SEMINAR - DEC 7, 2005

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At our last meeting, Jollean shared with us her story of being diagnosed with breast cancer and having a double mastectomy…. and the importance of early detection. Pam from the Screening Mammography Program of BC gave us information about mammograms. They are located in the Madrona Clinic and the phone number is (250) 716-5904. If you are a woman over 40 and you have not had a mammogram – I urge you to go – Pam and her team there are very good and make you comfortable and informed about the procedure. I have had 4 mammograms and they seem to get a bad rap that it hurts, what we learned from Pam is that it depends on your breast density not size of whether or not it may be a little uncomfortable. For me it did not hurt at all – it was uncomfortable for a short period – maybe a couple of minutes. But ladies you have to remember that if they do detect something – early detection may save your life. Information on breast self-examination was also given. You should be doing those at least once a month. For more information you can go to the following websites:

www.bccancer.bc.ca/breastscreening / Madrona clinic – 716-5904
www.cancer.ca
www.breastcancer.org

Here is some extra information about Breast Cancer:

Myths About Breast Cancer

What is your risk of breast cancer? Which breast cancer treatment is right for you? What about antiperspirants and breast cancer?

What you don't know CAN hurt you. Misinformation can keep you from recognizing and minimizing your own risk of breast cancer or getting the very best possible care. Arm yourself with the facts.

Here are ten common myths about breast cancer, followed by myths about specific types of breast cancer treatment.

1. Breast cancer only affects older women.

No.

While it's true that the risk of breast cancer increases as we grow older, breast cancer can occur at any age. From birth to age 39, one woman in 231 will get breast cancer (<0.5% risk); from age 40–59, the chance is one in 25 (4% risk); from age 60–79, the chance is one in 15 (nearly 7%). Assuming you live to age 90, the chance of getting breast cancer over the course of an entire lifetime is one in 7, with an overall lifetime risk of 14.3%.

2. If you have a risk factor for breast cancer, you're likely to get the disease.

No.

Getting breast cancer is not a certainty, even if you have one of the stronger risk factors, like a breast cancer gene abnormality. Of women with a BRCA1 or BRCA2 inherited genetic abnormality, 40–80% will develop breast cancer over their lifetime; 20–60% won't. All other risk factors are associated with a much lower probability of being diagnosed with breast cancer.

3. If breast cancer doesn't run in your family, you won't get it.

No.

Every woman has some risk of breast cancer. About 80% of women who get breast cancer have no known family history of the disease. Increasing age – just the wear and tear of living – is the biggest single risk factor for breast cancer. For those women who do have a family history of breast cancer, your risk may be elevated a little, a lot, or not at all. If you are concerned, discuss your family history with your physician or a genetic counselor. You may be worrying needlessly.

4. Only your mother's family history of breast cancer can affect your risk.

No.

A history of breast cancer in your mother's OR your father's family will influence your risk equally. That's because half of your genes come from your mother, half from your father. But a man with a breast cancer gene abnormality is less likely to develop breast cancer than a woman with a similar gene. So, if you want to learn more about your father's family history, you have to look mainly at the women on your father's side, not just the men.

5. Using antiperspirants causes breast cancer.

No.

There is no evidence that the active ingredient in antiperspirants or reducing perspiration from the underarm area, influences breast cancer risk. The supposed link between breast cancer and antiperspirants is based on misinformation about anatomy and a misunderstanding of breast cancer.

6. Birth control pills cause breast cancer.

No.

Modern day birth control pills contain a low dose of the hormones estrogen and progesterone. They have not been associated with an increased risk of breast cancer. The higher-dose contraceptive pills used in the past were associated with a small increased risk, in only a few studies. Today's birth control pills can provide some protection against ovarian cancer.

7. Eating high-fat foods causes breast cancer.

No.

Several large studies have not been able to demonstrate a clear connection between eating high-fat foods and a higher risk of breast cancer. Ongoing studies are attempting to clarify this issue further. We can say that avoidance of high-fat foods is a healthy choice for other reasons: to lower the "bad" cholesterol (low-density lipoproteins), increase the "good" cholesterol (high-density lipoproteins); to make more room your diet for healthier foods, and to help you control your weight. Excess body weight, IS a risk factor for breast cancer, because the extra fat increases the production of estrogen outside the ovaries and adds to the overall level of estrogen in the body. If you are already overweight, or have a tendency to gain weight easily, avoiding high-fat foods is a good idea.

8. A monthly breast self-exam is the best way to diagnose breast cancer.

No.

High quality, film-screen mammography is the most reliable way to find breast cancer as early as possible, when it is most curable. By the time a breast cancer can be felt, it is usually bigger than the average size of a cancer first found on mammography. Breast examination by you or your healthcare provider is still very important. About 25% of breast cancers are found only on breast examination (not on the mammogram), about 35% are found on mammography alone, and 40% are found by both physical exam and mammography. Keep both bases covered.

9. I'm at high risk for breast cancer and there's nothing I can do about it.

No.

There are several effective ways to reduce—but not eliminate—the risk of breast cancer in women at high risk. Options include lifestyle changes (minimize alcohol consumption, stop smoking, exercise regularly), medication (tamoxifen, also called Nolvadex); and in cases of very high risk, surgery may be offered (prophylactic mastectomies, and for some women, prophylactic ovary removal). Be sure that you have consulted with a physician or genetic counselor before you make assumptions about your level of risk.

