Fact #: You Can Lower Your Risk Of Breast Cancer
Regular screenings appropriate for your risk level is the number one way to reduce your risk of breast cancer. Other ways to lower your risk are:
Maintain a healthy weight. Data show that weight gain as an adult is linked with a higher rate of breast cancer. Exercise regularly. Reduce alcohol consumption. The ACS recommends no more than one alcoholic drink per day for women and no more than two drinks per day for men.
Learn more about breast cancer care at NewYork-Presbyterian.
Luona Sun, M.D. , is a board-certified breast surgeon at NewYork-Presbyterian/Columbia University Irving Medical Center and an assistant professor of surgery at Columbia University Vagelos College of Physicians and Surgeons. She is trained in minimally invasive nipple sparing mastectomy, skin sparing mastectomy, intraoperative radiation therapy, and various frontline localization skills. Dr. Sun is also an active researcher, focusing on rare diagnoses like small cell carcinoma in breast cancer and high-risk lesion management in patients with coexisting cancer. One of her major research interests is in Asian American breast cancer disparities.
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Are Mammograms Covered By Insurance
Host: 14:47 Dr. Vincoff, in the beginning of this conversation you had mentioned that a lot of this can be confusing. And that makes it worth talking about insurance for a moment because some women fear not having some of these screenings covered. And obviously, the out-of-pocket costs can be quite pricey. Dr. Vincoff: 15:06 I’m really glad that we’re bringing this up because this is really important for women to know. Northwell, obviously, we are here in New York. New York is actually a great place for breast cancer advocacy. We’ve had people who have fought for the rights of women, and your mammogram will actually get paid for if you have a New York insurer.
How Does Age Affect Breast Cancer
Age is one of several factors related to the risk of developing breast cancer. As a person gets older, their risk of developing breast cancer increases. Breast cancer develops when the cells in the breast grow uncontrollably to form a tumor. Malignant tumors can spread into surrounding tissue or even to distant parts of the body.
What Is The Earliest Age You Can Get Breast Cancer
Are women under 40 at risk for breast cancer? Younger women generally do not consider themselves to be at risk for breast cancer. However, breast cancer can strike at any age: 5% of breast cancer cases occur in women under 40 years of age. All women should be aware of their personal risk factors for breast cancer.
Why Is Weight A Factor
Women who are overweight or obese have higher levels of estrogen in their bodies. Even though the ovaries stop making estrogen after menopause, the hormone is still stored and produced in fat tissue. Estrogen causes certain types of breast cancer to grow and spread. Work with your doctor to develop a weight loss plan that fits your life, if necessary.
Breast Cancer Screening And Covid
The COVID-19 pandemic caused many people to miss their mammograms. If you are due for a mammogram, do not wait. Call your health care provider to schedule your appointment as soon as you can. If you are having any symptoms of breast cancer, call your health care provider right away. Getting a mammogram regularly is the best way to find breast cancer early, when it may be easier to treat.
Health care providers are taking steps so that important health visits can happen safely. All staff and patients must wear masks and be screened for COVID-19 symptoms before going in the office. Equipment, exam rooms and dressing rooms are cleaned after each patient. Other safety steps may include socially distanced waiting rooms, on-line check in, and more time added between appointments.
How Old Is Too Old To Get Breast Cancer
Females over 50 years of age are more likely to receive a breast cancer diagnosis. A persons risk of developing breast cancer increases as they get older. As people age, abnormal changes in their cells are more likely to occur. Breast cancer is most common in females over the age of 50 years. Trusted Source.
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Previous Breast Cancer Or Lump
If you have previously had breast cancer or early non-invasive cancer cell changes in breast ducts, you have a higher risk of developing it again, either in your other breast or in the same breast.
A benign breast lump does not mean you have breast cancer, but certain types of breast lumps may slightly increase your risk of developing cancer.
Some benign changes in your breast tissue, such as cells growing abnormally in ducts , or abnormal cells inside your breast lobes , can make getting breast cancer more likely.
Estrogen Receptor Progesterone Receptor And Her2 Status
Associations between MD and breast cancer defined by ER status differed by age group . For women aged < 55 years, a stronger association was observed for ER-negative disease versus ER-positive disease for MD 51%+versus MD 11 to 25% , while associations for women aged 55 years were nonstatistically significantly stronger for ER-positive tumors versus ER-negative tumors. MD was similarly associated with PR-negative and PR-positive tumors in all age groups . While there was evidence of a significant interaction between MD and breast cancers by HER2 status and age group , MD was positively associated with both HER2-negative and HER-positive disease in all age groups and there were no clear patterns of differences in associations .
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Menstrual And Reproductive History
Starting menstrual periods at a younger age or going through menopause at a later age raises the bodys exposure to these hormones, which can increase a persons risk of breast cancer.
