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Tuesday, Oct. 17, 2023

Breast Cancer Prevention and Screening

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Empower yourself by being proactive in your breast health

Breast cancer is a daunting diagnosis, and with good reason. In December 2020, the International Agency for Research on Cancer (IARC) released statistics revealing that breast cancer had officially overtaken lung cancer as the most diagnosed cancer worldwide, and breast cancer has continued to hold the top spot since then.

Breast cancer is the most common cancer in women in the United States. An estimated 297,790 new cases of invasive breast cancer and 55,720 new cases of localized breast cancer will be diagnosed in women in the United States in 2023. Breast cancer commonly affects middle-aged and older women. The median age at the time of breast cancer diagnosis is 62; this means that half of all the women in the United States diagnosed with breast cancer are 62 or younger. It is the second leading cause of cancer death in women in the United States (lung cancer leads as the most common cause of cancer death).

While these facts seem disheartening, they are nonetheless facts. On the bright side, breast cancer death rates have dropped by 43% from 1989 to 2020, largely due to timely screening, which leads to an early diagnosis, better treatments and greater breast cancer awareness. Now more than ever, it is important to understand how to prevent breast cancer and how to ensure an early diagnosis.

A risk factor is anything that increases a person’s chance of getting a disease. Having a risk factor does not mean a person will get that disease; it just means that they have a higher chance of developing that disease. Multiple factors contribute to the increasing cancer diagnoses in our general population worldwide – unhealthy diets, insufficient physical activity, tobacco use, harmful use of alcohol and inherited genetic mutations, to name a few.

The accompanying table lists the risk factors for breast cancer. Some of the risk factors are modifiable, meaning a person can decrease that risk in their lifetime by their choices. For example, by regularly exercising, a person can reduce their overall risk of getting any cancer, including breast cancer. Women who engage in 30 minutes of brisk exercise three times a week have a 12% to 21% lower risk of breast cancer than those who do not.

Other risk factors are non-modifiable – these are risk factors that we cannot change. For example, our family history and genetic history cannot be altered. It is easy to see that by choosing to amend the modifiable risk factors, women can potentially decrease their odds of getting breast cancer.

Lifestyle changes are not to be approached as an all-or-none decision. Not every modifiable risk factor has to be altered all at once. We encourage modification of any risk factor at any age and to whatever extent is feasible. Our body has a phenomenal capacity to adapt, and an intervention at any age has benefits. It is never too late to make lifestyle changes and reap its benefits. A detailed discussion with your health care provider can help you understand your personal risk factors (modifiable and non-modifiable), and, if required, you can then develop a plan to change the modifiable risk factors.

While it is an excellent strategy to adopt lifestyle changes to decrease the risk of getting breast cancer, it is equally important to undergo routine and timely screening. This enables early detection of breast cancer at a lower stage, which has higher survival rates and lower cost of treatment. Most medical professional organizations recommend annual screening mammograms or X-rays of the breasts starting at age 40.

According to the American College of Radiology and Society of Breast Imaging, there is no defined age to stop screening; screening mammograms can continue as long as a woman is in good health. The above-mentioned breast screening guidelines are appropriate for most women – women who are at average risk for breast cancer. However, certain women fall into the high-risk category, such as women with specific inherited genetic mutations, a strong family history of breast cancer and those who received chest radiation therapy for cancer between the ages of 10 and 30.

Women at high risk for breast cancer should start getting their annual mammograms earlier and receive additional annual screening by breast MRI. All women should get their breast cancer risk assessed by their health care provider by age 25. This will help determine at what age they potentially need to begin screening for breast cancer.

Women need to be aware of their risk factors for breast cancer to make better decisions for themselves. I encourage all women to actively discuss with their health care providers how to protect themselves from this dreaded disease. While we may not succeed in abolishing breast cancer, we can enable early diagnosis with appropriate screening. This will increase the odds of beating breast cancer and increase the chances of longterm survival.

Anyone interested in learning more about breast cancer prevention, diagnosis and treatment is encouraged to attend VIPink hosted by Ochsner LSU Health, presented by Dr. Nayanatara Swamy. This free lunch-and-learn event will occur on Saturday, Oct. 21, 11 a.m. - 1 p.m.

at the Ochsner LSU Health Shreveport – St. Mary Medical Center Community Center, 911 Margaret Place, Shreveport. To sign up or for more information, contact Bonnie Hughes at bonnie.hughes@ochsnerlsuhs.org.

Dr. Nayanatara Swamy is an assistant professor of radiology at LSU Health Shreveport.

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