By Patrice Cleveland
Lowering your Cancer Risk
There are lots of factors that contribute to your risk of breast cancer, not just genetics or family history. Lower your risk for breast cancer by following these tips from the Centers for Disease Control and Prevention.
Keep a Healthy Weight
Try to keep your body mass index, or BMI, at between 18.5 and 24.9. This is a ratio or your weight to height, but it may not be accurate for all body types. This is particularly true after menopause, the Susan G. Komen Foundation says. Talk to your health care professional about an ideal weight for you.
Physical activity helps you maintain a healthy weight, reduces risk of cardiovascular disease and diabetes, lowers your blood pressure, reduces your risk for stroke, can ease arthritis pain and reduce depression and anxiety. Get at least 150 minutes of moderate activity or 75 minutes of vigorous aerobic activity per week. Talk to your doctor before you begin an exercise regimen.
Limit Alcoholic Drinks
Alcohol consumption raises the risk of cancer proportional to the amount of alcohol consumed, the CDC says. That means that the more you drink, the more at risk you are for breast cancer and other cancers. Limit drinks to one per day.
Hormone Replacement Therapy and Oral Contraceptives
Women who take these kinds of replacement hormones can affect your risk of breast cancer. Talk to your health care provider about the type of therapy or birth control you take and the associated risks.
Breastfeed Your Children
Mothers who breastfeed their children have a lower risk of breast cancer, ovarian cancer, type 2 diabetes and high blood pressure. The longer a woman breastfeeds, the greater the benefit. Women who breastfed for a lifetime total of more than two years got the most benefit from the practice, the Susan G. Komen says. Breastfeeding may be particularly good at lowering the risk of estrogen receptor-negative cancers, which do not need hormones to grow.
If you have a high risk of breast cancer, there are options, Susan G. Komen says. These include risk lowering drugs such as tamoxifen or raloxifene or a prophylactic mastectomy. Talk to your doctor if you think these options are right for you.
Stages of Breast Cancer
You may have heard someone talk about their cancer in stages. This is the level of progression to which the cancer has spread. The stage of the cancer at detection often determines the treatment.
In breast cancer, the stage is based on the size and location of the primary tumor, the spread of the cancer, the tumor grade and whether certain biomarkers are present, the National Cancer Institute says. After you receive your diagnosis of breast cancer, doctors will perform tests such as biopsies, X-rays and various scans to see how far it’s spread.
Cancer can spread through tissue by growing into nearby areas, through the lymphatic system by spreading through lymph vessels to other parts of the body or through the blood. When cancer spreads to another part of the body, it’s called metastasis. The metastatic tumor is the same kind of cancer as the primary tumor. If breast cancer spreads to the bones, it’s metastatic breast cancer, not bone cancer.
There are three types of breast cancer stage groups. The clinical prognostic stage is the first stage for all patients based on health history, physical exam, imaging tests and biopsies. Mammography or ultrasounds can be used to check the lymph nodes for signs of cancer. In the pathological prognostic stage, patients have surgery as their first treatment. It’s based on clinical information, biomarker status and lab results. The anatomic stage is based on the size and spread of the cancer. It’s used in parts of the world where biomarker testing is not available, which doesn’t include the United States.
The TNM system — tumor, lymph node, metastatis — is used to describe cancers, including breast cancer. T values refer to the size of the tumor and range from TX, meaning the tumor can’t be assessed, to T4, meaning the tumor has grown into the skin or chest wall or is inflammatory. N values refer to the size and location of lymph nodes where the cancer has spread. When the lymph nodes are checked using mammography or ultrasound, it’s called clinical staging. M values show if the cancer has spread to other parts of the body. M0 means it hasn’t; M1 means it has. Breast cancer most often spreads to the bones, lungs, liver or brain. This system, along with grading that describes how quickly the tumor is likely to grow and spread, and biomarker testing is used to determine the breast cancer stage and the treatment of the cancer. Your doctor will be able to explain how your cancer was staged and discuss treatment options going forward.
Triple-negative breast cancer is a form of breast cancer that doesn’t have receptors commonly found in breast cancer: estrogen, progesterone and human epidermal growth factor, or HER2.
If your cancer has any of these receptors, doctors have an avenue for treatment they can use to help destroy the cancerous cells. But with triple-negative breast cancer, doctors must look to other treatment options, such as chemotherapy.
Triple-negative breast cancer tends to be more aggressive and have a poorer prognosis than other breast cancers and the cancerous cells tend to resemble healthy breast tissue.
Who Can Get It?
Anyone can get triple-negative breast cancer, but it tends to affect more younger people, Black and Hispanic women and people with a BRCA1 mutation. About 10-20% of breast cancers are triple-negative breast cancers.
Types of Treatment
Without these receptors to reach the cancer cells, doctors turn to other forms of treatment. The first step is usually to have the tumor removed – a lumpectomy – or the whole affected breast removed – a mastectomy. These surgeries are usually followed by radiation therapy, where high-energy radiation is given to your breast to kill any remaining cancer cells. Chemotherapy can kill any cancer cells that have spread elsewhere in the body and lowers the chance that cancer will recur.
These treatments, though they may be successful, aren’t without side effects. The Centers for Disease Control and Prevention says to expect hair loss, nausea, tiredness and skin changes. There are new treatments that may be able to help with hair loss from chemotherapy; talk to your doctor if losing your hair is a concern. Chemotherapy can also cause nausea, but your doctor can give you medication to help. Fatigue is associated with both chemotherapy and radiation. It will subside a few weeks after your therapy ends. There may also be skin changes with radiation, including redness or peeling like with a sunburn.
People of Ashkenazi Jewish heritage have a higher risk of certain types of cancer, including triple-negative breast cancer. Genetic testing followed by genetic counseling can help you determine a course of treatment and risk management both for you and your family.