October is National Breast Cancer Awareness Month, so I'm focusing  this issue on some of the things that we know about breast cancer.


Are You At Risk?

Specific factors that can put you at risk for breast cancer include:

1. Having a close relative who has had breast cancer
2. Having your first child in your thirties, or later
3. Not having children
4. Early menstrual cycles (before age twelve)
5. Being African American
6. Diet, as discussed below
7. Antibiotic use - a new study found that antibiotic users had
a 50% higher risk of breast cancer and the higher the use, the
higher the risk. Researchers believe that the antibiotic
use was due to chronic inflammation, which was linked to cancer
and heart disease.

Diet and weight are starting to appear as major risk factors for breast cancer. Here are some of the facts that we know about the correlation of diet and weight with breast cancer.

* Obese women, in other words, those with a Body Mass Index of 30 or more (calculate your BMI at http://nhlbisupport.com/bmi/), face two-to-four times the risk of breast cancer (and endometrial cancer). The fat found around the abdomen, in apple-shaped women, seems to be more reactive, leading to faster cell growth, including growth of cancerous cells.

* Research by the American Cancer Society shows that postmenopausal women who had gained 21-30 pounds over their weight at age 18 were at a 40% greater risk of getting breast cancer than those who had only gained 5 pounds or less. It's thought that breast cancer risk increases due to the excess fat tissue increasing the body's estrogen levels.

* A study of women in Mexico who consumed high-carbohydrate diets (especially high in corn products) found that they were twice as likely to get breast cancer. Researchers theorize that the carbohydrates raise blood sugar and provide an environment favorable for replication of cancer cells. Women in the study who consumed more fruits, vegetables, and whole grains, all of which contain insoluble fiber, had far less breast cancer risk, leading to speculation that diets higher in insoluble fiber put women at less risk of breast cancer. American women typically consume diets that are much lower in carbohydrates than the women studied.

What about Hormone Replacement Therapy (HRT)? Is it a risk factor? We don't really know. Until fairly recently, doctors prescribed HRT for protection against heart disease, colon cancer, and osteoporosis, especially if you had a family history of those. The downside was an increased risk of breast cancer. However, the US Women's Health Initiative studies found no protective effect for the heart from HRT, and in the estrogen-only study there was no breast cancer risk increase. However, scientists in Scandinavia called off their HRT study among women who had already experienced breast cancer due to the high risk of breast cancer
recurrence among study participants. We just don't know, but for now, HRT may be OK for short-term symptom relief, but is not a long-term strategy.


Getting Checked Out

Talk with your doctor about whether you have a family history of breast cancer. If you have had one, or more, female relative(s) with breast cancer, you need to be on a more frequent and aggressive screening program and you may even want to consider genetic testing for you and other family members.

How frequently to do mammograms is a subject of some debate, but here are some facts that may help.

* For women over age fifty, having a mammogram annually saves lives due to a 30% reduction in death rates from breast cancer. For women in their forties, the reduction is 16%-18%.
 
* The American Cancer Society and the National Cancer Institute recommend starting to have mammograms at age 40, and to have them every one–two years thereafter.
 
* Mammograms aren't as accurate for pre-menopausal women because their breast tissue is denser, resulting in a higher rate of false positives. For example, 97% of women in their forties who underwent surgical biopsies resulting from the findings on their mammograms
didn't actually have breast cancer.

This year, October 15 is National Mammography Day, and throughout the month many facilities will give free or reduced-price mammograms.


Managing Your Risk

What are some things that you can do to manage your risk of breast cancer?

* Get moderate levels of exercise (30-60 minutes per day), which has been shown to reduce breast cancer in post-menopausal women, and is good for all of us. (It reduces your risk of heart disease and stroke, too.)
 
* Control your weight and manage your diet. Focus on fruits, vegetables, and whole grains, to get insoluble fiber, and maintain a diet lower in fats and carbohydrates. A couple of specific
food examples include:

- Flavones, found in some fruits and vegetables, such as celery, lettuce, peppers, spinach, chili pepper, lemon, and parsley, protect against breast cancer; for each 0.5 gram per day consumed, breast cancer risk decreases by 13%.

- Lignins, found in ground flaxseed (a whole grain containing healthy Omega-3 fatty acids), appear to reduce the incidence of breast cancer.

* If you're on a statin drug (Lipitor, Zocor, Crestor, Pravachol, or others) for controlling your cholesterol, that appears to also reduce the risk of breast cancer (and colon cancer) by easing
inflammation (as measured by a test called C-Reactive Protein).


Bottom line: Diet and exercise can reduce your risk of breast cancer. If you're dieting and exercising, but not losing weight, consider whether you're under a lot of stress. Stress can negate the impact of diet and exercise, so managing that stress may help you lose that excess weight, and be the third pillar in your strategy to avoid breast cancer.

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Mellanie True Hills (http://www.mellaniehills.com), the Health & Productivity Revitalizer, works with individuals and organizations that want to be healthier and more productive. She is the author of 'A Woman's Guide to Saving Her Own Life: The HEART Program for Health & Longevity.' Read the first two chapters online at http://www.mellaniehills.com/bookawgexcerpt.htm