Healthy Living Helps Fend Off Breast Cancer

And for women over 40, mammograms are critical

SATURDAY, Oct. 20, 2001 (HealthDayNews) -- Health experts can't say with certainty what steps women should or shouldn't take if they want to prevent breast cancer. Scientific proof that one course of action or another works best remains minimal -- at best. And theories and advice abound as the United States marks National Breast Cancer Awareness Month this month.

So, what's a woman to do?

Plenty, says Debbie Saslow, director of breast and cervical cancer for the American Cancer Society.

"This is a health issue that's a huge concern to women," she adds. "Being a woman and growing older" -- two of the main risk factors for the disease -- "are not things you can change."

But there's a lot you can do, Saslow says, on other fronts. For instance, she suggests women:

  • Limit alcohol, or avoid it altogether;
  • Exercise regularly;
  • Lose weight if you're overweight;
  • Eat a varied diet, high in fruits and vegetables and low in fat;
  • Breast-feed if possible, and for as long as possible.

Most experts seem to concur with that advice. But they also say early detection of breast cancer is critical, given the lack of proven preventative measures.

"It's very complicated," explains Dr. Worta McKaskill-Stevens, director of an ongoing National Cancer Institute study of specific drugs that might prevent breast cancer in some women. "Hard data for many of the lifestyle changes is not available. Clearly, though, we've seen some trends from clinical trials."

For instance, researchers sponsored by the National Cancer Institute are now looking at how a low-fat diet might affect a woman's chances of developing breast cancer.

"We don't think that overall fat intake has a noticeable effect on breast-cancer risk," Saslow says. "Some fats are healthier than others. But as to what type of fat [might have an impact], we don't know the answer yet."

Earlier this year, researchers from the Harvard School of Public Health reported that eating lots of fruits and vegetables -- fat-free foods already shown to be beneficial in staving off heart disease and some other types of cancer -- actually did next to nothing to lower the risk of breast cancer.

But women's health advocates remain optimistic about the possible breast cancer benefits of a low-fat diet.

"We haven't ruled it out," Saslow says.

In fact, much of the breast cancer experts' advice also benefits a woman's overall health. Losing weight, for instance, not only seems to help lower the risk of breast cancer in older women but also can contribute to healthier hearts.

"Clearly, weight reduction and obesity have some impact" [on the occurrence of breast cancer]," McKaskill-Stevens says. "And this lifestyle change may also prevent other diseases as well."

"For women who are seeking to be healthy, it's important not to focus in on just one thing," she adds, noting that "more women are going to die of cardiovascular disease than breast cancer."

Heart disease stands as the No. 1 killer of American women, according to the National Center for Health Statistics. Cancer ranks second: lung cancer is the leading killer for women, and breast cancer comes right behind.

More than 200,000 women in the United States will be diagnosed with some form of breast cancer this year, according to Cancer Society projections, and 40,200 will die from the disease in 2001. Statistics have shown that breast cancer occurs more often in white women than in black or Asian women.

But the best way to beat the disease, experts say, is by detecting it early.

A mammogram -- a low-dose X-ray of the breast -- can identify cancer long before symptoms appear, allowing for earlier and better treatment options. And that makes living longer much more likely, according to Swedish research published this past spring in the American Cancer Society's journal Cancer.

Regular use of mammograms can cut the death rate from cancer by 63 percent, the study showed.

Women 40 and older should have a mammogram every year along with an annual doctor's exam of the breasts and monthly self-exams, according to Cancer Society recommendations. Women between the ages of 20 and 39 should have a doctor's exam every three years, with monthly self-exams.

The criteria vary so greatly by age, cancer experts say, because the disease strikes older women much more often than younger women. Between 1994 and 1998 in the United States, 77 percent of all new breast cancer cases and 84 percent of all deaths from breast cancer were among women 50 and older, according to the Cancer Society.

"Very, very, very few cancers of the breast happen in women before the age of 40," Saslow says.

Still, one of every eight American women will develop breast cancer during her lifetime, according to the Cancer Society.

But if women follow what the experts recommend, from diet and lifestyle changes to regular mammograms, Saslow says, they "should feel good that [by] doing a lot of these things, they're going to live longer and be healthier."

What To Do

Has someone in your family had breast cancer? McKaskill-Stevens urges all women "to ask questions about their family history [because] many people just don't know." A woman's chances of developing breast cancer increase if her mother, sister or daughter had the disease, and certain inherited genes also have been shown to increase the risk.

"That's very important information to give your physician," she says.

To learn more about breast cancer, visit the American Cancer Society, or the National Cancer Institute online. Information also is available from the Breast Cancer Information Center, sponsored by the Feminist Majority Foundation.

For a primer on mammography, check out information from the American College of Radiology.

SOURCES: Interviews with Worta McKaskill-Stevens, M.D., program director, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, Md.; Debbie Saslow, director of breast and cervical cancer, American Cancer Society, Atlanta
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