If I asked you to name the one disease that most women fear these days,
you would probably reply "breast cancer". And you'd be right!
The media are deluging women with menacing statistics about
the likelihood of developing breast cancer. It's hard to know whether to
rush off immediately to get a mammogram, to swear off ice cream and prime ribs forever, or to just sit back and hope the odds are in your favor. Being 43, childless, an avid reader on women's health, and a women's doctor, I'm in the same boat. I've had to sort out for myself the best way to limit my chances of developing breast cancer. I'd like to share with you what I've learned so that you can protect yourself to the greatest extent possible from finding yourself with the tough choice about how to deal with breast cancer.
What are the facts? Breast cancer is the leading cause of death for women aged 35 to 50 in the United States. An individual woman's risk of developing breast cancer in this country is about one in ten. Approximately 130,000 women are diagnosed with breast cancer each year in the United States. About 25-35% of these women die from their cancer. The incidence of breast cancer increased by 23% from 1947 to 1975 and by another 21% from 1975 to 1985. Women over 50 have up to a ten times higher risk of breast cancer than those under 50. Between 1975 and 1986, the incidence has increased by about 23% for women over 50 and by 9% for women under 50. Native Hawaiian women have the highest incidence of breast cancer, followed by whites, then blacks. Asian and Pacific Island women, along with Hispanics in New Mexico, are somewhere in the middle. Native American women have the lowest incidence of breast cancer. Studies of Polish and Japanese women show their risk of breast cancer to be significantly higher if they migrate to the United States than if they stay in their native countries.
What is my risk of breast cancer? l) Family history - Your chance of getting breast cancer doubles if your mother or sister had it.The risk is even greater if more than one of your immediate relatives had it. 2) Menarche and menopause- - The longer you continue to have menstrual periods, the higher the chance of getting breast cancer. Women whose menarche (onset of menses) began after age 13 and who experience menopause before 45 have the lowest risk. This suggests that a prolonged, uninterrupted presence of high levels of estrogen in the body may predispose to breast cancer. Women who have anovulatory cycles due to anorexia, obesity, or other reasons, may actually be somewhat protected against breast cancer. 3) Pregnancy - Women who are nulliparous (have not borne children) or whose first full-term pregnancy occurs after age 30 are two to five times more likely to develop breast cancer than women whose first pregnancies occured before age 18. Abortions or miscarriages, though they do interrupt the menstrual cycle, do not appear to offer protection against breast cancer. 4) Hormones - There is a strong suspicion among many people, including myself, that taking estrogen, either in the form of birth control pills or as estrogen replacement therapy after menopause, may increase the risk of developing breast cancer. There is not yet conclusive scientific evidence to back this up. It is common practice to give progesterone along with estrogen in postmenopausal women who still have their uteruses. This is because estrogen replacement alone may cause cancer of the uterus and progesterone has been shown to decrease this risk. One recent study of 23,000 women in Sweden found the women who were given progesterone along with the estrogen to have a four times higher incidence of breast cancer. 5) Dietary fat - There seems to be an increasingly stronger correlation between a high intake of dietary fat and breast cancer. The United States, the Netherlands, and Great Britain, which all have very rich diets, also have the world's highest rates of breast cancer. Japan and Romania, both having lean diets, have one-sixth to one-half the rate of the United States. 6) Weight - Excess body weight and caloric intake definitely predispose to breast cancer. 7) Alcohol - Alcohol consumption of more than one drink of beer, wine, or liquor a day has been as-sociated with a 40% increase or risk of breast cancer. 8) Fibrocystic breasts - This factor may be overrated in regards to breast disease. It appears that only certain types of cystic breasts, as confirmed by mammogram rather than just a breast exam, actually result in a greater risk of breast cancer. 9) Caffeine - Many women find their breast cysts to go away when they remove caffeine from their diets, however there is no evidence yet that women who have high caffeine intakes are more likely to develop breast cancer.