I care for women’s health throughout their lifespan, and part of well care is also education. Since October is Breast Cancer Awareness month, I want to share some information.
It is estimated that in 2022, there will be over 320,000 new breast cancer diagnoses (this represents 1 out of 8 women). 65% of breast cancer cases are diagnosed at a localized stage (meaning the cancer has not spread outside of the breast), for which the 5-year relative survival rate is 99%.
Breast cancer is a disease in which abnormal cells in the breast overgrow and invade healthy cells. Sometimes, the growth process goes wrong, and new cells form when the body doesn’t need them, resulting in old or damaged cells not dying as they should. When this occurs, a buildup of cells often forms a mass of tissue called a lump, growth or tumor.
Breasts are made up of three main parts: lobules, ducts and connective tissue. Cancers can begin in any of these parts and spread into nearby blood vessels and lymph nodes and therefore classified as either invasive or non-invasive (in-situ). Most commonly, breast cancers start in the ducts or lobules.
No one knows exactly what causes breast cancer, but what research has found is that it is always caused by damage to a cell’s DNA. We still don’t know if this is caused by genetics or the environment, but what we do know is that women with certain risk factors are more likely to develop breast cancer. However, just because you have some risk factors does not mean you will get breast cancer; in fact 60-70% of people with breast cancer have no risk factors at all, and other people with risk factors will never develop cancer.
Risk factors include:
- Being a woman
- Getting older
- Inherited genes (BRCA1/BRCA2)
- Family history
- Dense breast tissue (making lumps harder to detect)
- Personal history of breast cancer
- Previous radiation treatment (in chest area)
- Taking hormones
- Reproductive history- getting your period before age 12, menopause after age 55 (being exposed to hormones longer)
- Physically inactive, obesity after menopause
- Poor diet
How can you reduce your risks?
- Healthy diet
- Regular physical activity
- Breastfeed if possible
- Limit alcohol intake; quit smoking
- Eliminate chemicals/toxins (personal care products, cleaning products, your environment, etc.)
- Review the risks versus benefits of taking oral contraceptives or hormone replacement therapy
- Discuss preventative measures with your provider if you carry inherited genes/mutations
I encourage annual exams with your primary care provider. The American Cancer Society recommends mammography screening starting at age 40 for an average risk woman (no personal breast cancer history, no strong family history, no genetic mutation known to increase your risk of breast cancer and no chest radiation therapy before the age 30).
Are you checking your breasts?
Knowing how your breasts/breast tissue look and feel is the most important measure of breast health. The presence of one of these symptoms does not necessarily mean you have breast cancer, but it should be evaluated by a healthcare professional:
- a new lump or mass
- unexplained swelling of all or part of your breast, or recent asymmetry
- skin dimpling (like an orange peel)
- nipple retraction
- breast or nipple pain
- nipple discharge (when not breastfeeding)
- red, dry, flaky skin/patches
- swollen lymph nodes
Luckily, with the decline of prescriptive hormone replacement therapy for women after menopause, we are seeing a reduction of breast cancer incidence rates among women over 50 years of age. Additionally, the death rates from breast cancer have been declining since about 1990, in part due to better screening and early detection, increased awareness and continually improving treatment options. The conversation can feel awkward, but it’s vital. Together we rise in ensuring every woman has access to the screening she needs and the support she deserves.
Let’s rise together!
Anne Schwanke, APRN, CNM, WHNP