So much is out of your control when it comes to breast cancer. Follow these tips to take back some control and help prevent it.
by Featured Provider Rachel Preisser on Wednesday, September 29, 2021
October is Breast Cancer Awareness Month. But you shouldn’t wait until October every year to think about your own breast health and the steps you can take to reduce your cancer risk.
It’s true that annual mammography screening doesn’t start for most patients until age 40. That’s based on current recommendations from all major professional organizations for women of average risk of developing breast cancer. This recommendation results in the highest rate of breast cancer detection and the most lives saved — up to 13,000 a year in some studies.
But for women under 40 who haven’t aged into the routine annual mammogram pool, or those who are uncertain of their own risk of developing breast cancer, there are several important and potentially life-saving actions you can take to better manage your breast health.
1. Schedule a breast cancer risk assessment.
“I read a handful of screening exams every day from women with risk factors that combine to place them at high risk for breast cancer who have no idea they are at higher risk,” says Dr. Rachel Preisser, a radiologist at The Iowa Clinic. “Some women don’t realize their risk for developing breast cancer until they come in for their first mammogram at age 40.”
The American College of Radiology (ACR) now recommends every woman should have a breast cancer risk assessment before age 30. This will inform women of their risk of developing breast cancer and help determine whether breast cancer screening is needed earlier than age 40.
“Less than 15 percent of breast cancers are considered hereditary, meaning they’re associated with a gene mutation,” says Dr. Preisser. “We recommend a risk assessment to look at a lot of different risk factors so we don’t miss out on an opportunity to do high-risk screening earlier.”
The ACR still recommends that all women start annual screening at least by age 40. The ACR also recently released updated breast cancer screening guidelines for LGBTQ+ persons and Black women — both groups are at a higher risk of developing breast cancer.
IBIS Breast Cancer Risk Evaluation Tool
One in every eight women are diagnosed with breast cancer in their lifetime. But individual risk varies. The risk assessment tool Dr. Preisser recommends for patients — the IBIS Breast Cancer Risk Evaluation Tool — gives you a personalized risk score.
It calculates your chances of developing breast cancer based on your family history, the age when you had your first child, other breast diseases you’ve had and many other factors.
If the risk assessment shows you’re at high risk — meaning you have a 20 percent or greater chance of developing breast cancer in your lifetime — you’ll start a breast cancer screening program before the age of 40. In addition to an annual mammogram, you’ll also get an annual breast MRI. Those tests will be staggered in six-month intervals so your provider can monitor changes in your breast tissue more frequently and catch any changes as soon as possible.
A lifetime risk of breast cancer of less than 20 percent is considered average. No early screening is necessary in most instances. But you can still follow good breast health practices by controlling for other risk factors, performing regular self-checks and scheduling annual exams with your primary care physician or gynecologist.
“It’s always a good idea to have your provider do a clinical evaluation of the breasts when you go in for an annual or health maintenance exam,” says. Dr. Preisser.
2. Focus on the risk factors you can control.
There are many risk factors for breast cancer that are out of your control — your gender and advancing age being the most prevalent among them. However, there are several actions you can take now to lower your risk of developing breast cancer and improve your overall health.
- Maintain a healthy weight. You don’t need to obsess over losing weight. However, maintaining a healthy weight through managing your diet and exercising is beneficial to your health and can lower your risk of developing breast cancer in later years.
- Exercise regularly. Regular physical activity has major health benefits. It is also one way to maintain a healthy weight, which can reduce your risk of breast cancer. Most healthy adults should aim for at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity weekly, plus strength training at least twice a week.
- Limit alcoholic drinks. The more alcohol you drink, the greater your risk of developing breast cancer. Medical experts recommend women limit themselves to one drink or less per day. That’s 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of hard liquor.
- Stop smoking. Several studies have demonstrated a link between smoking and an increased risk of developing breast cancer. While quitting smoking is difficult, the health benefits of doing so are plentiful. They start to kick in minutes after you kick the habit.
“Some risk factors, including gender, age, gene mutations, excessive estrogen exposure and breast density are often out of our control.” says Dr. Preisser. “The same can be said for chest radiation therapy from childhood or early adulthood cancer treatment.”
“Beyond that, there are some other, less robust risk factors that you can account for,” she says. “Those include not having a sedentary lifestyle, avoiding smoking and heavy alcohol use, and trying to maintain a healthy weight. While any one of those things individually is not a huge risk factor for breast cancer, if you put them all together, that can have an impact.”
3. Know what is normal for your breasts.
Nearly 80 percent of breast cancers in young women are initially found by the women themselves. So the biggest thing you can do, especially if you are at average risk, is to know what normal is for your breasts and proactively seek help when something’s not right.
“Do those monthly self-exams. The best thing you can do is to know your breast tissue. We’d rather have you come in for an evaluation and ease your concern than have you ignore a problem and miss an opportunity to intervene,” says Dr. Preisser, who advises you look out for:
- New lumps and bumps
- Persistent pain that doesn’t go away with your cycle
- Nipple discharge — particularly if it’s clear or bloody
- Changes to the skin or nipple
Pay special attention during pregnancy and breastfeeding.
Breast cancers diagnosed in young women are very rare.
Start Managing Your Breast Health
Schedule your annual exam or breast cancer risk assessment today.
Contact the Women's Center
But within the population of early breast cancers, there’s a unique group of patients who have pregnancy-associated breast cancer (PABC). Thirty percent of breast cancer diagnoses in younger women occur during pregnancy or within a year after having a baby.
Between pregnancy and lactation, your breasts undergo a lot of change in those years. It can be difficult to understand what’s normal for a mom to experience or what is a cause for concern. But if something doesn’t feel right, Dr. Preisser advises you to still get your concern evaluated.
“The breasts are obviously going through some pretty drastic changes in that experience. If you come in for an evaluation of a new lump while pregnant or breastfeeding, the majority of the time it’s going to be something noncancerous,” she says. “However, although pregnancy-associated cancers are very rare, they do occur, so we don’t want anyone to ignore breast changes.”
4. When in doubt, consult a doctor.
While risk assessments, monthly self-exams and taking control of your overall health go a long way toward reducing your risk of and detecting breast cancer, nothing replaces the expert opinion of a physician with experience in women’s health and breast cancer detection.
Whether you notice something unusual during a self-exam or you just need a risk assessment, schedule an appointment to start managing your breast health — it could save your life.