10. A breast cancer diagnosis is an automatic death sentence.

No.

Fully 80% of women diagnosed with breast cancer have no signs of metastases (no cancer has spread beyond the breast and nearby lymph nodes). Furthermore, 80% of these women live at least five years, most longer, and many live much longer. Even women with signs of cancer metastases can live a long time. Plus promising treatment breakthroughs are becoming available each day.

Individual Risk Factors

Growing older is the biggest risk for breast cancer. The longer you live, the higher your risk:

• From birth to age 39, 1 woman in 231 will get breast cancer (<0.5% risk).

• From ages 40–59, the chance is 1 in 25 (4% risk).

• From ages 60–79, the chance is 1 in 15 (nearly 7%).

The chance of getting breast cancer over the course of an entire lifetime, assuming you live to age 90, is one in 7, with an overall lifetime risk of 14.3%.

Risk increases with age because the wear and tear of living increases the chance that a genetic abnormality, or "mistake," will develop that your body doesn't find and fix.

Personal history of breast cancer is a risk factor for breast cancer recurrence or the formation of a new breast cancer. In other words, if you have already been diagnosed with breast cancer, your risk of developing it again is higher than if you had never had the disease. The risk is about 1% per year, so that over a 10-year period, your risk would be about 10%. However, there is medication available to help you reduce that risk.

Family history of breast cancer can have a significant impact on your risk, but don't automatically assume that any case of breast cancer in your family means you are a high-risk candidate. For example, if your grandmother was diagnosed with breast cancer at age 75, this does NOT mean your risk of the disease is increased. Your grandmother was most likely just one of the 1 in 15 women in that age bracket who gets breast cancer from the wear and tear of aging.

Other patterns of family history may strongly suggest an inherited gene abnormality that is independent of normal aging, and is associated with a relatively higher risk of breast cancer. The following signs suggest that there may be an inherited gene abnormality in your family (These apply to either your mother's OR your father's side of the family):

• having a mother, sister, or daughter with breast cancer,

• having multiple generations of family members affected by breast or ovarian cancer,

• having relatives who were diagnosed with breast cancer at a young age (under 50 years old),

• having relatives who had both breasts affected by cancer.

You can inherit a breast cancer gene abnormality from your mother OR your father. If one of your parents has a gene abnormality, you have a 50% chance of inheriting the gene from him or her. If you do inherit a gene abnormality, your risk of developing the disease depends on the specific abnormality found, the pattern of its behavior in your family, plus the uniqueness of your own body. The risk of breast cancer in these families ranges greatly—from 40–80% over the course of a lifetime. Keep in mind that breast cancer caused by an inherited gene abnormality is not necessarily any more severe or less treatable than other types of breast cancer.

Certain types of breast cancer gene abnormalities are also associated with a higher risk of ovarian cancer (from 20–60%).

Genetic counseling can help you better define and understand the significance of your own family history.

Lower Your Risk

A tremendous amount of promising research is under way to determine the cause of breast cancer and to establish effective ways to prevent it. Still, doctors can't always explain why one woman develops breast cancer and another doesn't.

Everyone seems to know someone with breast cancer, and we wonder whether we, too, will be affected during our lifetime. All of us want to do everything we can to reduce the chances of ever getting the disease. Right now, though, we just don't know enough about what causes breast cancer and we haven't yet figured out how to keep it from happening—so we can't say that we can “prevent” it.

However, researchers are working to learn how our “external” and “internal” environments may work separately and together to affect our health and possibly the risk of developing breast cancer. “Internal environment” means the things inside our bodies that influence our health, such as genetics (the genes you got from your mother and father), hormones, illnesses, and feelings and thoughts. “External environment” refers to the things outside of our bodies that influence our health, such as air, water, food, danger, music, noise, people, and stress. Also, the external environment enters our internal environment every day—think of the food you eat, water you drink, air you breathe (including whether you smoke or not), and medicines you take. More subtlety, there's the way you “breathe in” or absorb your environment, such as your home or workplace, and the way you take in energy from the people you spend time with.

Some of these factors, such as your genetic makeup and the medicines that you take, have a very direct effect on your breast health. The impact of other, indirect factors, such as air quality, exercise, meditation, and spending time with friends, is less well understood.

Anything that INCREASES your chance of developing breast cancer is called a risk factor. Anything that REDUCES your risk of developing breast cancer is called a protective factor.

You can control some risk factors. For example, if you are overweight, you can seek to lose excess pounds, which may reduce your risk of breast cancer. You can also make informed choices about the medicines you take.

But other factors are beyond your control. For instance, you can't change your gender. Women are much more likely than men to have breast cancer. This is mostly because women have more estrogen and progesterone in their bodies. These hormones stimulate breast cell growth—both normal and abnormal. Also, you can't stop growing older. Aging is the biggest risk factor for breast cancer (besides being a woman).

Risk reduction means making choices to avoid or minimize any possible risk factors that you can. It also means increasing the protective factors in your life so your chances of developing breast cancer are lower.

Although you can control many risk factors, remember that doing so does not guarantee zero risk. It is also important to keep in mind that many women who have a particular risk factor for breast cancer never develop it.

Knowledge is power. Instead of living under the shadow of myths and misunderstandings, KNOW your own realistic level of risk. Then you can talk to your doctor about ways to lessen controllable risk factors and boost your protective factors.

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