October is the Breast Cancer Awareness month. This theme is intended to alert everyone around the world about the still high mortality rates of this cancer. According to the National Breast Cancer Foundation (NBCF) this year 3,000 will lose their life – 8 every day. In Australia, 53 Australians are diagnosed every day. It is a sad reality, but there is always a light at the end of the tunnel. Prevention is the best solution, but also advanced treatments are being tested to get an end to these stories. There is still a long path, but the NBCF mission brings exciting news: Zero deaths by 2030.
Risk & Prevention
If you’re a woman and you live to the age of 85, your risk of getting breast cancer over your lifetime is 1 in 7 or about 14 per cent. There are many factors that contribute to an individual’s chance of developing this type of cancer over another’s. Some are risks we can reduce based on lifestyle factors. Other risks, like being a woman and getting older, are ones we have no control over.
Ways to Reduce Risks
- Reduce your alcohol intake: Research has shown a strong link between alcohol and the risk of developing breast cancer, or cancer returning. To reduce your risk, try to limit your alcohol intake to two standard drinks a day.
- Maintain a healthy weight throughout your life: Women who put on a lot of weight in adulthood, particularly after menopause, may have a higher risk of mammary cancer.
- Be active: Studies have shown that regular exercise reduces the risk of this type of cancer. The exact amount of physical activity needed is not yet clear. However, studies show that moderate exercise, like a brisk walk, can be enough to reduce your risk. The more you do, the greater the benefits.
- Have children early and breastfeed if you can: Not having children or having children later in life can increase your risk of developing this type of cancer. The reverse is true as well. Having more children early in life and breastfeeding (for 12 months or more) provides long-lasting protection from breast cancer.
- Eat well: A healthy diet, of at least five serves of vegetables and two serves of fruit a day, may help to reduce your risk of cancer. Research recommends sticking to low-fat dairy products, limiting how much red meat and sugar you eat to prevent increasing your risk of this type of cancer.
- Try not to stress: There is no conclusive evidence that stress causes mammary cancer. However, people under stress often develop certain behaviours (such as smoking, overeating, or drinking alcohol) which increases their risk of cancer.
- Avoid long-term use of hormone replacement therapy (HRT): Many women use HRT to alleviate the symptoms of menopause and/or osteoporosis and to boost female hormones that lower with age. However, evidence suggests that long-term use of HRT increases the risk of breast cancer. Once HRT use ends, the risk returns to normal levels.
- Don’t smoke: A landmark US study demonstrated a strong association between active smoking and breast cancer risk. This was specifically evident for women who had started smoking at a very early age and before their first pregnancy. Smoking should always be avoided to prevent a range of diseases and to maximize health and well-being.
Risk factors you can’t change
- Being a woman: 99 per cent of mammary cancer cases are women. A small minority of men can get this type of cancer, but women are at a much higher risk.
- Ageing: The older women get the higher their risk of developing breast cancer. In Australia, breast cancer can occur in younger women, but about three out of four cancer cases occur in women aged 50 years and older.
- Early puberty: Reaching puberty early prolongs the amount of time you are exposed to the fluctuating levels of estrogen and other female hormones that are associated with the menstrual cycle. Starting menstruation before the age of 12 is associated with higher breast cancer risk.
- Late menopause: Women who experience menopause later (at age 55 or after) have twice the risk of developing mammary cancer of women who experience natural menopause at ages younger than 45.
- Family history: Breast cancer is a common disease so having one relative diagnosed over the age of 40 is not unusual and would not normally suggest that other family members are at increased risk. However, you might have an increased risk of developing the disease if several blood relatives in your family have had mammary cancer or ovarian cancer and may be unknowingly passing a faulty gene down the family line.
- BRCA1 and BRCA2: Women who carry a fault in the BRCA1 or BRCA2 genes have a high lifetime risk of breast cancer, estimated to be in the range of 30-60 per cent, and a lifetime ovarian cancer risk of about 20 per cent. Genetic testing is available for high-risk women who are referred by their doctor.
- Being tall: Studies have found that being 175cm or taller is associated with a slightly increased risk for breast cancer.
