The American Cancer Society predicts 34,170 new cancer cases in Texas this year. Of those, 2, 480 are expected to be breast—in third place, following lung (9,920 cases expected), and colon/rectum (3,220). Nationally, 26% of new cancer diagnoses—178,480—will be breast, accounting for one-third of all cancers in women. Warnings about environmental toxins, the dangers of inadequate diet and nutrition, and risk factors associated with family history abound. Combined with dismal statistics on the declining number of those able to afford individual health insurance—25.1% in Texas are uninsured—it can all seem more than a little overwhelming.
The lifetime risk of being diagnosed with breast cancer is approximately one in eight, or 13.2%. Risk substantially increases with age, genetic tendencies, family history, personal medical history, and obesity. A woman in her thirties has only a 1 in 229 (0.4%) chance of being diagnosed, while a woman in her sixties has a 1 in 26 chance (3.8%). Survival rates for cancer increase with proper screening, early detection, and quality treatment (which, in turn, increases with health insurance coverage). These low percentages overall seem unconcerning, very low, in fact, but when we stop to consider what this means in actual numbers, or the fact we probably know someone affected by the disease, it hits closer to home.
Susan G. Komen for the Cure, along with the American Cancer Society and other non-profit groups, are helping women in Texas and across the country take control of their health by reducing risk factors. Women of all ages are fighting back with knowledge, support groups, and a push for healthier lifestyles. One can substantially reduce risk by becoming aware of, and adjusting for, personal vulnerabilities to the disease and establishing healthy habits. The younger the better, and young women are becoming more and more aware.
Many still believe that what puts a woman primarily at risk is genetic tendency (i.e., family history), but this simply isn't true. Only 5-10% of cases are linked with the BRCA genes, and only 30% of women with breast cancer have a family history of it. While certain uncontrollable factors significantly contribute to its incidence—including family history, early onset of menarche (having the first period before 12), late onset of menopause, the first full-term pregnancy after 30, hormone use, and being over 5'3"—a woman can reduce her risk, family history or not, by following a healthy lifestyle and making certain key medical decisions.
Obesity and physical activity are among those controllable risks. Weight gain of more than 20-30 pounds after 18 is of particular note. An obese woman has a higher risk of getting breast cancer, as do physically inactive women. The belief is that higher fat content produces more estrogen in the body, which, in turn, increases risk.
In 2005, Texas reported 27% of its residents as obese, above the national average of 24.4%. Recent studies of children in Dallas, Houston, and other cities across the state indicate troublingly high percentages of obesity in those under 18, as well. A child with unhealthy lifestyle habits has a higher chance of retaining those unhealthy habits as an adult, which, in turn, puts that adult at higher risk for certain cancers and chronic conditions. Establishing regular exercise and smart diet choices as early as possible in young women not only reduces the risk of breast cancer, but also improves overall well-being. A consistent physical regimen, producing an elevated heart rate for thirty or more minutes, several times a week, will decrease chances of not only breast cancer, but also many other diseases.
Estrogen exposure is another reason behind the slight increase of breast cancer in women taking (and shortly after taking) the birth control pill, as well as the risk associated with women participating in HRT (hormone replacement therapy), particularly after menopause. While short-term use of these hormones has been associated with reduced danger, anyone considering these treatments would be wise to weigh all the pros and cons before beginning.
Alcohol consumption increases cancer risk. Even a few drinks a week could affect one's chances, but, in general, physicians say not to worry too much about enjoying a glass of wine or the occasional beer. Data suggests that the biggest concern over alcohol is its overuse; alcohol affects the way the liver processes estrogen.
Larger breasts, as well as asymmetrical breasts, may work against a woman, and choosing not to nurse may also increase the chances of getting breast cancer. Why nursing can dramatically influence risk—reducing it by as much as 50%--is not exactly known, but studies have shown that women who breastfeed several children, for extended periods, gain the greatest benefits.
Overall, it can be a little frightening. Cancer is one of the leading causes of death in the United States, and, with so many women being diagnosed with breast cancer alone every year, it's hard not to become overwhelmed. But we're fighting back, and young women are becoming more aware every day of what they can do to reduce their chances. Exercise, reduce stress, don't drink too much alcohol, nurse if possible, and, for goodness sake's, monitor yourself. If you're without individual health insurance and find it difficult to go for annual exams (which should include a breast exam), do everything you can to get it. In the end, it's up to you to take control and to fight back.
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