When my sister Julie was diagnosed with breast cancer eight years ago, it was pretty scary. Even though the doctors caught it early and her prognosis was good, hearing the news still felt like someone had punched me in the gut—the ‘C’ word does that to you, I guess.
But I’m happy to report that like so many women today, Julie had a great outcome. After a successful lumpectomy and seven weeks of radiation—and, due to her tumor being estrogen-receptive, a long course of tamoxifen to halt her production of estrogen and reduce the risk of the disease returning—she is cancer-free. In fact, now that she has passed that all-important five-year mark, her doctors consider her to be cured.
Still, she stays vigilant. She watches her breasts closely (“my girls,” as she refers to them), gets regular mammograms and sees her oncologist yearly. And despite some unsavory side effects such as hot flashes and headaches, she will continue to take tamoxifen until she completes her full 10-year course. As Julie knows, despite the incredible advances in detection and treatment of breast cancer, it is up to her to make sure that she—and her girls—stay healthy.
We’d like to help you keep healthy, too. In honor of Breast Cancer Awareness Month, here are the latest recommendations on what you can do to help keep your breasts—and the rest of you—in top form.
Watch Your Breasts
According to the American Cancer Society1, you should become intimately familiar with how your breasts look and feel—regardless of your age—so if you do notice any changes, you can act quickly. You should watch your breasts closely for any of the following changes:
Changes to your nipples (such as if they turn inward or retract, or if the skin gets red or scaly).
Discharge from your nipples.
Lumps in your breasts.
Pain anywhere in your breasts.
Swelling in or around your breasts, armpits or collarbones.
Thickening or redness of the skin on your breasts (often referred to as an orange-peel appearance).
Warmth or itching of your breasts.
Keep in mind that non-cancerous breast conditions are very common and most breast changes are benign.2 Still, if you notice any changes, it’s important to follow up with your doctor right away.
Stay on Top of Screening Tests
Once you reach your 40s, it’s time to start considering—or getting—screening tests, usually mammograms. According to the National Cancer Institute3, screening mammograms can help detect breast cancer earlier, in turn allowing for earlier treatment. In fact, research4 has shown that screening mammography helps reduce death from breast cancer among women aged 40 to 74, particularly for those over the age of 50.
These are the American Cancer Society’s guidelines5 for women who have an average risk of breast cancer:
If you are between the ages of 40 and 44: You should have the choice to have yearly mammograms.
If you are between the ages of 45 and 54: You should have a mammogram every year.
If you are 55 or older: You should have a mammogram every two years—or you can continue yearly screening.
Women who are at high risk for breast cancer should get an MRI and a mammogram every year, typically starting at age 30. This includes women who:
Have a known BRCA1 or BRCA2 gene mutation (based on having had genetic testing)
Have a first-degree relative (parent, brother, sister, or child) with a BRCA1 or BRCA2 gene mutation, and have not had genetic testing themselves. Learn more about genetic testing and if it’s right for you.
Have a lifetime risk of breast cancer of about 20% to 25% or greater. Talk to your healthcare provider about assessment tools and your family history to help determine your risk
Had radiation therapy to the chest when they were between the ages of 10 and 30 years
Have Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or have first-degree relatives with one of these syndromes
Know if You Are at Increased Risk
Following are some of the factors that increase your risk of developing breast cancer. If you have any of them, it pays to remain extra alert to the breast changes mentioned above—and to be extra diligent about screening tests as well. And as always, work with your medical provider to help guide you to take the best course of action for your specific medical history.
Being older: According to the American Cancer Society6, most breast cancers occur in women aged 55 or older.
A family history of breast cancer: If you have a mother, sister or daughter (called a first-degree relative) who had breast cancer, your risk is almost doubled. And if you have two first-degree relatives with breast cancer, your risk increases almost threefold.7
A close male relative with breast cancer: According to the University of Texas MD Anderson Cancer Center7, men can get breast cancer, too—although it’s much less common than in women. If you have a male relative who has had breast cancer, you may be more likely to develop it, too—especially if it’s a close relative, such as a brother, father or son. MD Anderson recommends talking to your doctor about genetic testing if you do have a male relative with breast cancer.
Your heredity: Approximately 5 percent to 10 percent of breast cancers are likely hereditary, meaning they are caused by defects in genes passed from one or both parents.7 The most common of these is the BRCA1 or BRCA2 mutation; if you carry this gene, you have about a 70 percent chance of developing breast cancer by the age of 80. You are also more likely to develop breast cancer at a younger age and to have cancer in both breasts and have a higher risk of developing some other cancers, mainly ovarian cancer.
A personal history of breast cancer: Unfortunately, if you have had breast cancer before, you are more likely to develop it in the future.7
Starting menstruation early or menopause late: If you started getting periods before the age of 12, or if you went through menopause after the age of 55, you have a slightly higher risk of developing breast cancer.7
Help Reduce Your Risk of Breast Cancer
While there’s no absolute way to prevent breast cancer, there are steps you can take to help reduce your risk of developing it. Here are several:
1. Limit your alcohol consumption.
According to the American Cancer Society,8 alcohol consumption is clearly linked to an increased risk of breast cancer. In fact, women who have two or three drinks per day have about a 20 percent higher risk than women who don’t drink at all. If you do drink, the ACS recommends having no more than one drink a day.
2. Reach a healthy weight.
Being overweight or obese after menopause increases your risk of breast cancer.9 Research also shows that having metabolic syndrome—which is often linked to obesity10—was associated with a 13 percent increased risk in a 2018 study.11
What’s more, a new study published in the American Cancer Society’s journal Cancer found that postmenopausal women who lost at least 5% of their body weight over a three year period had a 12% lower risk of developing breast cancer than those whose weight remained the same.12-13
3. Eat healthfully.
According to breastcancer.org,14 researchers are studying possible links between diet and breast cancer, with some studies suggesting that very low-fat diets may reduce your risk. In the meantime, they recommend that you:
Eat at least five cups of fruits and vegetables a day.
Limit saturated fat to less than 10 percent of your total daily calories.
Limit your fat intake to about 30 grams per day.
Avoid trans fats, processed meats, and charred or smoked foods.
Eat foods that are high in omega-3 fatty acids, such as seafood, nuts and seeds, and plant oils.15
4. Stay active.
According to research,16 physical activity is linked with a lower risk of breast cancer. The American Cancer Society7 recommends that you get at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity activity every week.
5. Consider your choice of birth control.
Birth control that uses hormones—including oral contraceptives, birth control shots and hormonal IUDs—might increase your risk of breast cancer, according to the American Cancer Society.17 But also take into consideration that older studies have linked hormonal contraceptives to a lower risk of getting ovarian, endometrial, and colorectal cancers later in life. It’s important to discuss the benefits and risks of hormonal contraceptives with your doctor.
The thought of breast cancer can be scary, but keep in mind these statistics from the Susan G. Komen Breast Cancer Foundation18: If you are 20, your absolute risk of developing breast cancer in the next 10 years is 0.06 percent. If you are 30, your absolute risk is 0.4 percent. And if you are 40, your absolute risk of developing the disease in the next 10 years is 1.5 percent. And even if you are one of the estimated 12.4 percent of women who will develop breast cancer in their lifetime,19 keep in mind that advances in diagnosis and treatment have led to huge successes in women not only surviving the disease, but thriving. Just like Julie.