Breast Cancer Prevention Myths and Facts from the Experts

Today, women have a 1 in 8 risk of developing breast cancer in their lifetime. For men, that risk is much lower at about 1 in 800.

October is National Breast Cancer Awareness Month. It’s a time for everyone to get to know their risk factors and what they can do to minimize their chances of developing breast cancer.

What causes breast cancer?

Breast cancer is the result of a multistep process that turns a normal cell into a cancer cell. There is not one cause but multiple contributing factors.

Can certain foods cause breast cancer?

There’s no particular food that causes breast cancer and no breast cancer prevention diet. However, we do know that healthful eating as recommended by the American Cancer Society and the American Heart Association makes sense.

Can wearing a bra cause breast cancer?

There have been some rumors that bras, especially underwire bras, block lymph flow. Some believe a blockage causes breast cancer.

The American Cancer Society says this is false. After breast surgery, many women avoid underwire bras due to discomfort, but this is not because of a link of bras to cancer. No research has proven bras cause breast cancer.

Can your deodorant cause breast cancer?

Another myth. The American Cancer Society says based on the evidence, chemicals, such as aluminum, in antiperspirants do not increase the risk of breast cancer.

What are the risk factors for breast cancer in women and men?

Baystate Health’s Rays of Hope (ROH) has supported researchers delving into finding out what makes an individual susceptible to breast cancer.

“Every woman is at some risk for breast cancer with the biggest risk being her age. Women who are 50 or older account for over 70% of all breast cancer diagnoses. While some risk factors can be reduced simply by lifestyle changes, others cannot be changed. Not everyone with risk factors will develop the disease and many women with no known risk factors still get breast cancer,” said Dr. Grace Makari-Judson, co-director of the Rays of Hope Center for Breast Cancer Research.

Age is a risk factor for men too. The American Cancer Society says most men with breast cancer are about 72 years old when they’re diagnosed.

Are there breast cancer risk factors specifically for men?

Yes, there are some risk factors men should be aware of.

Men with Klinefelter syndrome are more at risk for breast cancer. The condition causes men to have more than one X chromosome. They also have more estrogen compared to other men.

Taking estrogen-related drugs once used as prostate cancer treatment can also increase a man’s risk of getting breast cancer.

Some testicular conditions, like having a testicle removed, can also increase a man’s risk.

Why are some women more likely to get breast cancer than others?

Rays of Hope scientists, clinicians and advocates have prioritized questions around why some women develop breast cancer and others don’t. The ROH Breast Research Registry includes a tissue repository, overseen by Dr. Sallie Smith Schneider, that provides a unique opportunity to study these questions.

Estrogen is one key to the development of breast cancer. It can cause damage to DNA, which in turn may lead to cancer. Dr. Joseph Jerry, co-director of the Rays of Hope Center for Breast Cancer Research, and collaborators have studied estrogen exposure from the environment and how individuals respond differently. Specifically, they studied exposure to propylparaben and benzophenone-3 (compounds used in cosmetics and sunscreens) and how individual tissues differed in their sensitivity to these environmental estrogens.

Dr. Jerry often asks why seven out of eight women do not get breast cancer. What protects these women? ROH researchers have looked at genomic polymorphisms – small changes in an individual’s DNA that may lead to variable responses to both our own estrogen and environmental estrogen exposures. The search to understand what protects some women and to identify women who may be more vulnerable is a recurring theme.

Can breast cancer be prevented?

There is no fool-proof way to prevent breast cancer.

But there are things you can do to reduce risk factors.

How to reduce your risk of breast cancer

As research continues, it’s important to focus on prevention. Although there are medications to reduce the risk of getting breast cancer, for the average individual, the primary prevention for breast cancer is to live an overall healthy lifestyle.

“If women pay attention to their lifestyle such as eating a healthful diet, exercising regularly, limiting alcohol intake, not smoking and maintaining a close to ideal body weight after menopause, their breast cancer risk could be reduced by 30-40%,” Dr. Makari-Judson said.

Dr. Makari-Judson shares ten ways to reduce the risk of developing breast cancer:

1. Avoid weight gain after menopause

Although obesity throughout life has its health risks, weight gain after menopause is specifically associated with a higher risk of breast cancer. After menopause, women may tend to lose muscle mass and gain belly fat.

Men also need to maintain a healthy weight to lower their risk of breast cancer.

