Photo illustration by Tania Savayan
One in every eight American women will develop breast cancer at some point in her lifetime.
A frightening statistic? Absolutely.
And hopefully, you're not one of those women. But don't you wish there was more you could do than just hope? There is. The fight against breast cancer starts long before diagnosis: It starts right now. With you.
First, and perhaps most obvious, get regular breast exams. They're crucial to ensure that problems are caught early, when cancer is more easily treated.
Mammograms have attracted controversy but they're still the gold standard of prevention
Next, research shows that other positive lifestyle changes can make a big difference, too. What kind of changes? That depends on your age. The older you get, the more your breast cancer risk increases. So while in your 20s, you might adopt healthier eating habits and a solid exercise routine; at 40, you'd be smart to put an annual mammogram on your calendar.
Believe it or not, the everyday choices you make could help increase or decrease your risk of getting breast cancer. So we put together this guide, which shows you steps you can take — and should take — in your 20s, 30s, 40s, 50s and beyond. Our point? Every year, you've got to be more vigilant , because the little things that you can do could save your life.
20s and 30s
If you're a woman in your 20s or 30s, you're probably worried about climbing the career ladder and juggling the kids — not about cancer.
And for most, there's not much cause for alarm: The probability of a woman in her 20s developing breast cancer is one in 1,837, according to the American Cancer Society. (Men can get breast cancer, too, although it's about 100 times less common.)
Still, women in this age group should check their breasts for changes regularly. It's rare, but more than 11,000 women under 40 will be diagnosed with the disease this year. Younger women also tend to have more aggressive breast cancers than older women.
Start establishing good habits now and you'll lay the groundwork for a lifetime of healthy choices. Here are a few more things to keep in mind.
Know your family history. Women with a family history of breast cancer, especially in first-degree relatives (parent, sibling, child), have a higher risk of developing the disease. And don't forget about Dad: It's just as important to gather information about your father's side of the family. "Genetics are equally from the mother and the father," says Dr. Andrew Ashikari, co-founder of the Ashikari Breast Center at the Dobbs Ferry Pavilion of St. John's Riverside Hospital. Talk to your doctor about whether you're considered high risk; you may need to start cancer screening tests earlier than you'd think.
Get to know your breasts. Specialists agree that you should be aware of how your breasts normally look and feel; doctors suggest starting monthly breast self exams while in your 20s. "You might be the first (to pick up) some subtle change that someone else…might not be aware of," says Dr. Nancy Mills, an oncologist with the Memorial Sloan-Kettering Cancer Center in Sleepy Hollow. Symptoms like lumps, swelling, redness, nipple pain and discharges don't necessarily mean cancer, but they shouldn't be ignored. Get a professional evaluation as soon as possible.
Start getting clinical breast exams. The American Cancer Society recommends that women in their 20s and 30s have a clinical breast exam by a health professional at least every three years. Many get this test during annual check-ups with their gynecologist.
Drink less. Alcohol consumption is consistently linked with an increased breast cancer risk; one analysis of more than 40 studies indicates that two drinks a day may boost the average woman's risk by 21 percent.
Exercise more. There's growing evidence that physical activity can help protect you. Aim for at least three hours of aerobic exercise a week, says Dr. Anthony Cahan, chief of breast surgery at Northern Westchester Hospital in Mount Kisco. He notes that it's easier for younger women to build a regular exercise routine into their lives, one that will hopefully last for decades. "What I recommend to all of my patients, regardless of age, is find something … fun, so you're not dreading it every time you do it," he says.
Watch what you eat. The relationship between diet and cancer is unproven, but some studies have found that breast cancer is less common in countries that favor a low-fat diet. One tiny way to make a change? Start cooking with canola or olive oil, which are rich in the omega-3 fatty acids that are thought to provide some benefits, says Dr. Helen Pass, director of breast care at the Center for Advanced Surgery at Bronxville's Lawrence Hospital.
If you're having a baby, breastfeed. Research isn't conclusive, but some studies suggest that nursing may slightly reduce the breast cancer risk.
In your 40s
Now, you need to be more aware than ever about changes in your breasts, because the risk jumps significantly: The chance of a 40-year-old developing breast cancer in the next decade is 1 in 70. Here's what's critical at this age:
Get an annual mammogram. A government task force created controversy last year with the suggestion that women in their 40s don't need annual mammograms, contradicting the longtime standard rule of thumb. But the American Cancer Society and other prominent medical organizations still strongly urge women to get this test every year, starting at 40. "I see a lot of cancer in 40-year-olds," says Mills. "When they're mammographically detected, they're small and they're more curable." Bumping up clinical breast exams to once a year is advised, too.
Check your vitamin D level. Cahan points out that we're not getting the same sun exposure as in past decades because of fear of melanoma and aging effects of the sun. The result? "Women are finding out that they're vitamin D deficient all over the place," he says. Researchers are still looking into the therapeutic possibilities of vitamin D, but some studies indicate that higher levels of the "sunshine vitamin" may be linked to a lower cancer risk. One Canadian report published earlier this year in the American Journal of Clinical Nutrition found that women who took at least 400 international units of vitamin D every day slashed their breast cancer risk by 24 percent. A simple blood test can determine your total level; Cahan adds that women in their 40s — who may have taken vitamin supplements during their prime childbearing years — tend to slack off once they're done having kids.
Continue to eat right and exercise. Pass notes that women this age tend to neglect their health because they're too busy balancing work and a robust family life. "At 40, am I still exercising and eating right?" she says. "These are questions that we have to re-ask."
In your 50s and beyond
It's a fact, and one that many women don't know: The older you get, the greater your risk of developing breast cancer. The majority of breast cancer cases are in women over 50; the National Cancer Institute puts the median age of diagnosis at 61. So for postmenopausal women, careful screening is more important than ever. You should also:
Try to avoid or limit hormone replacement therapy. The average age of menopause is 52, and hormone replacement therapy used to be a standard treatment to help relieve hot flashes and other symptoms. That changed in 2002 when a landmark study by the Women's Health Initiative found that there is an increased risk of breast cancer (as well as heart disease, stroke and blood clots) associated with the use of estrogen and progestin (known as combined HRT). Yet the use of estrogen alone in the short-term seems to be OK in certain cases. "What you need is the lowest dose for the least amount of time," says Pass. Some specialists strongly discourage hormone use for high-risk women, noting that medications like certain anti-depressants can also ease menopause symptoms. Cahan, however, has no problem prescribing HRT if nothing else works. "There's a subset of women who, for them, menopause is holy hell," he says. "Sometimes you have to accept the risks for the quality of life improvement that it gives you."
Maintain a healthy weight, or lose some pounds. Diet and exercise are key, since adult weight gain and obesity clearly increases the breast cancer risk. One recent study found that losing at least 22 pounds after menopause — and keeping it off — lowered that risk by 57 percent. Age is no excuse for not staying active: "Walking is something you can do when you're 85," says Pass.
Make your yearly mammogram appointment. You are never too old for this test, but Mills says that she sees far too many older patients who believe the opposite. As long as a woman is in good health and a candidate for treatment (should cancer be detected), there's no reason to stop getting mammograms. "I see lots of 60- and 70-year-olds — and 80-year-olds — who are very effectively treated if early detected," says Mills. "We shouldn't lose sight of the older women whose lives can be saved by mammograms."
When Erika Hanson Brown was going through colon cancer eight years ago, she often felt alone in navigating her treatment and staying connected with others, especially locally in Denver where she lives. Six months into treatment, she decided to ditch her “passive patient” mentality and became a committed advocate to her fight with cancer, networking with others who had a similar diagnosis, researching resources and seeking second opinions.
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