[YOUR HEALTH] Mammogram still saves lives

For the average adult woman, the concern about breast cancer is not unfounded, what with the fact that it is the top cancer in women, both in the developed and developing world.

The World Health Organisation notes that incidence of breast cancer is increasing in the developing world due to increased life expectancy, increased urbanisation and adoption of western lifestyles. The WHO Global Estimates 2013 shows that worldwide, over 508,000 women died in 2011 due to breast cancer alone.

Experts worry that although some risk reduction might be achieved with prevention, these strategies cannot eliminate the majority of breast cancers that develop in low- and middle-income countries where the disease is diagnosed in very late stages.

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“Therefore, early detection in order to improve breast cancer outcome and survival remains the cornerstone of breast cancer control,” WHO counsels.

Symptom

The Head of Radiotherapy and Oncology Unit, Lagos University Teaching Hospital, Idi-Araba, Prof. Remi Ajekigbe, warns that the first sign of breast cancer, often, is a breast lump or an abnormal mammogram. Oncologists say breast cancer stages range from early, curable breast cancer to metastatic breast cancer.

According to the American Cancer Society, the chance of a woman having invasive breast cancer during her life is about one in eight, while the chance of dying from breast cancer is about one in 36.

Risk factors

Ajekigbe says, “While we do not yet know exactly what causes breast cancer, we do know that certain risk factors are linked to the disease. Some are preventable, others are not. Risk factors that you can’t change include your sex, and that is why breast cancer is about 100 times more common in women than in men.”

Another risk factor is age, experts say, as the chance of getting breast cancer goes up as a woman gets older. Ditto the generic risk factors, family history, dense breast tissue that can make it harder for doctors to spot problems on mammograms.

Again, experts say, women who start periods early (before age 12) or who experienced menopause after the age of 55 have a slightly increased risk of breast cancer.

Ajekigbe says further, “Women who have not had children, or who had their first child after age 30, have a slightly higher risk of breast cancer; while being pregnant many times or pregnant when younger reduces breast cancer risk.

“Some studies have also shown that breastfeeding slightly lowers breast cancer risk, especially if breastfeeding lasts one-and-a-half years to two years.”

As for those on some forms of contraception, researchers say women who are using birth control pills or an injectable form of birth control called depot-medroxyprogesterone acetate (Depo-Provera) have a slightly greater risk of breast cancer than women who have never used them. “This risk seems to go back to normal over time once the pills are stopped,” studies show.

Scientists also warn that taking estrogen and progesterone after menopause (sometimes called combined hormone therapy) increases the risk of getting breast cancer, though the breast cancer risk seems to go back to normal over time once the hormones are stopped.

The use of alcohol is also linked to an increased risk of getting breast cancer. “Even as little as one drink a day can increase risk,” studies show.

There’s virtue in being slim, as being overweight or obese after menopause (or because of weight gain that took place as an adult) has been linked to a higher risk of breast cancer.

Lower your breast cancer risk

Physicians agree that there are steps you can take to lower your risk of breast cancer as follows:

Maintain healthy weight

“Fat cells make estrogen. The more fat you carry, the higher your estrogen levels. And the higher your estrogen levels, the higher your risk, especially in women who gain extra weight post-menopause,” says a director of the cancer genetics programme at Northwestern University, USA, Dr. Virginia Kaklamani. So, don’t lose heart, lose weight!

Be active

Experts say women who exercise regularly have a 25 percent lower risk of developing breast cancer, compared to inactive women. You can do a brisk walk for 30 minutes thrice a week, and other physical exercises your gym instructor may recommend.

A study that examined 73,615 post-menopausal women found that those who simply put one foot in front of the other seven hours per week — about an hour a day — had a 14 percent lower risk of breast cancer, compared to those who were inactive.

Reduce alcohol intake

Researchers warn that the more drinks you take, the more your risk of breast cancer increases. Studies show that usually, women who drink have higher estrogen levels, because alcohol increases cholesterol, which gets converted into estrogen, hence the advice to reduce alcohol intake or stop it altogether.

Breastfeed

Ajekigbe says the more months you breastfeed, the lower your risk of developing breast cancer. Experts say active breastfeeding makes you to start your period later, and also end it sooner. “Having fewer periods because you’ve been breastfeeding or exercising a lot all reduce your risk,” researchers say; and decreases your exposure to estrogen.

“Giving birth to your first child at a younger age also decreases the likelihood of developing breast cancer,” physicians say.

Get regular mammograms

“Mammograms enable you to detect breast cancer at a stage where it is more likely to be curable,” Ajekigbe says. Experts say breast cancer is curable in 90 percent of stage one cases, 80 percent of stage two cases, and 60 percent of stage three cases.

-Punch

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