As a writer who's focused on women's health for the last 22 years, I know all too well the many myths and misperceptions that persist about breast cancer. Even a friend of mine who works in healthcare won't wear an underwire bra or use antiperspirants because she's afraid they'll increase her risk of breast cancer—but she's never had a mammogram. And that's just the issue: Misinformation can make us concerned about the wrong things.
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"Women often focus on claims that wearing underwire bras or using antiperspirants causes breast cancer, even though there's zero evidence that they do," says Victoria Seewaldt, MD, director of the breast cancer prevention program and professor of medicine at Duke University. Meanwhile, too many women (like my friend) are delaying screenings such as mammograms that can help catch the disease in its earliest, most treatable stages.
Another misperception is that the news is only bad when it comes to breast cancer. The truth is, survival rates are higher today than ever before, and there are steps you can take to shift the odds in your favor even more. The key is to arm yourself with solid, reliable information. Fortunately, the country's top breast cancer experts are here to tell you how to protect yourself.
1. Self-exams are no longer officially recommended—but do them anyway.
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Familiarizing yourself with the look and feel of your breasts is still a smart move, since some breast cancers aren't picked up by mammograms and others can develop between annual mammograms. "The fastest-growing, most aggressive tumors are often the ones that often crop up between screenings," says Anne M. Wallace, MD, professor of clinical surgery and team leader at the University of California San Diego Moores Cancer Center Breast Program.
You don't necessarily have to examine your breasts in a certain pattern or do it on the exact same day every month, but you should check them often enough to be able to distinguish a worrisome change from your usual lumps and bumps. If you notice anything odd, don't panic (many lumps are completely benign), but call your doc right away to get it checked out.
2. The radiation you get from a mammogram is minimal.
New research has found that the risk from exposure to mammogram radiation is even lower than previously thought. What's more, the newer digital mammograms use about 22% less radiation than traditional film mammography, says Dahlia Sataloff, MD, a clinical professor of surgery at the University of Pennsylvania School of Medicine and director of the Integrated Breast Center at Pennsylvania Hospital in Philadelphia. They also take sharper pictures, so there's less of a chance that you'll get called back for a repeat test. "Most centers have digital mammography, but check beforehand to make sure," Dr. Sataloff says.
3. Having a drink a day is probably too much.
Alcohol may be good for your heart, but when it comes to your breasts, it's another story: Research suggests that even one drink per day could raise your breast cancer risk, says Christine Laronga, MD, clinical director of breast surgical oncology at H. Lee Moffitt Cancer Center in Tampa. To be safe, limit it to three drinks per week—but don't get in the habit of "saving" your weekly drinks and downing them all in one night. If you regularly have two or three glasses of wine or cocktails at once, your risk of breast cancer jumps to 20% higher than if you abstained completely, according to Susan G. Komen for the Cure. The way alcohol is metabolized in a woman's body may increase estrogen levels in the bloodstream, which increases your breast cancer risk.
Research has shown that getting enough folic acid (folate)—at least 600 mcg per day—may help undo some of the damage of regular drinking. You'll find it in orange juice, leafy greens, beans and fortified breakfast cereals. For extra insurance, ask your doctor if you should take a multivitamin that contains it.
4. What you weigh matters more than what you eat.
Though it's true that a healthy diet may help, whether individual foods can really lower your breast cancer risk is up for debate. But there's no denying the powerful impact of weight. Numerous studies have found that extra pounds increase your risk of postmenopausal breast cancer or having a recurrence. "The more body fat you have, the more estrogen your body stores," and estrogen can stimulate tumor growth, explains Dr. Laronga. The good news: If you're overweight, slimming down may help reduce your risk.
5. If you're at increased risk, taking a preventive medication could cut your risk in half.
If taking a pill could slash your breast cancer risk by more than 50%, you'd seriously consider it, right? Unfortunately, the reality is that many women who are eligible for preventive drugs (selective estrogen receptor modulator or aromatase inhibitors) don't, because they don't even know that they're good candidates. How to find out if you should consider one of these potentially lifesaving drugs? Start by asking your doctor to calculate your breast cancer risk using a tool such as the Gail Model, says , says Therese Bevers, MD, medical director of the Cancer Prevention Center at the University of Texas MD Anderson Cancer Center in Houston. You'll answer a series of questions about risk factors, then you'll get a score. If your risk is high—at least a 70% higher-than-average risk of developing breast cancer in the next five years—talk to your doctor about the pros and cons of using these meds, since they can have serious side effects.
