Five Questions about Breast Cancer Prevention, Answered
In an effort to increase awareness around the importance of cancer screening and prevention, this series asks experts in five cancer specialties – breast, colorectal, gynecological, lung, and prostate – five questions focused on wellness, prevention, and the crucial screenings that help save lives.
October is Breast Cancer Awareness month. The pink ribbons we see widely displayed on products in stores and supermarkets are a colorful reminder of the disease that affects one in eight women in the U.S.
It’s also an opportune time to spread awareness about the importance of screening and prevention for breast and several other types of cancer that we diagnose and treat.
As a Breast Surgical Oncologist and Medical Director of the Breast Care Center at the Dana-Farber/Brigham and Women’s Cancer Center in clinical affiliation with South Shore Hospital, I often discuss the importance of breast cancer screening and prevention with patients.
Here are five common breast cancer questions I cover with patients.
When it comes to breast cancer prevention, how important are routine or annual screenings?
It is important to recognize that breast cancer screening (mammography) does not prevent breast cancer. The role of screening is to detect cancer early when it is easier to treat.
When we identify very early cancers on mammography, women tend to have better treatment options and an overall excellent prognosis.
In fact, due to the widespread availability of screening mammography in our region, the majority of breast cancers that we identify are in very early stages and treatment outcomes are very favorable.
What kind of screening is available for breast cancer and at what age should people start being screened?
Mammography is the best tool for breast cancer screening.
For a woman at average risk, screening should begin at age 40 and continue annually until age 75. At 75, some women have other significant medical issues that are their primary health concerns.
At this point, a discussion is encouraged between a woman and her primary care doctor to decide if there is a role for ongoing screening.
If a woman is determined to be at high risk for breast cancer, she should have a “Risk Assessment” at a dedicated breast center and screening recommendations will be individualized for her.
What are some of the risk factors for breast cancer and are there lifestyle or diet changes that can lower someone’s risk?
There are modifiable and non-modifiable risk factors for breast cancer; things that we can affect and things we cannot change.
Non-modifiable risk factors include:
- Being a woman
- Family history
- Previous history of having had a breast biopsy
- Early age of first period
- Late age of menopause
- Never bearing a child
Potentially modifiable risk factors:
- Trying to complete your first pregnancy by age 30
Modifiable risk factors include:
- Avoid smoking
- Maintain a healthy body mass index (BMI)
- Exercise 150 minutes a week
- Eat a diet low in red meat/ processed food and high in vegetables, whole grains, fruit, and lean meats (a Mediterranean diet is an example of this)
- Limit alcohol consumption to no more than three drinks per week
What are some of the symptoms of breast cancer that someone should be concerned about and discuss with their primary care provider or specialist?
The American Cancer Society no longer recommends self-breast exams, but it does advocate for self-breast awareness.
This means that a person should have a sense of what their breasts are like at a baseline and if there are changes, they should report them to their primary care doctor.
Changes could include feeling a lump in the breast or armpit, a change in the size of the breast, nipple changes, redness, or skin changes.
Remember we have two breasts, so it is always a good idea to look at both breasts and if there is a change in one that is not mirrored in the other, have it checked out.
What kind of treatment options are available for someone diagnosed with breast cancer?
The treatment options for breast cancer are extremely focused to the individual patient and the unique features of the cancer. Therefore, it is critically important to have a team approach to breast cancer care.
Patients who are diagnosed with cancer have a team of at least three physicians – a medical oncologist, a surgical oncologist, and a radiation oncologist. This team of three works with the individual patient to create a unique care plan.