Each October, a wealth of information on breast cancer circulates online, in print and on television. Unfortunately, much of the information can be contradictory and confusing to the average person.
But experts say understanding the disease, which will strike 1 in 8 women over the course of her lifetime, isn’t as difficult as it may seem.
Who’s at Risk?
Although it’s often the faces of young women diagnosed with breast that tend to be the focus during the month of October, Dr. Diana Zuckerman, president of the National Research Center for Women & Families, said that women over the age of 50 are still most at risk for the disease.
“We know that young women get this disease,” she said. “But this is not the norm. And when the media focuses on young women, we end up scaring young women to death and making older women think that they don’t have anything to worry about when actually the opposite is true.”
Dr. Marisa Weiss, an oncologist and the president of breastcancer.org, said the median age for women diagnosed with breast cancer in this country is 61.
“The incidence of breast cancer is much higher in women who have gone through menopause,” she said. “Of the 200,000 women who will get breast cancer next year, about 25,000 will be under age the age of 50. That’s still a significant number, and it always comes as a huge shock, but it’s still a small percentage of the overall number of women who will get the disease.”
In addition to post-menopausal women, people with a family history of breast cancer on both their mother’s and father’s sides, and women who carry the BRCA1 or BRCA2 genes are at high risk for the disease. Obesity, smoking, drinking and menstruating before age 12 also raise the risk of breast cancer. African American women also appear to be at higher risk for the disease.
Diagnosing Breast Cancer
Both Zuckerman and Weiss recommend mammograms at least once a year for women age 40 and older and say it is one of the best measures of early detection. Women at high risk for breast cancer should begin getting mammograms earlier, however, they might not be as effective as they are for older women, the doctors said.
“As women age, their breasts become less dense,” said Zuckerman. “A mammogram on a dense breast comes back all white and cancer shows up on a mammogram as white, so it’s not really effective on many younger women.”
Weiss recommended digital mammography, which she said has a better resolution than traditional mammograms.
“It’s like the difference between using a film camera and digital camera,” she said. “With the digital mammography, you can take the image and put it on the computer. You can zoom in and zoom out, blow up and do all those kinds of fancy things that have real value in diagnosing breast cancer.”
A specialized MRI has also been developed to diagnose breast cancer. The technology is still new, but experts seem to agree that it is more effective than mammograms.
“The problem is that it’s very expensive,” said Zuckerman. “It’s like $1,000 for an MRI versus $100 for a mammogram. And insurance companies won’t always pay for them. So while it’s a great technology, there are still obstacles to using it. But women who are at high risk may want to consider it.”
Women younger than 40 can use self exams to diagnose breast cancer, however, Zuckerman cautions that breast cancer is often in its advanced stages by the time it can be felt through the breast.
“I certainly wouldn’t discourage women from doing it,” she said. “But the drawback is that by the time you can feel it during a self exam, it more than likely would also be noticeable in some other way.”
Treating Breast Cancer
Perhaps the biggest fear women have about getting breast cancer is that they will lose their breasts to the disease. In most cases, however, this is no longer true.
“The one message, I would give to women is not to take advice from women who have had the disease in the past and had to get mastectomies,” Zuckerman said. “In most cases, a mastectomy is no longer necessary.”
More often then not, breast cancer can be treated through a lumpectomy with radiation and chemotherapy.
“There are a lot of newer fancier tests that give us a better look at the cancer itself,” said Weiss. “Now, we can look at the proteins and the genes to figure out the personality of the cancer, so treatments can be more customized. It’s a more personalized medicine. You spend the time upfront so that your treatment plan is not generic. It’s a thoughtful strategic plan just for you.”
Weiss said there is no proof that women who have mastectomies or more aggressive treatments have better survival rates than those who do not.
“More does not mean better,” she said. “A lot of people believe they have to suffer to get better. This is not necessarily true. A less aggressive therapy may be just as effective.”
Zuckerman said women also need to let go of the mindset that breast cancer is a death sentence.
“Breast cancer is not fatal,” she said. “Breast cancer will not kill you. It’s when the tumors spread into the lymph nodes and into other organs, or into the bones or the blood stream that it becomes possibly fatal, but getting breast, if it caught early and treated, will not kill you.”
Diet and exercise are the best ways to prevent breast cancer, said the experts.
“Stay as physically active as possible, exercising three to four times a week,” said Weiss. “Stay as close to your ideal body weight as possible and maintain it throughout your life. No smoking and limit your alcohol intake to three or fewer drinks a week.”
Both Weiss and Zuckerman recommend a diet heavy in fruit and vegetables, avoiding hormone replacement therapy after menopause, and added that women should avoid using plastic containers or saran wrap in the microwave.
“What we do know is that if you take some of the chemicals in plastic and put them in a Petri dish with cancer cells, the cells will blow up,” said Zuckerman. “So people in general should never use plastic in the microwave.”
Weiss said women with breast cancer should always make sure their information comes from a trusted source and/or medical expert.
“There are a lot of people who will do a ton of research when trying to figure out which lawnmower to buy, but don’t do the same when it comes to their health,” she said. “Make sure that the advice you’re following is medically vetted. Your life could depend on it.”