Let’s talk about breast cancer and how you should start to think about it no matter your age — specifically the ways you should start to understand the associated risk factors and how to talk about them with your physician.
1. It’s not all in the family
Contrary to popular belief, only 5 to 10 percent of breast cancers can be attributed to known single, high-risk inherited genetic mutation, like BRCA1 or BRCA2. That means the other 90 percent is mostly due to a combination of risk factors: some you can control and some you cannot. Each person is unique and so is her or his risk of developing breast cancer. New discoveries of moderate-risk genes may help guide the care of some families. If you have a family history of breast cancer, speak with your doctor to get the best advice on the role of genetic testing, the best strategies for early detection, and the preventive steps you should take.
2. You can lower your risk
There are a lot of myths about risk, like antiperspirants and bras increasing your odds of developing breast cancer. Neither of these things is a proven cause of breast cancer, and there is no evidence to support that either increases your lifetime risk. But there are five things you can do to lower your risk: maintain a healthy weight, exercise three to five hours a week, eat a mostly vegetarian diet, limit alcohol to fewer than three drinks per week and avoid smoking. Avoiding hormone replacement therapy after menopause is also important.
3. Adolescence impacts adulthood
Things that happen to us while our breasts are developing can have lasting effects on our risk of developing breast cancer later in life. These risk factors include having radiation to the chest or face before age 30 as treatment for acne or another cancer, being diagnosed with a benign breast condition, or early onset of menstruation at age 12 or younger. Significant exposure to chemicals found in pesticides, food, plastic and personal beauty products may contribute to abnormal breast cell activity and may affect breast cancer risk.
4. Density matters
No, we’re not talking about how heavy or firm your breasts are. Dense breasts have less fatty tissue and more non-fatty tissue compared to breasts that aren’t dense. The radiologist reading the mammogram reports the amount of density. Research has shown that dense breasts can be six times more likely to develop cancer and make it harder for mammograms to detect it. If you’ve been told you have dense breasts by your doctor, have a conversation about all of your risk factors, ask about the role of genetic testing and adhere carefully to a screening plan. Discuss screening options with your doctor and look for a center that offers 3-D mammograms.
5. Risk changes over time
The two biggest risk factors for developing breast cancer are being a woman and aging. That means your risk of developing breast cancer today is not the same as it will be tomorrow. Your doctor should start the conversation about risk when you’re in your twenties (if they don’t, you should), and it should continue over the course of your lifetime. Family history, medications, pregnancies, hormones and more all affect your lifetime risk — and they can all change over time. Keep your doctor in the know about what’s happening in your life.