One in eight women in the United States will develop invasive breast cancer in her lifetime. In 2019, nearly 270,000 women will be diagnosed with invasive breast cancer, and approximately 42,000 women will die of breast cancer. Except for skin cancers, breast cancer is the most commonly diagnosed cancer among American women, and it is the second leading cause of cancer-related deaths in women, behind lung cancer.
Now for the better news — there are also more than 3.1 million breast cancer survivors in the United States, and death rates have dropped 40% between 1989 and 2016. Since about 85% of breast cancers are sporadic and occur in women with no family history, it’s even more essential to know the answers to major questions related to risk, diagnosis and treatment.
What are some of the risk factors?
• Gender— Being a woman is the #1 risk factor. Male breast cancers account for less than 1%.
• Age— The older we are, the more likely we are to develop breast cancer.
• Race— Breast cancer is more common in Caucasian women, but mortality is higher in African-American women due to increased prevalence of higher-risk breast cancers.
• Family history and genetic predisposition— Having one first-degree relative (mother, sister, daughter) with breast cancer approximately doubles a woman’s risk, and having two first-degree relatives increases her risk by three-fold, even without a genetic mutation. About 5-10% of breast cancers are thought to be hereditary and due to a genetic mutation, which can increase risk as much as 50-80%.
• History of abnormal biopsy— Atypical changes in the breast can increase the risk of breast cancer by three-fold.
• Prolonged combined hormone replacement therapy— The risk of breast cancer increases with duration of therapy, but thankfully returns to almost normal upon stopping.
• Lifestyle risk factors— Obesity, lack of exercise, smoking and excessive alcohol intake all negatively impact your breast cancer risk.
How can I help myself?
• Know what your normal breasts feel and look like. If you notice a change, be sure to notify your physician, even if you’ve had a normal mammogram within the year.
• Get screening mammograms beginning at age 40. Some newer guidelines recommend waiting until 45 or 50 years old, however the American College of Radiology and Society of Breast Imaging continue to recommend annual mammography beginning at age 40 to save the most lives. All women should get mammograms regardless of family history — please encourage your friends and family!
• Know your family history. It is important to know if anyone in your family has ever had breast or ovarian cancer. If so, it is important to know at what age they were diagnosed and to discuss this with your physician. This can impact your risk of developing breast cancer.
• Stop smoking. Smoking has been linked to many cancers, including breast cancer.
• Exercise. Being physically active for at least 30 minutes per day, five days per week can lower your risk of breast cancer.
• Maintain a normal weight. Be sure to eat a diet with plentiful fruits and vegetables.
• Lower your alcohol intake. You should be drinking less than or equal to one alcoholic drink per day. Women who consume 2-5 drinks daily compared to non-drinkers have about 1.5 times the risk.
• Breastfeed, if able. This is protective against breast cancer.
What happens if I am diagnosed with breast cancer?
• Take a deep breath. This is easier said than done! Everyone reacts differently to receiving a cancer diagnosis, and it is important to give yourself time to process this life-changing news.
• Meet with your doctor. This physician should be someone you can trust and feel comfortable with. They will be with you the entire journey and help guide your different treatments in coordination with your breast cancer team.
• Get the facts. There are many different types of breast cancer. Depending on which type you have, the treatments can vary dramatically. Each cancer and patient are unique, and we try to individualize each patient’s treatment accordingly. Your doctor can help you find good resources for education.
• Develop a support system. The next several months will be a roller-coaster ride emotionally, mentally and physically for some patients. Surround yourself with people who support and love you. Family and friends want to help and asking for tangible things helps everyone – let them bring you a meal, give you a ride, help with child care or run an errand for you.
For more information about breast cancer care at Ochsner, visit ochsner.org/services/breast-cancer.
Dr. Blakely Kute is a board-certified medical oncologist and hematologist who completed training at the University of Louisville School of Medicine, the University of Alabama at Birmingham, and the James Graham Brown Cancer Center. Prior to joining Ochsner’s Gayle and Tom Benson Cancer Center, she practiced oncology and hematology in Louisville, Kentucky where she developed a passion for caring for breast cancer patients. She moved to New Orleans in late 2018 with her husband and their two daughters.