Breast Cancer: Why Not You?
By Edel Jarboe

Breast cancer awareness programs such as "Race for the
Cure", reminders to do monthly breast self-exams in the back
of women's magazines, and greater media coverage on the
subject make it virtually impossible for women to ignore
breast health.

However, this is what some women are doing.  They are
ignoring their breast health in the hopes that they won't
have to deal with breast cancer.  By not actively practicing
preventive breast health, they are denying that they could
potentially get breast cancer.  This is playing the naive
and dangerous game of "Not me," when, in reality, the name
of the game is "Why not me?"  Personal beliefs and attitudes
about breast cancer are the first things one must face in
order to start taking responsibility for one's health and
body.

Which Profile Fits You?
Anna  R.* is a 65-year-old woman whose mother died of breast
cancer.  While she eats healthy and has a mammogram every
year, Anna is overweight and does not exercise.  When asked
why she doesn't take the threat of breast cancer seriously
enough to do anything about her weight and lack of physical
fitness, she volunteers that she believes that since her
mother had breast cancer, there is nothing that she
can do.

According to the American Cancer Society, only 5-10% of all
breast cancers are believed to be inherited.  In short,
family history and a genetic predisposition do not
necessarily mean that you will get breast cancer.  Other
factors such as obesity, reproductive patterns, and similar
lifestyles among family members are a better explanation for
increased risk.
___________________________________________________________

Bianca L. is the 32-year-old mother of two children.  She
breastfed both children and had her first child at age 22.
She has no family history of breast cancer.

Bianca does a breast self-exam every once in a while and has
an occasional drink with friends.  She admits that she
doesn't always eat well but that's okay, right?  She's not
really at risk.  She believes that she has another 20 years
to start worrying about breast cancer.

Does she?
According to a study which appeared in the Jan/Feb 1998
issue of the CA- A Cancer Journal for Clinicians,
approximately 75% of women newly diagnosed with breast
cancer have no identifiable risk factors.  This means that
only 25% of breast cancers are positively associated with
known risk factors.  In other words, even if you have no
identifiable breast cancer risk factors, you are still at
risk.
___________________________________________________________

Helen S. is 43 and has no children. She admits that she does
not perform a monthly breast self-examination, nor has she
had her first mammogram.  Her grandmother died of breast
cancer.

Why doesn't Helen take steps to safeguard her health?

Helen believes that because her mother has not contracted
the disease, she is safe.

Lack of knowledge about all of the risk factors for breast
cancer is dangerous.  According to the National Cancer
Institute, a woman in the United States has a 1 in 8
lifetime risk of developing breast cancer and 1 in 29
lifetime risk of dying from breast cancer.  These are not
good odds.  Every woman should stay informed of the risk
factors for breast cancers and do all they can to lower
their chances of developing breast cancer.  Because the sad
truth is that just being a woman puts you at risk.

Know Your Family's Health History
Knowing your family's medical history is an important factor
in detecting and treating serious illnesses.  Evidence has
shown that women with a first-degree relative (mother,
sister, or daughter) who has had breast cancer have a 2-3
times greater risk of contracting the disease.  Moreover,
women with second-degree relatives (cousins) who have had
the disease, have an increased risk of twice that of a woman
who has no family history of breast cancer.

Be sure to fully discuss your medical history with your
doctor, because the use of specific screening tests varies
based on your known risk factors.

Know the Breast Cancer Risk Factors

- Early menstruation (before age 12)

- Use of oral contraceptives (currently using and if used
within past 10 years)

- Late first pregnancy (after age 30)
- No children
- Late menopause (after age 50)
- Long term (10-15 years) estrogen replacement therapy (ERT)
or hormone replacement therapy (HRT).


What do all of these risk factors have in common?  Breast
cancer is a hormonal cancer and as such, it has been closely
linked to estrogen levels.  Each of the above risks has to
do with changes in a woman's estrogen levels, when they've
taken place, how often, and for how long.  Unfortunately,
the more risk factors you have, the greater your chances of
contracting breast cancer.

Know the Breast Cancer Facts
A study which appeared in the February 18, 1998 issue of the
Journal of the American Medical Association (JAMA), showed
that women consuming at least 30 g/d of alcohol a day (2.3
bottles of beer, 2.8 glasses of wine, or 2 shots of liquor)
are at an approximately 30%-40% higher risk for breast
cancer than non-drinkers.  Why?  Higher levels of alcohol
consumption have been associated with higher levels of
estrogen in alcoholic women.  Moreover, alcohol may act as a
cocarcinogen, improving the permeability of carcinogens,
inhibiting the detoxification of carcinogens, and activating
procarcinogens.  For this reason, it is recommended that
women limit alcohol intake to 1 alcoholic beverage a day
(12-oz beer, 5-oz wine, or 1.5-oz liquor)

In another study, which appeared in the November 5, 1997
issue of JAMA, avoiding weight gain after menopause may
contribute to the prevention of breast cancer, particularly
among women who do not use postmenopausal hormones.  Thus, a
lifelong commitment to exercise plays a vital role in your
long-term health.

Diet and Breast Cancer
Eating well has a variety of health benefits, whether or not
it helps reduce the risk of breast cancer is unknown.
Despite all the media attention revolving around soy, it has
not yet been proven that soy products reduce breast cancer
risk.  Likewise, while the controversial Nurse's Health
Study showed no correlation between fat intake and breast
cancer risk, scientists aren't convinced.  Other studies do
show a link between diets high in saturated fat and breast
cancer risk.

Because no one is quite sure which type of diet makes a
difference in reducing or increasing breast cancer risk; the
American Cancer Society recommends the following guidelines:

- 5 or more fruits and vegetables per day
- 6-11 Whole grains such as wheat, rice, oats, barley and
  whole-grain based products
- Choose beans, seafood and poultry and/or choose lean cuts
of   beef, pork, and lamb
- Replace high-fat foods with lower fat versions (preferably
  fruits, vegetables, beans, and grains)
- Bake and broil foods instead of frying
- Use vegetable and olive oils(avoid saturated fats)
- Choose non-fat and low-fat milk and dairy products

Overall, with the exception of excessive alcohol
consumption, diet is a lessor factor when compared to other
breast cancer risks, such as genetic predisposition, early
menstruation, and late menopause.

Know the Breast Cancer Weapons
Self-care is the most powerful weapon against breast cancer.
Eat a healthy diet, limit alcohol intake, stay physically
fit, and visit your doctor regularly.  Each month examine
your breasts for any lumps or changes.  Do the examination a
few days after your period ends.  If you are using oral
contraceptives, do it on the day you begin a new pill pack.

In addition, have regular breast exams by a medical
professional and, if you are over 40, you should have
mammograms every 2 years or as often as your doctor
recommends.  After 50, you should have a mammogram every
year.  Breast cancer is an age-related disease.  The older
you are, the greater your risk of developing breast cancer.

If you are post-menopausal, weigh the options of hormone
replacement therapy and estrogen replacement therapy
carefully.  Discuss your risk factors with your doctor and
do not be afraid to keep asking questions about the choices
available to you.  Also, if you are post-menopausal, avoid
weight gain as this raises estrogen levels and keep
physically fit in order to reduce the rise in estrogen
levels.

In short, the "Why not me?" game is a serious one.  The
stakes are too high for it not to be.  When it comes to
breast cancer prevention (and treatment), these are the
rules: Be vigilant.  Be healthy.  Be informed.  Play as if
your life depends on it.

*Names have been changed.

Copyright (c) 1999 by Edel Jarboe.  All Rights Reserved.

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About the Author: Edel Jarboe is the founder of Self Help for 
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