Breast Cancer Awareness: New Frontiers

October is Breast Cancer Awareness Month. Take the time to learn more about the disease, what you can do to fight it, and the cutting-edge treatments that are saving lives.

Breast Cancer Awareness: New Frontiers

About 1 in 8 women is expected to receive a diagnosis of breast cancer in her lifetime. And 70% of women who have breast cancer have no identifiable risk factors. Read on to learn about the many different faces of breast cancer, what you can do to reduce your risk, and the best ways you can keep track of the changes within your breasts, and more. 

  • Who Is Breast Cancer?: Learn more about the celebrities and personalities who have fought very public battles with breast cancer – and what they have done to raise awareness and find a cure.
  • Breast Cancer Prevention: Reduce your risk of breast cancer. Learn about special foods and recipes to fight breast cancer.
  • If I Find a Lump, Do I Have to Say Goodbye to My Breasts?: Learn about the process every woman goes through when she discovers a lump that may be cancer.
  • Cutting-Edge Cures: A new procedure that may change the world of breast cancer treatment forever. 
  • Improved Mammography: New research suggests that a newer digital version of mammography may catch life-threatening breast cancers earlier and more accurately.

Who Is Breast Cancer?

Breast cancer is everyone. It’s one of the leading causes of death in the United States. About 1 in 8 women is expected to receive a diagnosis of breast cancer in her lifetime. In 2011, 230,480 women and 2,140 men were estimated to have received a diagnosis of invasive breast cancer in the US.

Many famous celebrities have fought (and sometimes lost) public battles with breast cancer, including:

  • Olivia Newton John:Diagnosed in 1992 at age 43: The singer and actress is currently a 19-year breast cancer survivor. “When you’re dealing with cancer, your mind is just as important a part of your healing as your body,” she says. Since 2008 she has been raising funds to construct the Olivia Newton-John Cancer and Wellness Centre in her hometown of Melbourne, Australia. The center is designed to provide cutting-edge cancer treatments available nowhere else in Australia.
  • Christina Applegate: Diagnosed in 2008 at age 36: Because her mother survived breast cancer in her 30s, the actress made sure to get regular mammograms. Her doctor recommended that she get an MRI, which caught a cancer that the mammograms had missed. After genetic testing, she discovered that she carried the BRCA 1 gene, a mutation that increases one’s risk of breast and ovarian cancer. After a double mastectomy, she is healthy and advocates for breast cancer testing. She founded Right Action for Women: The Christina Applegate Foundation which educates women about what it means to be at "high risk" for breast cancer and encourages them to talk to their doctors about appropriate screening.
  • Sheryl Crow: Diagnosed in 2006 at age 44: Her cancer was detected early via a routine mammogram. After a lumpectomy and radiation therapy, she has become the ultimate advocate for breast-cancer prevention and routine mammograms. She talked about her diagnosis on The Dr. Oz Show. Watch her answer audience questions on breast cancer, meditation, motherhood and more..
  • Minnie Riperton: Diagnosed in 1976 at age 28: Known for her phenomenal vocal range and her 1975 hit single “Lovin’ You,” Riperton was diagnosed in 1976 with breast cancer and lost a breast through a mastectomy. She became a spokeswoman for the American Cancer Society’s 1978-79 campaign and received the American Cancer Society’s Courage Award. She lost her battle to breast cancer on July 12, 1979 at the age of 31, leaving behind her husband, songwriter Richard Rudolph, and daughter, actress Maya Rudolph.
  • Bette Davis: Diagnosed in 1983 at age 75: Davis was a legendary actress with over 100 film, television, and theatre roles to her credit. After her diagnosis and subsequent mastectomy, she eventually continued acting before her death in 1989 at age 81.

Other celebs who have been diagnosed with breast cancer include:

  • Kathy Bates: Diagnosed in 2012 at age 64
  • Suzanne Somers: Diagnosed in 2001 at age 54
  • Edie Falco: Diagnosed in 2003 at age 40
  • Wanda Sykes: Diagnosed in 2011 at age 46
  • Kylie Minogue: Diagnosed in 2005 at age 36
  • Cynthia Nixon: Diagnosed in 2006 at age 40
  • Robin Roberts: Diagnosed in 2007 at age 46
  • Jane Fonda: Diagnosed in 2010 at age 72
  • Elizabeth Edwards: Diagnosed in 2004 at age 55
  • Giuliana Rancic: Diagnosed in 2011 at age 36
  • Melissa Etheridge: Diagnosed in 2004 at age 43
  • Diahann Carroll: Diagnosed in 1998 at age 63

Breast cancer is more common that you think, and that’s why awareness is so important.  

Next, tips on how you can prevent breast cancer.

