By Lisa M. Belisle, MD, MPH
Originally published October 5, 2006, Community Leader

Mem knew she had breast cancer well before her doctors did. She noticed the changes in her breast tissue a year before she was given an actual diagnosis. She was 43 years old.

Mem is one of a growing number of individuals with this disease. Forty-five years ago, the incidence of breast cancer in women was 1 in 20. It is 1 in 7 today. This has been attributed to a constellation of factors, from improved cancer detection to worsening lifestyle and environmental hazards. (See www.cancer.org.) Regardless of the reason for the increase, breast cancer continues to be fatal. It kills more than 40,000 Americans each year.

Mem was fortunate. She survived breast cancer, and has been disease-free for almost a quarter of a century. Her children have given her nineteen grandchildren and seven (soon to be eight) great-grandchildren. As one of these grandchildren, I am pleased that October has been named Breast Cancer Awareness Month. In recognition of Mem—and all patients with breast cancer—I urge every woman to:

• Have a regular breast exam with a health care provider. Women from 20-30 should do so every one to three years, while women over 40 require a yearly exam.
• Consider routine breast self examination. This is no longer an official recommendation, but it still makes sense. Breasts are as much a part of your body as the skin you check regularly for abnormal moles. Shouldn’t you pay them some attention, too?
• Get a mammogram. The American Cancer Society advises women to get a mammogram every 1-2 years, beginning at age 40. This has generated some discussion in the medical field lately, but continues to be the current recommendation.
• Talk to a health care provider about your specific risk of the disease. If your mother, sister, or other close female relative has had breast cancer before reaching menopause, you may benefit from genetic testing.
• Realize that not having a relative with breast cancer doesn’t mean you aren’t in danger: 85% of cases are not inherited.

Genetics aside, some women are more likely to develop breast cancer than others. These include women who began their periods earlier, had fewer (or no) children, gave birth at an older age, didn’t breastfeed, and went through menopause later. It is hard to control most of the aforementioned, but it is possible to:

• Maintain a healthy weight. Breast cancer has been linked to obesity.
• Exercise 30-45 minutes most days of the week. This decreases breast cancer risk and improves survival after diagnosis.
• Cut back on alcohol. Increased alcohol = increased risk.
• Eat a fiber-heavy diet, rich in whole grains, fruits and vegetables. Results are mixed, but certain vegetables, such as broccoli, show great promise.
• Monitor meat intake. Nitrate-containing cured meats (i.e. hot dogs, sausage, and salami) and those prepared over an open flame are most harmful.
• Limit your exposure to hormones. Look for organic animal products (such as meat, eggs and milk) and aim for a short course of estrogen-replacement during menopause.
• Don’t smoke. Enough said.
• Limit your exposure to pesticides, some of which have estrogen-like properties. Eat organic when possible and be mindful when using chemicals to kill insects.
• Avoid antibiotics unless strictly necessary. Early studies show a link between breast cancer and these medications.
• Discuss taking a daily aspirin with your health care provider. Recent findings suggest this may be helpful in breast cancer prevention.
• Manage your stress. Research indicates that people with significant life transitions, such as divorce, job loss and relocation are more likely to get breast cancer (and less likely to survive it) if they have poor coping skills.

Coping skills, diet and lifestyle: all things that can be modified to decrease breast cancer risk. DNA, well, we’re still working on that one. Along with prevention, we also have the tools necessary for early breast cancer detection. We need to use these tools wisely in the face of the increasing incidence of this disease. Let’s do this in honor of breast cancer patients everywhere. Let’s do this in honor of Mem.