Breast Cancer: Why Not You?
By Edel Jarboe

Breast cancer awareness programs such as "Race for the Cure", reminders to do monthly breast self-exams in the back of women's magazines, and greater media coverage on the subject make it virtually impossible for women to ignore breast health.

However, this is what some women are doing. They are ignoring their breast health in the hopes that they won't have to deal with breast cancer. By not actively practicing preventive breast health, they are denying that they could potentially get breast cancer. This is playing the naive and dangerous game of "Not me," when, in reality, the name of the game is "Why not me?" Personal beliefs and attitudes about breast cancer are the first things one must face in order to start taking responsibility for one's health and body.

Anna R.* is a 65-year-old woman whose mother died of breast cancer. While she eats healthy and has a mammogram every year, Anna is overweight and does not exercise. When asked why she doesn't take the threat of breast cancer seriously enough to do anything about her weight and lack of physical fitness, she volunteers that she believes that since her mother had breast cancer, there is nothing that she can do.

According to the American Cancer Society, only 5-10% of all breast cancers are believed to be inherited. In short, family history and a genetic predisposition do not necessarily mean that you will get breast cancer. Other factors such as obesity, reproductive patterns, and similar lifestyles among family members are a better explanation for increased risk.

Bianca L. is the 32-year-old mother of two children. She breastfed both children and had her first child at age 22. She has no family history of breast cancer.

Bianca does a breast self-exam every once in a while and has an occasional drink with friends. She admits that she doesn't always eat well but that's okay, right? She's not really at risk. She believes that she has another 20 years to start worrying about breast cancer.

Does she?

According to a study which appeared in the Jan/Feb 1998 issue of the CA- A Cancer Journal for Clinicians, approximately 75% of women newly diagnosed with breast cancer have no identifiable risk factors. This means that only 25% of breast cancers are positively associated with known risk factors. In other words, even if you have no identifiable breast cancer risk factors, you are still at risk.

Helen S. is 43 and has no children. She admits that she does not perform a monthly breast self-examination, nor has she had her first mammogram. Her grandmother died of breast cancer.

Why doesn't Helen take steps to safeguard her health?

Helen believes that because her mother has not contracted the disease, she is safe.

Lack of knowledge about all of the risk factors for breast cancer is dangerous. According to the National Cancer Institute, a woman in the United States has a 1 in 8 lifetime risk of developing breast cancer and 1 in 29 lifetime risk of dying from breast cancer. These are not good odds. Every woman should stay informed of the risk factors for breast cancers and do all they can to lower their chances of developing breast cancer. Because the sad truth is that just being a woman puts you at risk.

Knowing your family's medical history is an important factor in detecting and treating serious illnesses. Evidence has shown that women with a first-degree relative (mother, sister, or daughter) who has had breast cancer have a 2-3 times greater risk of contracting the disease. Moreover, women with second-degree relatives (cousins) who have had the disease, have an increased risk of twice that of a woman who has no family history of breast cancer.

Be sure to fully discuss your medical history with your doctor, because the use of specific screening tests varies based on your known risk factors.

What do all of these risk factors have in common? Breast cancer is a hormonal cancer and as such, it has been closely linked to estrogen levels. Each of the above risks has to do with changes in a woman's estrogen levels, when they've taken place, how often, and for how long. Unfortunately, the more risk factors you have, the greater your chances of contracting breast cancer.

A study which appeared in the February 18, 1998 issue of the Journal of the American Medical Association (JAMA), showed that women consuming at least 30 g/d of alcohol a day (2.3 bottles of beer, 2.8 glasses of wine, or 2 shots of liquor) are at an approximately 30%-40% higher risk for breast cancer than non-drinkers. Why? Higher levels of alcohol consumption have been associated with higher levels of estrogen in alcoholic women. Moreover, alcohol may act as a cocarcinogen, improving the permeability of carcinogens, inhibiting the detoxification of carcinogens, and activating procarcinogens. For this reason, it is recommended that women limit alcohol intake to 1 alcoholic beverage a day (12-oz beer, 5-oz wine, or 1.5-oz liquor)

In another study, which appeared in the November 5, 1997 issue of JAMA, avoiding weight gain after menopause may contribute to the prevention of breast cancer, particularly among women who do not use postmenopausal hormones. Thus, a lifelong commitment to exercise plays a vital role in your long-term health.

Eating well has a variety of health benefits, whether or not it helps reduce the risk of breast cancer is unknown. Despite all the media attention revolving around soy, it has not yet been proven that soy products reduce breast cancer risk. Likewise, while the controversial Nurse's Health Study showed no correlation between fat intake and breast cancer risk, scientists aren't convinced. Other studies do show a link between diets high in saturated fat and breast cancer risk.

Because no one is quite sure which type of diet makes a difference in reducing or increasing breast cancer risk; the American Cancer Society recommends the following guidelines:

Overall, with the exception of excessive alcohol consumption, diet is a lesser factor when compared to other breast cancer risks, such as genetic predisposition, early menstruation, and late menopause.

Self-care is the most powerful weapon against breast cancer. Eat a healthy diet, limit alcohol intake, stay physically fit, and visit your doctor regularly. Each month examine your breasts for any lumps or changes. Do the examination a few days after your period ends. If you are using oral contraceptives, do it on the day you begin a new pill pack.

In addition, have regular breast exams by a medical professional and, if you are over 40, you should have mammograms every 2 years or as often as your doctor recommends. After 50, you should have a mammogram every year. Breast cancer is an age-related disease. The older you are, the greater your risk of developing breast cancer.

If you are post-menopausal, weigh the options of hormone replacement therapy and estrogen replacement therapy carefully. Discuss your risk factors with your doctor and do not be afraid to keep asking questions about the choices available to you. Also, if you are post-menopausal, avoid weight gain as this raises estrogen levels and keep physically fit in order to reduce the rise in estrogen levels.

In short, the "Why not me?" game is a serious one. The stakes are too high for it not to be. When it comes to breast cancer prevention (and treatment), these are the rules: Be vigilant. Be healthy. Be informed. Play as if your life depends on it.

*Names have been changed.

Edel Jarboe is the founder and editor of Simpler Living http://www.simplerliving.com , an online magazine helping women balance work, family and life.

Here you can find timely articles on health, fitness, diet, personal growth, relationships, parenting, spirituality, work, money, time management, and more. This is a place for working women and mothers to come and get practical insight and inspiration to help keep their busy lives in balance.

Edel also publishes a free weekly email newsletter, which features the advice column Balancing Act , an inspirational quote, happiness and time saving tips, and resources for living a simpler life. Subscribe at http://www.simplerliving.com/sln.htm 

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