2. Exercise started anytime in life reduces risk

Rigorous exercise in the premenopausal years can reduce the risk of breast cancer by 27%.

The American Cancer Society recommends men and women get at least 150 to 300 minutes of moderate intensity or 75 to 150 minutes of vigorous intensity activity each week.

Even moderate exercise, as little as 1-2 hours per week can reduce risk in postmenopausal women by 18%.

3. Limit alcohol

It doesn’t matter what type – beer, wine, or hard liquor – the more alcohol consumed, the higher the risk.

Some women and men may be especially susceptible as they may metabolize alcohol differently leading to higher risk with lesser amounts.

4. Don’t smoke

Although smoking impacts less on breast cancer risk than other cancers, it is still a contributing factor, especially in women who started smoking before age 20 or five years before their first pregnancy.

It’s not always easy to stop once you’ve started. Baystate health experts share their tips for quitting smoking.

5. Breastfeed your children

Cumulative nursing time of at least one year reduces risk of premenopausal breast cancer.

Having children prior to age 30 reduces risk, but this may not be a practical suggestion for many. Learn more about breastfeeding and find support.

6. Minimize estrogen use after menopause

Studies show a higher risk of breast cancer with higher doses, the combination of estrogen and progesterone, and more prolonged use. Consider estrogen replacement if you have bothersome menopausal symptoms for a few years but try not to stay on indefinitely.

7. Know your family history

Learn more about your family medical history. You should know about any medical conditions they may have had and what ages they were affected. Find out if relatives have had breast cancer, especially any men with breast cancer, ovarian cancer, pancreatic cancer, or metastatic prostate cancer.

One study found men with both an affected mother and sister have nearly ten times the risk of men without a family history.

If you do have a family history of breast cancer, ask your doctor for information about genetic counseling and testing. Baystate’s Family Cancer Risk Program offers counseling and testing. There are specific risk-reducing strategies for those who may have inherited susceptibilities.

8. Know your breast density

Half of all women undergoing screening mammography have breast tissue described as “heterogeneously or extremely dense.” This may be related to estrogen exposure, family history or other factors and may warrant a personalized approach to screening.

9. If you have had a breast biopsy, know the result.

Certain benign breast conditions can be associated with higher risk of breast cancer. Breast biopsy results described as “atypical” generally are associated with a 15-20% lifetime increase in risk of breast cancer. Women with these types of benign breast disease may be considered “high risk.”

10. Know whether you are considered high risk

Know your risk and consider a medication for breast cancer prevention. One way breast cancer risk can be assessed is by computerized models which take into account risk factors, benign breast disease and family history. Tamoxifen, aromatase inhibitors or raloxifene (EVISTA) taken for five years reduce the risk of breast cancer in high-risk women by 50%.

Dr. Makari-Judson recommends if you have any risk factors for developing breast cancer to talk to your doctor about ways to lower those risks and a personalized plan for breast cancer screening.

Why is getting screened for breast cancer important?

You can’t guarantee you won’t get breast cancer, even if you do practice these prevention methods. That’s why you should make sure you’re getting screened.

“We do know that women who have regular screening mammograms reduce their risk of death from breast cancer. While noting breast cancer screening does not prevent breast cancer, studies have shown women undergoing regular screening reduce their risk of dying from breast cancer by 60%,” Dr. Makari-Judson said.

The U.S. Prevention Services Task Force recommends women between ages 40 to 74 who are at average risk for breast cancer get a mammogram every two years Several other professional organizations including the American Cancer Society, and National Comprehensive Cancer Network, suggest that screening be yearly. Women at higher risk should get personalized recommendations from their healthcare provider.

Because there are so few cases of breast cancer in men, no screening is done in men except in rare circumstances. There are no recommendations regarding men and screening. Your doctor may recommend a screening if you have a genetic mutation that increases your risk of breast cancer and a condition called gynecomastia which causes enlarged breast tissue.

Men should make sure to be aware of their own body and changes to their chest area. The American Cancer Society says many men don’t notice changes or wait until the lump is very large to see their doctor. That may be why men are diagnosed at more advanced stages than women are.

To make an appointment

To make an appointment with a breast specialist, or to schedule a mammogram, call the Baystate Breast and Wellness Center, located on 100 Wason Avenue in Springfield, at 413-794-8899.

To make an appointment for genetic counseling, call the Family Cancer Risk Program, 413-794-8890.