6. If your mom had breast cancer after menopause, your risk may only be slightly above average.
If you don't carry a mutation of one of the so-called breast cancer genes (BRCA1 or BRCA2) and your mom got cancer late in life, your risk is only 2% to 5% higher than average, so your doctor may not screen you any differently than a woman with no family history, says Dr. Bevers.
"Postmenopausal breast cancer is typically a disease of aging," says Dr. Seewaldt. "Premenopausal breast cancer may mean that there is a gene or genes involved." So if your mother had breast cancer at, say, age 35, your lifetime risk of getting breast cancer increases by 30% to 40%. If you have an inherited mutation in BRCA1 or BRCA2, your lifetime risk may be as high as 80%, according to the American Cancer Society.
7. More than 90% of women who get breast cancer don't have a family history of the disease.
The biggest risk factor: being female. The second biggest: age. "Every woman is potentially at risk, just by virtue of being a woman," says Carolyn D. Runowicz, MD, associate dean for women's affairs and professor of obstetrics and gynecology at the Florida International University Herbert Wertheim College of Medicine in Miami.
However, if you do have a family history, you may need to be screened more vigilantly, so ask your doctor. It's also important to know if prostate cancer, pancreatic cancer, colon cancer, ovarian cancer or melanoma run in your family, since any of these might mean that you're predisposed to breast cancer as well. And don't forget to mention any cancer on your dad's side of the family. Both sides count equally, says Dr. Laronga.
8. Smoking is bad for your breasts.
It doesn't just raise your lung cancer risk: People who smoked for 10 years or more were at least 16% more likely than nonsmokers to develop breast cancer, according to recent research from West Virginia University. Long-term exposure to secondhand smoke may also up your risk. "Cigarette smoke causes chronic inflammation in your body, which in turn may lead to cancer," Dr. Wallace explains.
9. If you get breast cancer, you may not need a mastectomy or chemo.
A mastectomy (removal of the entire breast) used to be considered an absolute must, but studies have shown that lumpectomy (removal of only the tumor and some surrounding tissue) combined with radiation is often just as effective—especially if the tumor is small. That's because even if you remove the full breast, you never really get all of the breast tissue, so there's still a 5% to 10% chance of a recurrence in the same breast, says Susan Love, MD, author of Dr. Susan Love's Breast Book and president of the Dr. Susan Love Research Foundation.
Another major change: We now know that there isn't just one kind of breast cancer—there are five or six different types, which means there's no one-size-fits-all treatment. smoke causes chronic inflammation in your body, which in turn may lead to cancer," Dr. Wallace explains.
Another major change: We now know that there isn't just one kind of breast cancer—there are five or six different types, which means there's no one-size-fits-all treatment. Doctors also now use tests such as Oncotype DX and MammaPrint to examine tumors at the molecular level and figure out the chances of the cancer coming back following surgery. "These tests tell us whether or not chemotherapy would be helpful," says Larry Norton, MD, deputy physician in chief for breast cancer programs at the Memorial Sloan Kettering Cancer Center in New York City. Some forms of breast cancer respond better to hormonal treatments (such as tamoxifen or aromatase inhibitors) than to chemo, while others are best treated with both, he explains. And even if you do need chemo, it may not be quite as bad as you think. "We have better drugs to counteract the side effects, and we often use chemotherapy for a shorter time," Dr. Norton says.
10. Just 30 minutes of exercise five days a week can cut your breast cancer risk by nearly 20%
Regular exercise (2.5 hours a week, which you can break up into five 30-minute brisk walks) not only helps to keep your weight in check, it can also lower estrogen levels and boost your immune system, helping to prevent any abnormal cells from growing and spreading. And if you do get breast cancer, keep moving. Breast cancer survivors who did the equivalent of one to two hours of brisk walking a week had a 40% lower risk of dying from breast cancer, according to a study from Fred Hutchinson Cancer Research Center in Seattle.
Stacey Colino is an award-winning writer who specializes in health and psychology. Her work has appeared in many national magazines and books.