Commit to Breast Health All Year Long
|By Dr. Steve Vasilev, MD on Friday, October 18, 2013|
|Breast health should always be a focus. Discover the treatments and
research that have the medical community so excited and how to make
breast cancer prevention a priority.||
October is National Breast Cancer Awareness Month, but monitoring your breast health should be a year-long effort. If you're diagnosed with breast cancer, early detection can greatly increase your chances for a full recovery.
Becoming Breast Aware
The National Breast Cancer Foundation strongly encourages both men and women to become more aware of the typical look and feel of their breasts. Yes, although rare, breast cancer can affect guys too! So, pay close attention to any changes in your breasts. You are more likely to pick up a subtle difference than your doctor.
To really stay on top of the health of your breasts, practice regular breast self-examination. The simplest way to do this is in the shower. A breast exam should also be included as part of an annual physical with your doctor. Make sure to actively check both breasts on a monthly basis. Women should check their breasts during and after their period, as breasts may swell during the menstrual cycle. Cover all areas of the breast in small circles with the middle fingers, including the outer areas and the nipple. Be sure to also check the areas below and above the breasts and the armpits.
If something feels strange or painful, it's time to contact a physician for a focused examination and additional testing.
Breast Screening Tools
In addition to breast examination, annual mammograms after age 50 is the mainstream recommendation. If you have additional risk factors, such as a strong family history, some experts and organizations are recommending mammograms every year or every other year after age 40. Sometimes, it's even reasonable to start screening after age 30. Everyone is different, so check with your doctor. For example, if you have breast implants, an MRI may be a better screening test than a mammogram. Thermography, on the other hand, while promoted by many alternative practitioners is simply not as sensitive for early disease and should not be used as a primary screening tool.
Keep in mind that some breast findings like ductal carcinoma in situ (DCIS) don't require immediate treatment, but you should know if you have such changes because some of these progress to invasive life threatening cancer. Surgery or other treatment may not be what you need, and in some cases the extent of surgery can be limited, so always consider a second opinion from breast cancer specialists before undergoing potentially unnecessary and disfiguring surgery.
The benefit of mammography far exceeds the small risk of radiation-induced cancer. We live in a radiation-filled world unfortunately, whether it be from where you work or from other X-rays you need or you simply spend a lot of time under the sun. So, for example, if you're a flight attendant, 20 long distance, round-trip flights is roughly equal to the exposure you get from one mammogram. Take into account your other exposures and talk with your doctor about the risk benefit of annual mammograms at your age. There is also a new type of screening called 3D mammography, which may be more sensitive but also increases the amount of radiation exposure. Researchers haven't proven this to be a better tool, so the risk may not be worth the possible benefit at this point.
Stay with regular mammograms every year or two, depending upon your age and other radiation exposure.
New Advances In Breast Cancer Treatment
Research into what causes breast cancer and treatment options is ongoing. Radical disfiguring surgery has gone by the wayside when breast cancer is diagnosed earlier, in favor of simple removal of tumors by lumpectomy or segmentectomy. When more radical surgery is required, the reconstructive techniques today are so advanced that body image may not be affected at all. Radiation therapy has been improved markedly to limit scarring, pain and complications from that form of treatment.
The point is there's no "one size fits all" surgery and radiation these days. It can be tailored to maximize treatment while preserving body image and minimizing complications.
New Advances In Breast Cancer Research
As far as chemotherapy is concerned, that is also going by the wayside and will be replaced by personalized treatment using biological therapies that target cancer cells only, leaving normal cells unscathed. Forty million dollars and 10 years of research have led a team of researchers from the United States and Canada to develop what they're calling a "sharpshooter" medication that may be able to inhibit tumor growth in cancer cells. "Sharpshooter" biological drugs target specific enzymes integral to cell function in cancer cells and are in clinical trials today.
Another new treatment being studied for use in cancer is the combination of nanotechnology with molecular and cellular techniques. Cancer therapies combined with metallic sub-microscopic nanoparticles are being tested as a new means of treating cancer. The nanoparticles are first injected and proven to bind to tumor cells only. These particles can then be combined with various agents designed to damage the cancer cells alone, avoiding damage to normal cells.
So the beef against mainstream cancer treatment of "cut, poison and burn" are really about to become history as the result of ongoing research. Less radical surgery, gentler more targeted radiation as well as "sharpshooter" biological treatments are leading the way towards truly personalized cancer care. These are further refined by advances in genomic research which will predict which patient will benefit most from which treatment combination. We truly are finally winning the war against cancer, contrary to what some are saying.
Breast Cancer Prevention
There is no doubt the best way to avoid the morbidity of cancer treatment and possibly dying of cancer is to prevent it in the first place. It's a toxin filled-world out there and many of these toxins can act as hormones, increasing your risk of cancer. The more weight and fat cells you have, the more these xeno-hormones can sit around in your body for a long time causing harm. While 5 to 10 percent of breast cancers are related to genes like BRCA1 and BRCA2, and harder to prevent, the simplest thing you can do is to maintain a healthy body mass index(BMI) under 25. This is a rough guide of how much fat you have for your height and you can find calculators online.
Exercise itself, in addition to helping you maintain healthy BMI, has a complex biochemical anti-cancer effect. In addition to this, the short list of absolute must-do prevention steps is to not smoke, limit alcohol intake to one drink per day, limit hormone exposure, limit toxin exposure (e.g. personal care products with many chemicals) and breastfeed if you are having kids. Eating a diet rich in vegetables of all colors and fruits, as well as drinking tea, rounds out the recommendations. While a low-fat diet has been advocated, it doesn't seem to be as protective as once thought, unless it leads you to being overweight and a high BMI. If you're at very high risk of breast cancer, based on family history and/or BRCA gene testing, additional prevention steps may be required which include hormone blockers like Tamoxifen or Raloxifene.
If you want to take prevention one step further, start with curcumin (found in turmeric), which is being actively researched by major institutions for prevention as well as treatment. Beyond this, optimize your vitamin D intake (you can ask for a blood test to check your level), take in plenty of natural vitamin A and take fish oil if you don't have fish in your diet at least two to three times per week. Finally, CoQ10 has been shown to have a possible preventive effect. There are many others that may or may not help but this is a great start.
In summary, pay close attention and get to know your breasts well, discuss the risk vs. benefit of screening tools with your doctor, and follow the key prevention tips outlined here. Breast cancer is highly preventable but requires some active effort. Just do it.
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