Monday, October 22, 2007

Take an active role in fighting breast cancer

Reducing the risk for breast cancer is part healthy living and part vigilance about screening for the disease.
Doctors recommend a colorful, balanced diet of fruits, vegetables and whole grains. But no matter how many blueberries or broccoli bunches a girl eats, there remains some fundamental bad news when it comes to dodging breast cancer.
"The biggest risk factors are being female and getting older, and you can't control those," said Michele Ostrander, executive director of the Houston affiliate of Susan G. Komen for the Cure.
Indeed, 75 percent of women diagnosed with breast cancer's only risk factor is aging, said Dr. Therese Bevers, medical director of the cancer prevention center at University of Texas M.D. Anderson Cancer Center.
But that doesn't mean that women — or men — can't take an active role in fending off the disease, Ostrander said. In general terms, that means stay fit, eat healthy foods, know your risk category, perform monthly self breast exams and get regular mammograms.
"We know when we catch the cancer when it is still in the breast tissue...the survival rate is 98 percent," Ostrander said.
That's the good news.

Risk factors

• Age: "If you look at women diagnosed with breast cancer, the vast majority have no other risk factor," Bevers said.

• Family genes or history: Doctors pay particular attention to close relatives, especially fathers, and mothers, sisters and daughters who had premenopausal cancer.

• Hormones: Periods that started before age 12 or ended after age 55. Women who never had children or had the first child older than 30. Estrogen and progesterone hormone mixes taken for menopause.

• Breast biopsies: It's not so much the biopsies but the condition that required them or a diagnoses such as lobular carcinoma in situ.A run-in with cancer earlier in life is also a risk to consider.

Risk categories and tips

• Average risk: This group has few risk factors, but, well, we are all getting older by the minute. Maintain a body mass index of less than 25. Eat 5 to 9 servings of fruit and vegetables daily. Go easy on the red meat. Exercise at least 45 minutes five days a week since regular exercise can reduce the risk by 10 to 25 percent, Bevers said. Do not drink more than seven alcoholic drinks a week. Minimize use of hormone therapies for the symptoms of menopause.

• Increased risk: This group has more risk factors including a prior history of breast cancer, breast biopsies, or diagnoses such as lobular carcinoma in situ. Reduction tips include drug therapies. There are serious risks and varying opinions about the efficacy, so patients should consult their doctors and carefully make a decision. For some patients, drugs such as tamoxifen or raloxifene, recently FDA approved, can reduce risk, Bevers said.

• High risk: Group includes carriers of an abnormality in the breast cancer genes, and family history, especially of a mother or sisters with premenopausal breast cancer. For women at really high risk levels, running, eating spinach and abstaining from alcohol probably won't tip the scales much. But they can't hurt, doctors said. In addition to drug therapies, doctors and patients also consider prophylactic mastectomy, said Dr. Banu Arun, associate professor of breast medical oncology and co-director of clinical cancer genetics at M.D. Anderson. "It comes down to the patient's preference and choice," she said. "We are there to give them the facts in detail."

Komen's screening guidelines

• Age 20: Monthly self breast exams. Know your body.

• Age 20-39: In addition to self exams, exam by a physician every three years.

• Age 40: Mammography annually

• Note: Those at high risk should have a clinical breast exam every six months, MRI screening and ovarian screening.

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