Christine Koh

Hello!

I'm Christine Koh, a music and brain neuroscientist turned multimedia creative. I'm the founder + editor of Boston Mamas, co-author of Minimalist Parenting, co-host of the Edit Your Life podcast, and creative director at Women Online. Drop me a line; I'd love to chat about how we can work together!

8 Things To Know About Breast Cancer

8 Things To Know About Breast Cancer

Everyone seems to know someone whose life has been impacted by breast cancer. In the last few years alone, two women very close to me have undergone treatment (in totally quiet yet bad ass warrior fashion, I might add) and I just finished up a sequence of four exploratory mammograms (thankfully, cancer-free). Though we're just past National Breast Cancer Awareness Month, breast health is something that women need to think about all year round so I'm really excited to share this Q&A with Cate Mullen, RN, MSN, AOCNS (Nurse Coordinator of the Tufts Breast Center) as part of on ongoing editorial partnership with Tufts Medical Center. Cate, thank you so much for taking the time to answer my questions!

1. Let’s start off with the risk factors for breast cancer. What are they?

  • Being a woman
  • Getting older. The risk of developing breast cancer increases with age and the majority of women diagnosed with breast cancer are >50 years.
  • Having an inherited genetic mutation of certain genes, such as BrCA1 or BrCA2
  • Family history of breast cancer
  • Personal history of breast biopsy showing atypical hyperplasia or lobular cancer in situ
  • Having dense breasts; this can limit the ability to identify cancers on a mammogram.
  • History of prior radiation therapy to the chest or breasts under the age of 30; for example, with the treatment of Hodgkins disease
  • Taking hormonal replacement therapy for longer than 5 years
  • Obesity after menopause
  • Alcohol consumption

The next 3 risk factors have to do with uninterrupted exposure of estrogen on the breast tissue

  • Starting your menstrual cycle before the age of 12
  • Having your first pregnancy after age 30 or never having a pregnancy
  • Starting menopause after age 55

2. How can I lower my risk factors?

It’s important to remember that there are certain things you can’t change – family history, genetics, dense breasts, when you started your menstrual cycle – but you can certainly make a difference in other ways.

  • Stay active. We know you hear it everywhere, but regular exercise is key -- move your body daily for at least 30 minutes!
  • Maintain a healthy weight
  • Don’t drink alcohol or limit your alcohol intake to one drink a day
  • Breastfeed your babies
  • Know the risks of taking hormone replacement therapy

3. Can we talk about breastfeeding a bit more? What do the data look like in terms of length of nursing (i.e., how many months) and reducing risk?

When we are talking about breast cancer risk reduction, breastfeeding is recommended as it delays the onset of periods for the majority of women. So, the breasts have a break from the cyclical estrogen exposure that is linked to breast cancer. How long to breastfeed is very controversial and much of those results has to do with the health benefits for the infant. So I have to defer that question.

4. Let’s talk about breast self-exams. I have always been told I should be doing them and I AM THE WORST AT DOING THEM (meaning, I never do them). What do women need to know about breast self-exams?

This is a controversial subject. Breast self-exams (BSE) can cause much anxiety among women. There is no definitive research that BSE leads to earlier detection of breast cancers. So, the trend of recommending women learn the BSE technique in their early 20’s and perform BSE monthly is no longer a consistent message.

Women who are interested in doing the BSE should be shown the technique by a health care provider. The goal of the BSE is to detect any changes in the breasts and then bring it to the attention of their health care provider.  I think most would agree that women should be familiar with their bodies and how their breasts feel. But that is different from doing a breast self-exam. Many women find their own breast cancers, but it is something they notice as part of their normal activities, not during a breast self-exam. Women need to be proactive and make sure a breast exam is performed when seeing their primary care providers or gynecologists.

5. I hear a lot in the news about BRCA1 & BRCA2 and a close relative had breast cancer. Do I need to have these tests done?

Being knowledgeable about your family cancer history is very important. Genetics is a field that is changing rapidly as more research is being done. Women for whom genetic testing is recommended are: women who are diagnosed with breast cancer under the age of 50, are of Ashkenazi ancestry, have bilateral breast cancer, have ovarian cancer, have triple negative breast cancer, or have 2 or more family members with breast cancer. When possible, the preference is to obtain genetic testing on the person with cancer before testing other family members.

6. When should I start having a mammogram or other screening? Are there other screening options?

  • Women ages 40 to 44 should have the choice to start annual breast cancer screening with mammograms
  • Women age 45 to 54 should get mammograms every year
  • Women 55 and older should switch to mammograms every 2 years, or can continue yearly screening
  • For women who have an abnormal breast exam, mammograms can be done at earlier age
  • For women who have a family history of breast cancer, mammogram screening usually begins 10 years earlier than family member’s diagnosis

7. What are the options, if I’m diagnosed?

When you have a new diagnosis of breast cancer, you need to become educated about breast cancer. It is best if you are seen in a multidisciplinary breast center (like the Breast Health Center at Tufts Medical Center) where you will have access to a team of specialists.

Breast cancer treatment involves a combination of therapies including surgery, medications (chemotherapy, hormonal therapy), and radiation. Treatment recommendations may vary from one woman to another according to type of cancer and its characteristics. It is important that you understand your specific situation so you can advocate for yourself, along with the health care team, to get the care you need. Having access to psychosocial support during a cancer diagnosis for yourself and your caregivers is also very important.

8. I have a family member/friend/coworker with breast cancer. What are the best ways I can support them?

The best way to support a family member, friend, or coworker is to listen and to be present. Take your cues from them. Unless you yourself have had breast cancer, do not try to give advice because you really do not know what they are going through. I would advise against reassuring them that everything is going to be okay, because it certainly doesn’t feel that way to them.

Spend time with them – go for a walk or to a movie. Bring them a home cooked meal or mind their kids for a few hours. Go to appointments with them or take care of some errands. Go shopping for a wig, give a hug, text and call to check in. There are many, many ways you can support them.

Most importantly, ask them what you can do – and keep on asking them in the days ahead and the months ahead! It’s hard to accept help, but make sure it’s always there on offer. The journey is long and challenging and having good support makes it easier to bear.

About Tufts Medical Center

The Tufts Medical Center Breast Health Center was founded in 1978 and provides comprehensive care for all areas of breast health. The Tufts Medical Cener program was one of the first in the U.S. to bring a team of care providers under one room to give patients access to multiple specialists, all in one location. Whether you’re focusing on disease prevention and screening, treating breast cancer or working to stay cancer-free, our team provides the full spectrum of diagnostic, therapeutic and educational services To learn more about the Breast Health Center, visit our website.

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Disclaimer: The content provided in this post is intended solely for the information of the reader. This information is not medical advice and should not replace a consultation with a medical professional.

Disclosure: This post reflects a compensated editorial partnership with Tufts Medical Center. All personal commentary is, of course, my own.


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