One in 8 women in this country will be diagnosed with breast cancer in their lifetime. In American women, it is the second most common cancer after skin cancers.
While breast cancer will lead to the deaths of more than 43,000 women in the United States this year, the survival rate among older women is increasing. Medical experts believe increased awareness about the importance of regular breast screenings and better treatments have contributed to fewer diagnoses. Lifestyle changes are also helping.
In this video interview, Dr. Pamela Otto, the chief radiologist at University Health’s breast cancer imaging center, identifies steps women can take to reduce their risk for getting breast cancer.
Getting timely mammograms are key to prevention and treatment. When should women be screened?
There are a lot of different recommendations out there. Some say start at age 50 and every other year. Some say start at age 45 and go every other year until 50, and then every year after 50.
At the Breast Imaging Center, you start annually at age 40 and continue annually until you can't be treated for the disease. If you have another disease that prevents you from being treated, then you don't need to be screened anymore. That's what we recommend.
The most important thing you want to do is catch it early before it spreads so it's more easily curable.
What lifestyle habits will reduce the risks?
The most important things to decrease your risk of getting breast cancer would be:
- Keep your weight at normal, healthy level.
- Exercise regularly (three to five times a week just enough to get a sweat or a little bit out of breath, you don't have to overdo it.)
- Watch the amount of alcohol you drink. If you can keep it to three drinks per week that would be great; none would be even better.
Why does being overweight increase the risk?
It's felt partly to be due to your increased estrogen level, so fat tissue in the body secretes estrogens. A higher estrogen load in your body is felt to increase your risk for breast cancer. So that's why they say keep your weight down.
The CDC warns that menopausal women may increase their cancer risk by taking hormone replacement. What do you recommend?
Hormone replacement therapy is very common, and it's for women who have post-menopausal syndrome symptoms. So, maybe bad night sweats, insomnia, irritability, which impacts their lives negatively such that their quality of life isn't quite as good. So those are the ladies who should look at, "Do I need hormonal therapy?" They need to talk to their providers, whoever that is, usually it's an OB/GYN who are the biggest prescribers of that.
And then you take the hormonal therapy for as long as you need it, and you take it away when you don't need it. If you're going to take hormonal therapy, you need to be screened yearly. Most providers will not prescribe it if you won't get your mammogram
If you have a genetic mutation known as BRCA1 or BRACA2 you are at higher risk. When should you seek genetic testing to find out?
If you have the breast cancer mutation, it increases your risk for developing not only breast cancer, but ovarian cancer. BRCA 2 is a higher risk of developing ovarian cancer. If you have a strong family history of breast cancer, meaning mother, sister, daughter, grandmothers not so much, but first degree relatives, and you have enough of them and you have early age breast cancer, certainly you should be screened. But you should go to a genetic counselor or to your health care provider and really talk to them about, "Do I need to be screened or do I not need to be screened?"
If you have inherited the BRCA1 or BRACA2 genetic mutations, what are your best treatment options?
If you find you have the BRCA gene, then what you would do is you would, hopefully, increase your screening. Make sure you get your yearly mammograms, get your yearly MRIs. If you can't get an MRI at least get breast ultrasound yearly of your entire breast, along with your mammogram. There are some medications that can be given by the medical oncologist to decrease your risk.
Some women also decide that they would rather have bilateral mastectomies with reconstruction. That would pretty well decrease your risk for getting breast cancer. That's pretty radical, but some women do that. There's a lot of options available to women, but the last thing you want to do if you're at high risk is do nothing.