It is important to note that some demographics, like women with Ashkenazi Jewish ancestry (Central or Eastern European), have a higher prevalence of genetic mutations. And although not yet conclusively linked to specific mutilations, certain groups experience higher rates of more aggressive cancers at younger ages. For instance, African American women have a higher prevalence of Triple-Negative Breast Cancer, which is harder to treat.
The risk factors already discussed are immutable characteristics. You need to know about them and react to them, but you can’t change them. That is not true when it comes to lifestyle.
There are things you can do and things to avoid to lower your risk for breast cancer. To minimize your chances of breast cancer you should maintain a healthy weight, exercise, and eat nutritious food. In fact, post-menopausal, obese women are 30% more likely to get breast cancer than the rest of the population.
Higher rates of breast cancer are associated with smoking, excessive alcohol, lack of exercise, excessive sugar intake, and obesity. It is important to drink in moderation, not smoke, and avoid recreational drug use.
Breast cancer risk also increases with age. The best way to reduce mortality from breast cancer is to start annual, personalized screening at age 40 unless you have risk factors that require you to start screening even earlier. And you should do a self-exam every month starting at age 20.
Here’s the bottom line: if you know your risk factors, you have a strong chance of changing your outcome. Once you have a sense of your family history, density, and lifestyle risks, you can work with your provider to create a personalized screening schedule that’s best for you.
Join us in efforts to promote early detection education.
*Based on a five year survival rate.
Photo by Allyssa Olaivar on Unsplash