Many factors influence risk for breast cancer - Anderson Independent Mail

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Q I read your column on testing for the breast cancer gene, but I'm unsure what the other things I should worry about. As far as I know, there is no family history. — A.T., Seneca

A The good news with breast cancer is that improved screening techniques and an emphasis on educating women on the importance of self-breast examinations and mammography have resulted in better results from treatments. When women find something suspicious on a self-breast exam, they can initiate a discussion with their doctor, seek a mammogram and find out what is happening. Tumors are being found earlier, which means that the cancer tumor is more likely to be successfully treated.

Risk factors are those things that make it more likely that someone may develop a disease — in this situation, breast cancer. Some risk factors are things that you can do nothing about, such as having the BRCA1 or BRCA2 genes. Other risk factors are behavioral or environmental, and those factors may be things that you can change and improve your chances of avoiding breast cancer.

Risk factors that cannot be changed include: being female, aging, family history, starting your periods before age 12, reaching menopause after 55 and your race or ethnic group.

Factors that you may influence or change may be your weight, alcohol consumption, diet and use of hormone replacement therapies.

Women are more likely than men to develop breast cancer, and as you age the risk increases. Women older than 55 are at higher risk than those younger, which is why the recommendations for annual mammograms changes as you age. If you know that your family has a history of breast cancer, then you are better prepared to be observant and to participate in regular screening programs. We cannot change when our menstrual cycles begin or end, but when you add the knowledge to other bits of information it may help you understand your personal risk.

However, you can change your diet to avoid high fat content and to increase your vegetables, and limit your alcohol consumption to one drink per day. You may want to explore options for losing weight if you are overweight. Fat tissue produces estrogen. Hormonal replacement therapy (HRT) that combines estrogen and progesterone has been associated with an increased risk of breast cancer. You and your physician can explore alternatives to HRT or limited use.

The National Cancer Institute (part of the National Institutes of Health) reports that the highest overall incidence of breast cancer occurs in white, non-Hispanic women. Korean American women have the lowest incidence of breast cancer. African-American women have the highest incidence of breast cancer between the ages of 40 and 50 and also have the highest death rate.

The death rate among African-American women is concern for all health care providers. At the time of diagnosis, African-American women have more advanced stages of breast cancer. While earlier screening and self-breast examinations have decreased the overall death rate from breast cancer because of early detection and early stages when treatment is begun, the African-American community continues to have late-stage disease at diagnosis. It is important that the community begin to address the factors that limit African-American women from seeking and/or participating in screening programs and accessing health care options earlier.

25 Sep, 2011

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