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| Everyone is aware these days that mammograms can detect breast cancer at its earliest, curable stages, but are there any ways to prevent it? There are no simple methods of avoiding breast cancer. Certain factors increase overall risk and others decrease it. Some can be changed and others cannot. The best strategies involve knowing an individual’s risk factors and modifying the ones that can be. Lifetime estrogen exposure is the most recognized risk factor linked to breast cancer. The total number of years of exposure over a woman’s reproductive life directly relates to her overall risk. First menstrual period, starting at age 12 or younger, and menopause, starting after age 55, are well-established risk factors for breast cancer. We cannot change when a woman first starts her menstruation or when it stops, but minimizing hormone use beyond the natural menopause can reduce a woman’s overall risk. A maximum of no more than 5 to 10 years of hormone replacement is recommended, and avoidance is preferable. Having more than two children, your first child birth at an age less than 24 years old and breastfeeding for a total of at least two years, have been shown to be protective against breast cancer; however, these factors are often beyond a woman’s control. Modern birth controls pills and fertility treatments have been proven not to increase the risk of breast cancer. Exercise and avoiding obesity can reduce overall risk, as well as avoiding tobacco and heavy alcohol consumption (less than two drinks per day). Women with a strong family history or abnormal biopsies are candidates for estrogen blocking therapy for risk reduction, but this should be decided with a physician on a case-by-case basis. Several tools are available to your physician for calculating your chances of developing breast cancer. These tools can indicate if you are at a substantially increased risk. Many of these rely heavily on family history, and it is important to remember that 80% of newly diagnosed breast cancer occurs in women with NO family history. If you do have a parent, sibling or child with breast cancer, this well-established factor justifies increased surveillance. Talk with your physician about your personal risk at your next visit.
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Kelly S. Dempsey, MD, FACS Specializing in Breast Care and Diseases of the Breast.