By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

BREAST CANCER SCREENINGS KEY TO BEING A SURVIVOR, NOT A VICTIM

Question: Recently several women at work have been diagnosed with breast cancer. Fortunately it was found early, and they should all do well after surgery, chemotherapy and possibly radiation. I am worried because they are each about 10 years younger than I am. I thought breast cancer was a post-menopausal disease. Can you give me more information about what can be done to prevent this cancer?

Answer: After skin cancer, breast cancer is the most common cancer in women. In 2005 there were 211,400 women diagnosed with breast cancer. When we discuss breast cancer, it is often forgotten that we women are not the only ones who can suffer from it. Though accounting for less than 1 percent of all cases, men can and do get breast cancer. In actual numbers, there were 1,690 men diagnosed in 2005.

You are correct that breast cancer in women is most common after menopause. However, to put this in perspective, breast cancer is also the most commonly diagnosed cancer in women under the age of 35.

Indeed, there are several risk factors for breast cancer besides age. A very important one is genetics. Many cases seem to be inherited, and this genetic tendency is something you can’t really modify. That is why a family history in a close female relative, like a mother, sister or daughter, is a reason to start mammogram screening at a younger age than someone who doesn’t have that particular risk factor. Some other risk factors are having started your period at a young age, having a very late menopause, being older when you have your first child or having no children at all.

Certain specific behaviors -- most of which you have control over -- can also increase your chances of developing breast cancer. These behaviors include overeating that leads to excessive weight, long-term use of hormone replacement therapy (HRT), using oral contraceptives, heavy drinking and not getting regular exercise. Also, if you have a baby, not breastfeeding can increase your risk.

Many things can help lower your risk of getting breast cancer. Keep your weight down by making healthy food choices. Limit your alcohol intake. Regular exercise, in itself reduces the risk of developing breast cancer, and also helps with maintaining a healthy weight.

There are benefits from HRT for most women, but you should discuss with your physician the impact taking hormone medications might have on your individual breast cancer risk. HRT should only be used if the benefits outweigh the risks.

As you can probably deduce from my earlier discussion of the genetic link in breast cancer, it’s very important that you know your family medical history. Some people don’t like to talk about cancer and what relatives have died from, but this is important for you and your children. Get your family to talk about these things; they matter.

Finally, despite your best efforts, you may still develop breast cancer. If that happens, regular screenings can make you a survivor rather than a victim. Early diagnosis is always a key to conquering any cancer. Essential parts of your screening include monthly self-breast exams, annual exams by your physician and mammograms that are appropriate for your age group and family history. If finances are keeping you from getting a mammogram, check in your community to see if there is a free clinic or an organization that helps pay for mammograms.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.