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October 2009 - Breast Cancer
October is National Breast Cancer Awareness Month
Women Can Control Some Risk Factors for Breast CancerA woman has a one in eight chance of being diagnosed with breast cancer during her life.
Many women are aware of this grim statistic. What they may not fully realize, however, is that many risk factors for breast cancer are within their control.
| Breast cancer is the most common cancer among women, excluding skin cancer. Because breast cancer cannot be completely prevented, a woman’s best defense is identifying and reducing risk factors along with early detection. |
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See all previous monthly health topics in our archive. |
Breast Cancer Risk FactorsA risk factor is anything that increases a person’s chance of getting a disease, such as cancer. In terms of breast cancer, some risk factors are within a woman’s control, while others are not. It’s important to note that having one or more breast cancer risk factors does not mean a woman will get the disease. Most women with one or more risk factors never develop breast cancer, while many women who get breast cancer had no apparent risk factors. Even when a woman with a risk factor develops breast cancer, it cannot be proven that the risk factor caused the cancer.
Risk Factors Women Can ControlMany risk factors for breast cancer can be controlled to some extent. These include obesity after menopause, use of hormones after menopause, alcohol use and lack of physical activity. More information on these risk factors is available from the American Cancer Society.
Risk Factors Women Cannot Control“An estimated 5 percent to 10 percent of all breast cancers are inherited,” said Sara Svendsen, MS, cancer genetic counselor at Froedtert & The Medical College of Wisconsin. “Most inherited cases of breast cancer are associated with two genes — the BRCA1 (BReast CAncer gene 1) and BRCA2 (BReast CAncer gene 2). If a woman inherits one of these genes, there’s a 50 percent to 80 percent chance that she will develop breast cancer by age 70. These genes are also associated with an increased risk of developing ovarian cancer.”
Genes are the genetic instructions found in our cells. A gene with an abnormality, or mutation, may result in an increased risk for cancer and/or other diseases. In addition to breast and ovarian cancer, BRCA mutations are also associated with an increased risk for male breast cancer, as well as prostate, pancreatic and other cancers.
According to Svendsen, a woman may have an inherited risk for breast cancer if:
- Many women in the family — grandmother, mother, daughter, sisters, aunts, cousins — have had breast and/or ovarian cancer
- Women in the family had breast cancer before the onset of menopause (around age 50)
- If breast cancer has appeared in generations of family members
- Family members are of eastern European (Ashkenazi) Jewish ancestry
- There is a pattern of cancer (breast, ovarian, male breast cancer) in the family
- If an individual in the family has had multiple cancers (cancer in both breasts, or breast and ovarian cancer)
“If a woman is concerned about a possible inherited risk for breast cancer, she should discuss this with her doctor,” Svendsen said. “She may want to consider genetic counseling and testing to determine if she does, in fact, have an inherited risk. A cancer genetic counselor can help a woman make important decisions about managing her health.”
Other risk factors associated with an increased risk of breast cancer that cannot be changed include age, race, age of first full-term pregnancy, early menstruation and late menopause.
Cancer Genetics Screening ProgramThe Froedtert & The Medical College of Wisconsin Cancer Genetics Screening Program provides genetic counseling and testing for people concerned about their family medical history and personal risk for various types of cancer.
The program’s genetic counselors — health professionals with a graduate degree and experience in medical genetics and counseling — are trained to help people as they consider testing and when they receive the results.
During a genetic counseling session, the genetic counselor will obtain a thorough personal medical history and family medical history. The genetic counselor will analyze the disease inheritance patterns and risks of recurrence, identify individuals at risk within the family, and discuss medical management options for individuals with a BRCA mutation. She will discuss the benefits and limitations of genetic testing and help women put their risk in perspective. The genetic counseling session can help a woman understand that she may — or may not — have a high risk for developing breast cancer. The actual genetic test typically involves drawing blood to examine the genes in a laboratory.
If the BRCA1 or BRCA2 gene has been identified, the genetic counselor will discuss options for a woman to consider. These may include more aggressive screening for breast and ovarian cancers, surgery to remove the breasts and/or ovaries before cancer potentially appears, and the use of Tamoxifen, a drug used to prevent recurrence in women who have had breast cancer.
To learn more about these risk factors, visit the American Cancer Society Web site.
Early Detection ImportantWhile breast cancer cannot be prevented, if it does occur, early detection improves the chances that it can be treated successfully.
To detect breast cancer early, it’s important to do regular self-breast exams, have regular mammograms (follow the recommended guidelines), and see your physician for regular examinations. The American Cancer Society recommends that women at average risk of developing breast cancer use the following guidelines for the early detection of breast cancer:
Women at Average Risk
- Mammography — annually beginning at age 40 and continuing as long as a woman is in good health.
- Clinical breast exam — this should be a part of a woman’s periodic health exam, about every three years for women in their 20s and 30s, and annually for women age 40 and older.
- Breast self-exam — women should know how their breasts normally feel and report any breast change promptly to their healthcare providers. Breast self-exam is an option for women starting in their 20s.
“There are many good reasons women should learn and practice breast self-exams,” said Julie Griffie, MSN, RN, ACNS-BC, AOCN, clinical nurse specialist for the Froedtert & The Medical College of Wisconsin Breast Cancer Program. “Before age 40, women should get to know how their breasts normally look and feel, so they’ll be aware of any changes. And although clinical exams and mammography are proven and significant tools in early detection, there are some breast tissue changes — a small percentage — that are not visible on a mammogram but will be detected by a woman or her doctor through a physical exam.
“The real goal of breast self-exam is to report any changes to your doctor immediately. Many breast cancers that are found and treated early result in good outcomes for those women. We want to use every weapon available to prevent advanced or recurrent cancer and reduce breast cancer deaths.”
The American Cancer Society provides the following screening recommendations for women:
- Women age 40 and older should have a screening mammogram every year and should continue to do so for as long as they are in good health.
- Women in their 20s and 30s should have a clinical breast exam as part of a periodic (regular) health exam by a health professional, preferably every three years.
- BSE is an option for women starting in their 20s. Women should be told about the benefits and limitations of BSE. Women should report any breast changes to their health professional right away.
Women at Increased RiskWomen who have a personal or family history of breast cancer and/or a genetic tendency for breast cancer should talk to their doctor about the benefits and limitations of starting mammograms earlier, having additional tests (such as breast ultrasound or MRI) or having more frequent exams.
For more information on breast self-exams, clinical breast exams or mammography, visit the American Cancer Society Web site, call the American Cancer Society at 800-ACS-2345 or ask your physician.
Author: Marla Fraunfelder | Medical Reviewer: | Julie Griffie, MSN, RN, ACNS-BC, AOCN | | Sara Svendsen, MS |
Last Review Date: Oct. 1, 2009
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