- High breast density: Women with dense breast tissue are more likely to be diagnosed with breast cancer than women with less dense breasts. Breast density is measured by mammograms however dense breast tissue and tumours show up as white and bright on a mammogram so a potential tumour could go undiagnosed.
- Ethnicity: Women from different ethnic backgrounds have varying rates of risk for breast cancer. Caucasian and Jewish women are among the highest; Asian women among the lowest rates for mammary cancer.
- Previous breast cancer: Being previously diagnosed with a non-invasive breast condition such as ductal carcinoma in situ (DCIS) or lobular carcinoma in situ (LCIS), is associated with an increased risk of developing invasive breast cancer. In around 30 per cent of all breast cancer cases, cancer will return later in life. This metastatic stage of cancer of the breast is not currently curable.
How research is making a difference to cancer of the breast risk
Breast-cancer researchers are working towards saving lives through more effective treatments and earlier detection, and many are also seeking ways to better understand who is at risk and how this type of cancer can be prevented in the first place.
The NBCF funds research into breast cancer risk and prevention, such as:
- Better knowledge of the impact of lifestyle on mammary cancer risk
- Understanding of risk in order to develop more effective treatments in future
- Gaining a better understanding of the genetic and nongenetic factors that affect mammary cancer, to enable better monitoring, detection and treatment of those at high risk of developing the disease
There are many ways that women can reduce their risk of developing breast cancer and it’s important that these options are known and available across the entire population, regardless of where they live or their socio-economic situation. Professor Kelly-Anne Phillips has developed a web-based tool called iPrevent which is designed to help all Australian women to know their risk so they can take the right steps. NBCF has provided additional fellowship funding to complete the testing and roll-out of iPrevent so that women and their doctors can work together to try to prevent breast cancer.
Dr Kara Britt is studying the cellular and functional changes associated with childbearing to understand how the protective effect of having children works and if it can be replicated. Her research may suggest ways to prevent mammary cancer in the future.
Having dense breast tissue is a risk factor for mammary cancer, although the reasons are not yet fully known. Research to identify the reasons why women of the same age have variations in their breast tissue density will lead to a better understanding of the causes of breast cancer and how to prevent it. Researchers, including Dr Jennifer Stone, are also looking at more effective ways to detect this type of cancer in women with dense breasts.
Less than five per cent of mammary cancer cases can be attributed to an inherited faulty gene, such as BRCA1 or BRCA2, and others that have not yet been identified. Being able to identify women and men with an inherited risk provides them with the information required to make choices that would help them avoid facing a breast-cancer diagnosis. Researchers such as Professor Ian Campbell are investigating the family genetics of this type of cancer to identify inherited genes beyond BRCA so more Australians have that choice.
Early detection of mammary cancer provides the best chance of survival. From knowing your risk of checking for symptoms, it’s important to be informed, aware and proactive.
You can read more about the research NBCF is funding to better understand and improve the outcomes for cancer of the breast here.
Looking for a good Dr start preventing?
At Dee Why Medical Centre, we provide a comprehensive range of services for your medical and healthcare needs. Get to know our General Practitioners:
- Dr Kevin Ng (Male)
- Dr Robyn Maiolo (Female)
- Dr Trudi Ambler (Female)
- Dr Ester Han (Female)
- Dr Conny Harris (Female)
- Dr Michael Halpin (Male)
- Dr Richard Evans (Male)
Risk & Prevention, available at https://nbcf.org.au/about-national-breast-cancer-foundation/about-breast-cancer/what-you-need-to-know/risk-prevention/
NBCF, available at https://nbcf.org.au/
Awareness Month, available at https://canceraustralia.gov.au/healthy-living/campaigns-events/breast-cancer-awareness-month
How research is making a difference to risk, available at https://nbcf.org.au/about-national-breast-cancer-foundation/about-breast-cancer/what-you-need-to-know/risk-prevention/how-research-is-making-a-difference-to-breast-cancer-risk/
Risks factors that can’t be changed, available at https://nbcf.org.au/about-national-breast-cancer-foundation/about-breast-cancer/what-you-need-to-know/risk-prevention/risk-factors-that-cant-be-changed/