Act Now Against Breast Cancer

Screening saves lives—and there’s more you can do to reduce your risk, as two Bergen-based doctors explain. By Darius Amos

In 1985, the national breast cancer death rate reached nearly 33 per 100,000 women, the highest it had ever been, according to the U.S.

Department of Health and Human

Services Office on Women’s Health.

That year brought a new focus on the disease, as the American Cancer

Society (ACS) and other groups designated October as National Breast

Cancer Awareness Month. Since then, the mortality rate has gradually decreased.

The statistics are improving, but they are still distressing. It’s estimated that one of every 39 women will die of breast cancer and about 287,850 new cases of invasive breast cancer will be diagnosed in women this year, says the ACS, adding that there are roughly 3.8 million breast cancer survivors in the U.S.

Advances in technology, early detection and awareness (remember to wear those pink ribbons this month) are the primary reasons survival rates have improved. Yearly mammograms and screenings for specific age groups and demographics have become the norm, as has self-testing. And there’s a greater recognition of known contributors to cancer such as environment and genetics.

But outside of testing, there are other things you can do now to help curb your risk of developing breast cancer. Taking control of body weight and estrogen is important, especially for postmenopausal women, says Mindy Goldfischer, M.D., chief of breast imaging and medical director of The Leslie Simon Breast Care and Cytodiagnosis Center at Englewood Health.

“Prolonged exposure to estrogen after menopause poses an increased risk for certain types of breast cancer,” she says. “As fat cells store and produce estrogen, increased levels of fat cells also elevate estrogen levels, leading to a higher risk for this kind of breast cancer after menopause. The good news is that studies have shown that sustained weight loss, even a modest amount, can reduce the risk of developing breast cancer.”

The combination of a healthful diet with proper exercise can reduce the number of fat cells in the body. While there are no specific foods that have been conclusively linked to reducing breast cancer, Dr. Goldfischer notes that many nutritionists recommend a Mediterranean diet—and Vitamin D3 has been associated with decreased breast-cancer risk. Maintaining a sound diet, of course, also means curbing alcohol intake. It’s true that red wine contains antioxidants that may promote heart health, but consumption of any alcoholic drink should be in moderation.

“We’ve all seen headlines pronouncing that a glass of wine a day is good for your heart, but any more than that is not recommended for maintaining a healthy

lifestyle,” Dr. Goldfischer says, advising that women should limit themselves to one drink per day (one 12-ounce beer, 5 ounces of wine or 1.5 ounces of liquor). “To the extent that alcohol contributes to weight gain—and therefore increased estrogen levels—it is a risk factor for developing breast cancer.”

“The best line of defense against breast cancer is for women to know their risks and take action accordingly, because early detection is an important factor in an individual’s prognosis following a cancer diagnosis.”

—Mindy Goldfischer, M.D., Englewood Health

DEALING WITH HORMONES

New and expectant mothers can take an extra step in their breast cancer prevention efforts. Breastfeeding has long been associated with a decreased risk of breast cancer, as it can lower estrogen levels, says John Kollar, D.O., chair of surgery at Bergen New Bridge Medical Center.

“The longer someone breastfeeds, the more the risk of developing breast cancer decreases,” he says. That’s because breastfeeding can “trick the body” into thinking it’s still pregnant, a period when a woman can produce lower levels of estrogen.

In addition, women who breastfeed tend to eat more nutritious food and follow a healthy lifestyle, a good reason why the activity has also been linked to lowering the risk of type 2 diabetes, endometrial cancer and ovarian cancer.

But many depend on estrogen as they age, as the hormone can help ease some symptoms of menopause and decrease one’s risk of certain health conditions such as osteoporosis, heart disease, stroke and dementia. Postmenopausal women create estrogen and progesterone at lower levels, so many opt to receive hormone replacement therapy to boost production.

“That’s why the use of hormone therapy is a decision best made on an individual basis, as there are many risks and benefits to weigh,” Dr. Kollar says. For those concerned, he suggested exploring alternatives such as nonhormonal therapies and herbal supplements.

KNOW YOURSELF

The best defense against breast cancer is recognizing your own risk, especially for women when they turn 30. That’s the age that the American College of Radiology and the Society of Breast Imaging recommend a comprehensive risk assessment.

“At this age, risk assessment takes into consideration factors like age, family history, body mass index, history of prior breast biopsies with abnormal pathology, history of radiation therapy to the chest, ethnicity, alcohol intake, smoking history and age at the time of your first child,” says Dr. Goldfischer. “This information is combined to generate an individual risk score which will guide recommendations for future imaging.

“The best line of defense against breast cancer is for women to know their risks and take action accordingly, because early detection is an important factor in an individual’s prognosis following a cancer diagnosis,” she says.