How Do I Prevent Breast Cancer?

An ounce of prevention is worth a pound of cure, and it’s up to you to take the appropriate measures to lower your risk factors and protect yourself. There are some permanent risk factors that increase your risk, like family history and increasing age. The following, from the American Cancer Society (ACS), is a comprehensive list of lifestyle-related factors that can increase your risk for breast cancer:

  • Obesity: Having extra fat in your body can raise estrogen levels, which can “increase your chance of getting breast cancer.” Furthermore, women who are overweight tend to have higher insulin levels, which has been “linked to some cancers, including breast cancer.”
  • Physical Activity: Physical activity bestows numerous benefits, including a lower cancer risk. In one study from the Women's Health Initiative, “as little as 1.25 to 2.5 hours per week of brisk walking reduced a woman's risk by 18%. Walking 10 hours a week reduced the risk a little more.”
  • Alcohol: Many studies have linked alcohol use with an increased risk of breast cancer, and the more you drink, the higher your risk.
  • Having Children: Because they tend to have higher exposure to estrogen, women who have had no children or who had their first child after age 30 have a slightly higher breast cancer risk.
  • Breastfeeding: Though the connection isn’t clear, breastfeeding may slightly lower one’s risk of getting breast cancer.
  • Birth Control: “Studies have found that women using oral contraceptives (birth control pills) have a slightly greater risk of breast cancer than women who have never used them.”
  • Hormone Therapy After Menopause: “Using combined hormone therapy [with both estrogen and progesterone] after menopause increases the risk of getting breast cancer. It may also increase the chances of dying from breast cancer.” However, for unclear reasons, taking estrogen-only therapy hasn’t been linked to an increased risk for breast cancer.

The risk factors indicate that estrogen exposure is an important factor in determining one’s breast cancer risk. The exact connection between the two is unclear, but many researchers believe that some breast cancer types have estrogen receptors and are triggered by estrogen.

The foods you eat also have potential to lower your breast cancer risk. Below are the top superfoods that have been shown to protect you from breast cancer. Incorporate them as much as you can into your daily diet.

  • Green tea: Three cups of green tea a day can prevent breast cancer by as much as 50% because of its high EGCG antioxidant content. Squeeze a little lemon into your cup and increase its antioxidant power 10 times.
  • Garlic: This immunity booster also has anti-inflammatory properties.
  • Olive Oil: This monounsaturated fat can help suppress tumor activity.
  • Tumeric: This spice known for its beautiful orange color also helps decrease estrogen.As little as 1 teaspoon a day has been shown to reduce tumor growth. Get your daily dose by mixing it into salad dressings, rice or vegetable dishes.
  • Cruciferous vegetables: Leafy greens like kale, bok choy and Swiss chard bind estrogen in your GI tract and reduce tumor stimulation. They also detoxify the liver, so you don't have toxins flowing through your body that can irritate cells and turn them into early cancers.
  • Seaweed: High in iodine, this is another estrogen reducer.

 Read more about the foodsthatfightbreastcancer, and try some of these easy-to-makerecipesto prevent breast cancer and take charge of your health.

Being vigilant about your own health is important; however, despite your best efforts to reduce your risk, you may still develop breast cancer. In fact, 70% of women who have breast cancer have no identifiable risk factors. It is important to find the best ways to keep track of the changes within your breasts – either with breast exams, mammograms, or other new methods. Women who catch any developing masses early have a higher chance of survival.

The United States Preventative Services Taskforce (USPSTF) shocked the country with its 2009 guidelines for breast cancer screening. Because of the lack of evidence “to assess the balance of benefits and harms,” the organization started recommending regular biennial mammograms for women after the age of 50 instead of 40. In their new guidelines, the USPSTF cited the risks, which include “psychological harm, unnecessary imaging tests, and false-positive diagnoses of breast cancer.”

However, in spite of the new recommendations, many physicians report using mammograms to screen 40-something women for breast cancer anyway. A 2010 ABC News survey revealed that 21 out of 24 physicians ignore the new USPSTF guidelines and tell women in their 40s to get mammograms anyway.

A 2010 Swedish study justified some of those physicians’ actions. The study found that starting women on mammography at age 40 rather than age 50 was associated with a 26% reduction in risk of death from breast cancer. Experts will need to review the current guidelines again in upcoming years.

Because guidelines tend to change, nothing is more important than developing a relationship with your physician to discuss the pros and cons of mammograms or other breast imaging. You must take prevention into your own hands. 

In the News: Learn more about why digital mammography may catch life-threatening breast cancers earlier and more accurately

Next, learn more about what you should do if you find a lump.

What Happens if I Find a Lump? Do I Have to Say Goodbye to My Breasts?

