For more than 25 years, October has been recognized as National Breast Cancer Awareness month. This is the time of year when the familiar pink ribbons and, in more recent years, pink in general becomes more prevalent in our communities and in the media. Why does breast cancer awareness get so much attention?

Breast cancer is the most commonly diagnosed cancer in females worldwide.  In the United States, breast cancer is the second most common cause of cancer-related deaths in women (after skin cancer) and is the #1 cause of death in women ages 40-59. In Hispanic women, it is the #1 cause of death from cancer.  What this means for you is that most of you either know someone directly or indirectly affected by this potentially life-threatening disease.  In fact, 1 in 6 women will be diagnosed with breast cancer in their lifetime, according to government statistics.  In 2007 in the United States, there were 202,964 new cases diagnosed and 40,598 deaths related to the disease. (Editor's note: Some of you questioned Dr. Birdie's statistics, and she welcomes the debate. These statistics refer to cancer-related deaths, not diagnoses, and these numbers come directly from the CDC.)

The Importance of Early Detection

Before we learn about what you can do to protect yourself against breast cancer, I want to stress the importance of early detection.  How to prevent breast cancer will be the focus of many discussions regarding breast cancer this month, but despite your best intentions and lifestyle modifications, you or a loved one may still develop the disease.  

Many of the most significant risk factors for developing breast cancer are not in your control: family history, sex and age.  I want you to understand that if you have these risk factors you are at a higher risk of developing breast cancer but that the presence of risk factors will not predict if you will get breast cancer.   So, the best weapon that we have in this fight so far is early detection.  

Thanks to early detection, many women go on to live long lives.  Do monthly self-exams and get your screening mammograms.  Screening mammograms typically start at age 50, but some women may need to start earlier based on medical or family history. Please check with your physician by age 40 to determine your screening requirements, as it will be different for every woman. Early detection is crucial to survival. In my opinion, every discussion about breast cancer needs to start with this critical reminder. 

Now that we have some very important business out of the way (early detection, self-exams, mammograms!) we can discuss some of the risk factors from breast cancer and what you can do to modify your risk of developing the disease.

Risk Factors for Breast Cancer

What are some of the risk factors for breast cancer? There are many proposed risk factors, some more strongly associated than others. Many of the risk factors are non-modifiable (meaning that you have no control over them) and others are modifiable.  Please visit the Centers for Disease Control and Prevention's website for more information. 

Risk factors for breast cancer (from the CDC):

• Age and Sex
• Early first menstrual period (before age 12)
• Late menopause (after age 55)
• Older age at birth of first child
• Never giving birth
• Not breastfeeding
• Personal history of breast cancer or some non-cancerous breast disease
• Family history of breast cancer (mother, sister, daughter)
• Treatment with radiation therapy to the breast/chest
• Being overweight (increases risk for breast cancer after menopause)
• Long-term use of hormone replacement therapy (estrogen and progesterone combined)
• Changes in the breast cancer-related genes BRCA1 or BRCA2
• Using birth control pills, also called oral contraceptives (traditionally older formulations that contain much higher levels of estrogen)
• Drinking alcohol (more than 1 drink per day)
• Not getting regular exercise

Again, it is important to note that even if you do not have one or more risk factors for breast cancer you might develop the disease.  Many of these risk factors can be used to identify people who are at increased risk for developing breast cancer and are not used for predicting who will get the disease.  

What Can You Do?

At SparkPeople we strive provide accurate information regarding diet, fitness, and living a healthy lifestyle. The intention is to provide this information so you can incorporate it into and to improve your life.  That said, what are some of risk factors that you control (at least to some extent)?  Diet and exercise are two very important factors that you can control, which ties in nicely why we are here on SparkPeople.  What these two risk factors have in common is that they are linked by the hormone estrogen. 

How does estrogen play a role in breast cancer? Excess estrogen has been implicated in the development of breast cancer.  In women, the more ovulatory menstrual cycles in her lifetime the more exposure to estrogen she has.   But, did you know that fat actually produces estrogen as well?  As they age, obese women, and especially obese postmenopausal women, have an increased risk of breast cancer.  This is likely due to the excess fat, which increases estrogen exposure.   Estrogen levels do decline with menopause, but if you are obese, you are still producing excess estrogen through your excess fat cells. 

What about hormone replacement therapy? If possible discontinue or use short-term hormone therapy.  Speak to your physician about the risk versus benefits of continued use of hormone replacement therapy and your risk of breast cancer.
 
What about exercise and breast cancer prevention? Exercise is very important as well.  Women who exercise have a lower risk of breast cancer.   This correlation is possibly due to exercise decreasing estrogen levels. Women who exercise tend to have lower BMIs and therefore less fat for excess estrogen production.  So, this is a concept that may be new to a few of you.  Excess fat stored on your body can produce excess estrogen which can increase your risk for breast (and other)  cancers.

Do the types of foods you eat play a role in developing breast cancer?  This is controversial but various studies show that eating a high-fat diet can increase your risk of developing breast cancer.  The concept of the "anti-inflammatory diet" is gaining popularity as more studies support the findings that some bad foods are associated with more disease.

Does alcohol use play a role in developing breast cancer? Yes, moderate alcohol use (more than one drink per day) has been identified as a risk factor in the development of breast cancer. 

The information that I presented here can be overwhelming for those who are just  learning about breast cancer.  I always aim to teach so I will give you a few points that I really want you to take home:

1. October is National Breast Cancer Awareness month.
2. Early detection is critical for survival, so do your monthly self-exams and get your mammograms!
3. Obesity in women (especially post-menopausal women) increases the risk of breast cancer.
4. Excess body fat produces excess estrogen, which increases your risk of breast (and other cancers)!
5. Exercise decreases estrogen levels, which decreases your risk of breast cancer. 
6.  A healthy anti-inflammatory diet may protect you against breast cancer and other diseases!

 
I hope you will start or continuing doing your self-exams and scheduling your mammograms! Doctor's orders! Continue to eat healthy balanced meals and exercise! Support breast cancer research and keep sparking everyone!

Do you get yearly mammograms? And, do you do monthly self-exams?