Those who start their menstrual period before the
to prevent miscarriage. Women who took this drug while pregnant and any children they gave birth to have a slightly higher risk of breast cancer.
What Can I Do To Reduce My Chances Of Getting Breast Cancer
To help reduce the risk of getting breast cancer:
- Be aware of your family history and discuss any concerns with your health care provider.
- Discuss the use of hormone replacement therapy with your health care provider.
- If possible, breastfeed your baby. Studies have shown that breastfeeding for longer periods of time lowers the risk of getting breast cancer.
- Stay at a healthy weight.
- Exercise regularly.
- Discuss the risks and benefits of medical imaging, such as CT scans, with your health care provider to avoid unnecessary exposure to ionizing radiation.
Regular check-ups and screening tests can find breast cancer at an earlier stage, when treatment works best. The most important action women can take is to have routine breast cancer screenings. For more information on breast cancer screening, call the Cancer Services Program at 1-866-442-CANCER or visit the website at www.health.ny.gov/diseases/cancer/services/.
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General Considerations For Screening
The goal of screening for cancer is to detect preclinical disease in healthy, asymptomatic patients to prevent adverse outcomes, improve survival, and avoid the need for more intensive treatments. Screening tests have both benefits and adverse consequences .
Breast self-examination, breast self-awareness, clinical breast examination, and mammography all have been used alone or in combination to screen for breast cancer. In general, more intensive screening detects more disease. Screening intensity can be increased by combining multiple screening methods, extending screening over a wider age range, or repeating the screening test more frequently. However, more frequent use of the same screening test typically is associated with diminishing returns and an increased rate of screening-related harms. Determining the appropriate combination of screening methods, the age to start screening, the age to stop screening, and how frequently to repeat the screening tests require finding the appropriate balance of benefits and harms. Determining this balance can be difficult because some issues, particularly the importance of harms, are subjective and valued differently from patient to patient. This balance can depend on other factors, particularly the characteristics of the screening tests in different populations and at different ages.
Patient Characteristics With Reference To Age At Diagnosis
Clinical factors and tumor characteristics of the six age groups are shown in Table . Distant metastasis at the time of diagnosis was more common with increasing age. There was considerably more missing data for the oldest age category concerning axillary lymph node status. It was more common for older women to have been regarded as unsuitable for surgery, and it was also less common for these women to have undergone an axillary dissection.
Table 1 Distribution of age at diagnosis in relation to patient characteristics, tumor characteristics, and surgical treatment
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Inherited Breast Cancer And Risk Reduction
Family history is a known risk factor for breast cancer, with elevated risk due to both increasing number and decreasing age of first-degree relatives affected. For example, in a large, population-based study, risk of breast cancer was increased 2.9-fold among women whose relative was diagnosed prior to age 30, but the increase was only 1.5-fold if the affected relative was diagnosed after age 60 years.90 While twin studies indicate familial aggregation among women diagnosed with breast cancer, identification of true germline mutations, including BRCA1, BRCA2, p53 , PTEN , and STK11 , are quite rare, on the order of 5%-6%.91–93 However, the management of young women at an increased risk of developing breast cancer via a germline mutation requires careful consideration, as screening, risk reduction, and implications for relatives are of upmost importance.
What Is An Oncologist
A doctor who specializes in treating cancer. Some oncologists specialize in a particular type of cancer treatment. For example, a radiation oncologist specializes in treating cancer with radiation. oncologist know if you dont understand a treatment path, or you think a certain treatment might disrupt your lifestyle.
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Are Larger Breasts More Likely To Get Cancer
While breast size isnt a proven risk factor for breast cancer, theres no doubt that having large breasts can lead to other health concerns. If you are unhappy with your enlarged breast tissue, or find that it is affecting your quality of life, you may be a good candidate for breast reduction surgery.
Grade Invasive Histology Size And Nodal Status
MD was similarly associated with breast cancers of various grades . Further, this association did not differ when stratified by age group . MD was also similarly associated with both ductal and lobular histology among all ages combined . Despite evidence of heterogeneity in the association by histologic subtype overall , the magnitude of the association was similar within each age group and there was no evidence of significant interaction by age . Also, higher MD was positively associated with invasive tumors of all sizes but the association was stronger for large tumors compared with small tumors < 1.1 cm among all women combined and within age groups . The ORs for MD 51%+versus MD 11 to 25% ranged from 1.33 to 1.61 for invasive tumors < 1.1 cm and from 2.88 to 3.65 for tumors 2.1+ cm. Low MD was not significantly associated with a reduced risk of tumors < 1.1 cm compared with the referent category MD 11 to 25% however, for tumors > 1.1 cm, low MD was significantly associated with lower risk . MD was associated with both lymph node-positive and lymph node-negative tumors among all ages combined, with a stronger association of MD with node-positive than node-negative tumors . The MD association with breast cancer defined by nodal status was not different by age group , although there was evidence of a stronger association for node-positive versus node-negative tumors among women ages 65 .
