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Breast cancer: The disease you can defeat
Striking at random
Early and often

A clearer picture
A clearer picture

Here are some findings on breast cancer:

  • A study of tamoxifen found that the estrogen-suppressing drug reduced breast-cancer risk by 62 percent in women with the BRCA2 gene mutation but had no effect on women with the BRCA1 mutation.
  • A new technique, DNA microarray analysis, may accurately predict which women will experience breast cancer recurrence after treatment. Large-scale clinical trials are planned.
  • A super-thin endoscopic lens, inserted through the nipple to look for breast cancer cells, has raised hopes that breast biopsies could become obsolete within a few years.
  • To study a new therapy called ductal lavage, doctors inserted saline-filled catheters through 507 women’s nipples to flush cells out of the milk ducts. Lavage yielded enough cells for 78 percent of the women to be tested. Using nipple aspiration, in which a fine needle withdraws cells, only 27 percent could be tested.

Though breast cancer isn’t the leading cause of cancer death among women (lung cancer is first), the facts speak for themselves: More than 184,000 new cases of breast cancer are expected in 2008, along with more than 40,000 deaths. Put another way, American women face a one-in-eight chance of developing the disease over the course of their lifetime.

But other facts are important, too. Breast cancer isn’t the automatic death sentence it once was. Researchers have made giant strides in understanding the illness and how it can be detected and defeated. And they are even shedding light on preventive strategies. While still a serious problem, the truth is that breast cancer is almost always curable if it’s discovered and treated in time.

Striking at random

Risk factors include having mutations in the BRCA1 and BRCA2 genes (which can be detected with a special blood test), experiencing a first menstrual cycle before age 12, completing menopause after 55, drinking two or more alcoholic beverages a day, being childless or having a firstborn after age 30.

However, misunderstandings about breast cancer can cause many women to underestimate their risks. Here are a few common misconceptions:

  • “My family doesn’t get breast cancer.” While it’s true that breast and other cancers run in families, it’s also true that 90 percent to 95 percent of breast cancer strikes women with no family history of the disease.
  • “My breasts are small, so I won’t get cancer.” The fact is that breast size has no bearing on who gets breast cancer.
  • “Diet plays no role in breast cancer.” While no firm evidence links diet to higher or lower risk, being seriously overweight or obese is a suspected risk factor for breast cancer, especially for postmenopausal women who gain weight after 50. Fat tissue has the ability to change some hormones into estrogen, and the longer you’re exposed to estrogen, the greater your risk for breast cancer. A healthful diet low in saturated fat is your best choice while research continues.
  • “I’m past 50, so cancer probably missed me.” In fact, 78 percent of breast cancer cases are diagnosed in patients 50 and older.

Early and often

Though there’s still no cure for breast cancer, you may be able to significantly reduce your risk of developing it. Use these American Cancer Society and National Cancer Institute strategies:

  • Start over. It’s never too late to change lifestyles that may cause cancer. If you smoke, quit. Maintain a healthy weight by lowering fat and calories. Avoid eating charred meat—it contains carcinogens that may increase your risk of breast cancer. Get 30 minutes of exercise most days of the week. Limit alcohol to one drink daily.
  • Look around. Doctors recommend getting an annual mammogram as well as a clinical breast exam by a healthcare provider. If you’re at very high risk, you may need a magnetic resonance imaging scan as well.
  • Stay in touch. See your doctor immediately if you feel a lump, pain or changes in skin texture or breast shape.
  • Consider alternatives. Discuss with your doctor the benefits and risks of taking the drugs tamoxifen or raloxifene, which have been shown to prevent breast cancer in women at high risk for the disease.

The bottom line: No one can say for certain who will or won’t be stricken with breast cancer, but an amazing 98 percent of so-called stage 1 breast cancers—a tumor less than an inch around whose cells haven’t spread—can be successfully treated. That is, the patient lives more than five years after treatment because the cancer was found in time.