Sally Herschorn, MD, is Director of the Breast Imaging Division at the University of Vermont Medical Center.

While the prospect of getting breast cancer is scary, you can take control and reduce your anxiety.

First, put it in perspective
Most women overestimate their risk of breast cancer. Lung cancer kills more women than breast cancer. Heart disease, osteoporosis, diabetes and depression affect more women than breast cancer.

Know the risks
One in eight women will develop breast cancer at some point during their lifetime (which means to age 90). The average woman’s lifetime risk is 13 percent. This means that 87 percent of us will never get breast cancer! The rest of us will very likely not get cancer in the next five to ten years.

Become proactive about breast health
Here are some tips that I try to follow to minimize risk of developing breast cancer:

  1. Eat healthy: maximize consumption of fresh fruits and vegetables.
  2. Exercise regularly and keep your weight down. Obesity is linked to an increased risk.
  3. Keep alcohol consumption to a minimum. Consuming more than one drink a day is associated with increased risk.
  4. Become familiar with the way your breasts feel and seek medical attention if you notice a lump or change.
  5. Women age 40 and up should have an annual mammogram.  See my blog on this topic, as well as a new analysis supporting this assertion.
  6. Prolonged combined estrogen/progesterone hormonal treatment has been linked to breast cancer. If you’ve been on this form of hormone replacement therapy, consult your physician about alternative treatments.

Know your family history
You can’t change your genetics, but you can make sure you are getting proper screening if you’re at increased risk. If one or more immediate family members (mother, sister, daughter, or father) have had breast cancer, particularly pre-menopausal breast cancer, you may be in a higher-risk group. Find out your lifetime risk of breast cancer based on family history. You can estimate it yourself first using an online risk calculator. (Google:  breast cancer risk calculator. There’s even an app for that on the iPhone!) In reality it’s best to check with your physician so an accurate risk assessment can be performed.

If it’s elevated, you should consult the High Risk Clinic or Familial Cancer Center about whether or not to have genetic testing done (http://hrbp.vermontcancer.org/). You can also consider whether or not to take medication that would decrease your risk of breast cancer. Whether or not you decide to have genetic testing, if your lifetime risk is more than 20 to 25 percent, you should have annual MRI screening in addition to mammography.

Evaluate your prior radiation risk
Women who had radiation treatment to the chest from late childhood, teenage years and through their 20s and 30s are at greatly increased risk; approaching 35 percent by age 40. These women need to be screened beginning at age 25 with annual mammography. They also need supplemental screening with annual MRI in addition to mammography. If you had a childhood or adolescent malignancy, e.g., Hodgkin’s disease or know someone who has survived this, make sure they are aware of their risk and how they should be screened.

Know your breast density
Breast density is an independent risk factor for cancer, and you cannot judge breast density without a mammogram. Your breast density is on your mammogram report but not in the letter you receive (so you will need to ask your physician’s office for this information). If you don’t have other risk factors that put you in a high-risk group, but have heterogeneously or extremely dense breasts, you’re at moderately increased risk and finding breast cancer on your mammogram is more difficult. You may wish to consider supplementary screening methods in addition to mammography.

Check back next month for Taking Control of Your Breast Health, Part 2 – Early Detection Methods to learn more about the different methods available to detect breast cancer.

More helpful links

http://www.cancer.org/Cancer/BreastCancer/DetailedGuide/breast-cancer-risk-factors
http://www.cancer.org/Cancer/BreastCancer/DetailedGuide/breast-cancer-detection 

Sally Herschorn, MD, is Director of the Breast Imaging Division at the University of Vermont Medical Center and Associate Professor of Radiology at the Larner College of Medicine at UVM

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