First step: Breathe. If you find a lump, remember that it can be something that isn’t cancer –  though it may be one of the first terrifying thoughts you have. Studies have shown that 80% of all lumps are not cancer, especially in women under 40.

Second step: See your doctor. Even though most lumps are not cancer, they should still be checked out. Your doctor will do a clinical examination of your breasts and determine if further evaluation is necessary. She or he may suggest following the lump for a few months, scheduling you for a breast imaging procedure (like a mammogram or ultrasound), or referring you to a specialist – usually a breast surgeon.

This process can be very scary and anxiety-inducing. It may feel tempting to ignore the lump altogether and do nothing; however, the earlier a potentially cancerous lump is investigated, the better.

The following are non-cancerous conditions that can feel like a lump:

  • Cysts: Fluid-filled sacs that develop from dilated lobules or ducts. They most commonly occur in women in their 40s or 50s. A quick ultrasound can identify cysts. They usually do not require treatment, but can be removed by inserting a needle into the cyst and drawing the fluid into a syringe – a procedure called aspiration.
  • Fibroadenomas: Benign fibrous growths that form mostly in younger women in their teens and 20s, though some may form later in life. A large, growing fibroadenoma may be removed surgically. Having fibrous breasts does not increase your risk of cancer, but may make it harder to find growing cancers on mammograms.
  • Pseudolumps: Areas of dense normal breast tissue that can develop in premenopausal women.

Next, learn about a new treatment for breast cancer that may one day eliminate invasive surgeries.

Prolonging Survival: Cutting-Edge Treatments

Long ago, the treatment for breast cancer involved a radical mastectomy –  the surgical removal of your breast, nipple, breast tissue, and underlying lymphatics, which can potentially carry cancer cells to other parts of your body. Many women died from the procedure itself.

Now, less invasive procedures have been developed. Many women receive a lumpectomy – a procedure that involves surgically removing the tumor, saving most of the breast itself. This would be followed by a course of chemo or radiation to make sure remaining cancer cells are gone. A newer, modified mastectomy is also in use, which spares the nipple of the breast and makes reconstruction easier.

Currently, new technologies are developing better and less invasive ways to treat and cure this deadly cancer. Currently, there are nearly 700 clinical trials in the nation that are investigating new methods of curing breast cancer. Though many of them fail, some are succeeding.

This year, researchers from the Cancer Genome Atlas Network revealed research that may change the face of cancer treatment forever. After analyzing tumors from 825 breast cancer patients, they were able to paint a clearer genetic picture of the different types of breast cancers that affect women. If we know exactly what genetic changes occur in the development of breast cancer, doctors will be able to prescribe more accurate treatments to eliminate existing cancer and prevent any reoccurrences.  

The four types of cancer are:

  • Basal-like Breast Cancer: This especially deadly type of cancer is rarer than the other types. This type of cancer resembles some forms of ovarian cancer and some lung cancers and may respond to similar treatments, like PARP inhibitors, designed to treat ovarian tumors.
  • Luminal A Breast Cancer: Unlike basal cancers, this type of tumor is sensitive to estrogen and may respond to hormone blockers better than the other types.
  • Luminal B Breast Cancer: Like Luminal A, it, too, is sensitive to hormone blockers but tends to be more resistant. This type may respond better to a combination of hormonal therapy and chemotherapy.
  • HER2-Enriched Breast Cancer: This type of cancer tends to derive its growth from making too much HER2, a protein that drives the growth of cancer cells. An HER2-blocker drug, like Herceptin, may be pivotal for its treatment.

A new surgical technique is also showing promise. It is called cryoablation, which involves using extreme cold to freeze and destroy cancerous and benign tumors. This technique, if successful, may replace traditional surgeries for some women with cancerous tumors. The technique is currently under investigation in hospitals all over the country.

Dr. RacheSimmons, Chief Breast Surgeon at The New York Presbyterian Weill Cornell Medical Center in New York City, is the lead investigator of this trial. “One of the reasons why I like cryoablation is because it’s so painless for the patient," she says. "When you make the tiny little skin incision, and you go in with the probe, and you then begin the freezing process –  the freezing acts itself like an anesthetic.”

Early research also suggests that using cryoablation to kill cancer cells may stimulate the immune system to fight off any cancer recurrence. Simmons adds, “With the freezing, the cells actually burst, and so the cells die, but the cancer DNA is then released into your system. It’s not viable or live, but it’s recognizable by your own body’s immune response. That’s what we think is happening with the cryo that we don’t think is happening with the other technologies.”

Time will tell if this procedure is more effective than surgery at curing some types of breast cancer. A video simulation of the procedure, provided by Sanarus, is below.

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