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Cancer Recurrence: Knowledge Is Power
While researchers work to reveal the intricate mechanics of cancer and tumor growth, the reality remains that cancer can recur so what can a person do to cope with that knowledge and try to reduce that risk?
I think its important that women know that their breast cancer can come back in the future. Its a really hard thing to tell a woman, you dont want to tell them when youve removed the cancer Its really hard to say, Oh, well done, youve got a great result, and did you know it could come back in 2 or 3 years time?, said Dr. ORiordan in the podcast.
In her view, it is important for people to have accurate information about the possibility of recurrence, especially so that they are able to make healthy lifestyle choices going forward:
A lot of us shy away from having those discussions and women dont realize that can come back 20 or 30 years down the line. And I think for me, its all about helping women reduce the risk of that happening like exercising, like cutting down alcohol, like knowing how to check what symptoms to look out for.
First of all, knowing that there is a risk of recurrence can empower people to address a potential comeback early by seeking medical advice as soon as they notice a potential sign.
According to the research and support charity Breast Cancer Now, such signs could include:
Clinicopathologic Features Biology And Prognosis
The comparison of clinicopathologic and prognostic features of breast cancer arising in younger women with those in their older counterparts has been the subject of published studies for decades.27–29 Traditionally, breast cancer arising in a younger host is characterized by a more aggressive phenotype. Among 185 premenopausal women carrying a diagnosis of invasive breast cancer, referred for surgery at the European Institute of Oncology from April 1997 to August 2000, those aged less than 35 years had a higher percentage of ER-negative , progesterone receptor -negative , vascular or lymphatic invasion and pathologic grade 3 tumors compared with women aged 35-50 years.30 Differences in tumor size, lymph node involvement, and Her2/neu status between younger and older women diagnosed with breast cancer have been less clear.30–33
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Family History Of Breast Cancer
Having a family history of breast cancer increases a persons risk of developing the condition themselves.
A females risk if they have two first degree relatives who have had it. First degree relatives are parents, siblings, and children and can include males.
The recommend genetic testing for females with a family history of breast, ovarian, fallopian tube, or peritoneal cancer.
How Many Chances Of Getting Breast Cancer In 20 Years
If youre at least 70 years old, your chance of developing breast cancer in the next 20 years is about 1 in 26 yet most research around treatment, including clinical trials, focuses on women much younger. Older women have special challenges and concerns around breast cancer treatment including whether or not to have it.
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What About Breast Cancer In Men
The stages of breast cancer relate to how much the cancer has grown and how far its spread. Generally, the earlier breast cancer is diagnosed and treated, the higher the chances for long-term survival.
|Stage 0||This is a precancerous stage with no invasive cancer cells.|
|Stage 1||The tumor is small and localized to the breast. There may be a small amount of cancer in nearby lymph nodes.|
|Stage 2||The tumor is still localized to the breast but is larger and may have spread to several nearby lymph nodes.|
|Stage 3||This stage includes cancers that have spread to the skin, chest wall, or multiple lymph nodes in or near the breast.|
|Stage 4||This is metastatic breast cancer, meaning its spread to one or more distant parts of the body, most commonly to the bones, lungs, or liver.|
The stages of breast cancer are based on the following factors:
- whether the lymph nodes contain cancer cells
- whether the cancer has metastasized, meaning its spread to other, more distant parts of the body
Since 2018, the following factors have also been used to determine breast cancer stage:
- whether the cancer cells have hormone receptors and need estrogen or progesterone to grow
- whether the cancer cells have the HER2 protein that helps them grow
- tumor grade, meaning how aggressive the cells look under the microscope
Clinical Considerations And Recommendations
How should individual breast cancer risk be assessed?
Health care providers periodically should assess breast cancer risk by reviewing the patients history. Breast cancer risk assessment is based on a combination of the various factors that can affect risk Box 1610111213. Initial assessment should elicit information about reproductive risk factors, results of prior biopsies, ionizing radiation exposure, and family history of cancer. Health care providers should identify cases of breast, ovarian, colon, prostate, pancreatic, and other types of germline mutation-associated cancer in first-degree, second-degree, and possibly third-degree relatives as well as the age of diagnosis. Women with a potentially increased risk of breast cancer based on initial history should have further risk assessment. Assessments can be conducted with one of the validated assessment tools available online, such as the Gail, BRCAPRO, Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm, International Breast Cancer Intervention Studies , or the Claus model 34.
Is screening breast self-examination recommended in women at average risk of breast cancer, and what should women do if they notice a change in one of their breasts?
Should practitioners perform routine screening clinical breast examinations in average-risk women?
When should screening mammography begin in average-risk women?
How frequently should screening mammography be performed in average-risk women?
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