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Getting Ahead of Breast Cancer By Julie Nangia, MD Breast cancer is the most common cancer in women, including Asian women. One in eight women will be diagnosed with breast cancer. In 2012, it is estimated that 226,870 women in the United States will be diagnosed with breast cancer. There has been progress in curing breast cancer because of advances in prevention, early detection, and better treatment options. Screening and Prevention Breast cancer has very good screening available so that it can be detected at early stages when it is more often cured. Women should do monthly self-breast exam starting at age 20. It is very important that women learn early in life what their breasts feel like so that if a new lump appears they can seek medical attention. The most common reasons for women not doing breast exams are that they forget or they don’t know how — so, be proactive and put it on your calendar or ask your doctor how to do them! It is also recommended to start clinical breast exams at age 20 (performed by physicians) and annual mammography at age 40. Mammograms can detect breast cancer when it is stage 0 and too small to be felt. If there is a family history of breast cancer or ovarian cancer in more than 2 relatives on the same side of the family or a personal history of a breast biopsy showing a precancerous lesion (i.e. atypical hyperplasia or lobular carcinoma in situ) a risk assessment is recommended. This is done by a medical oncologist, preferably in a breast center. For high risk woman, a medication called tamoxifen or raloxifene can be used to decrease risk of breast cancer. If a woman does not have health insurance she can still get mammograms. The Rose (281-484-4708) will do mammograms for $100 or free if the family income is low. Lifestyle changes can significantly decrease a woman’s risk of breast cancer. Many cancers could be prevented with simple lifestyle changes! It is recommended to exercise 3-5 hours per week. Walking is very good exercise and this can be accomplished
by walking 30 minutes every day or 1 hour every other day and is best done if it becomes part of a daily routine. Exercise decreases breast cancer risk by decreasing estrogen levels in the body. Women should also stay thin and maintain a normal body weight. When a woman is overweight, the extra fat is converted into excess estrogen in the body, which increases the risk of developing breast cancer. The best way to remember this is that overweight men develop breasts! To calculate your ideal body mass index and to see what your ideal weight should be go to http:// www.halls.md/ideal-weight/body.htm There are no specific types of foods that have been associated with breast cancer risk but a low calorie, healthy diet is recommended. Alcohol has been associated with increased risk of breast cancer because alcohol causes excess estrogen in the body. It is recommended to consume less than 3 alcoholic beverages per week. If you drink alcohol start taking folic acid — one study showed that in women who drink alcohol, some of the negative effects can be reversed by taking a simple vitamin, folic acid 800ug daily. Diagnosis and Treatment Most women are diagnosed with breast cancer because of an abnormal mammogram or a palpable mass. The initial diagnosis is made by mammogram and ultrasound followed by a biopsy. At that time a woman would see a breast surgeon or a medical oncologist. Stage 1-3 breast cancer is curable when the cancer is limited to the breast and the lymph nodes in the armpit. Treatment would include some type of surgery and perhaps chemotherapy, radiation, and anti-hormonal therapy. There are many different types of breast cancer and each of these types is treated in different ways. Stage 4 breast cancer is not curable, but is treatable and a woman can live for many years. More information can be found at http:// www.cancer.gov/cancertopics/types/ breast or http://www.bcm.edu/breastcenter/
Julie Nangia, MD is an Assistant Professor of Medicine at the Lester and Sue Smith Breast Center at Baylor College of Medicine in Houston, TX. Dr. Nangia is board certified in internal medicine and oncology and specializes in the care of patients with breast cancer, with a special interest in breast cancer prevention and hereditary breast cancer. She also serves on the board of the Indian American Cancer Network (IACAN) who’s mission is to educate and support the Indian American community.
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