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Illness prevention and treatment

April 26, 2012

Advances in the battle against breast cancer

With new discoveries, drugs and treatments, there’s been a lot of progress in the battle against breast cancer. The best advice? Be your own advocate.

Dr. Tak Mak, the renowned breast cancer scientist, gets excited when he talks about new breast cancer research. The Toronto-based director of the Campbell Family Cancer Research Institute at The Princess Margaret Hospital, Mak is at the moment particularly interested in bacteria in our gut – known as microbiota – and how they might be connected to breast cancer. “These bacteria may play a role in the types of diseases we get,” he says.

Studying gut bacteria and their potential breast cancer role is just one part of current leading-edge research in breast cancer that has already led to breakthrough drugs such as Herceptin, which, combined with targeted radiation, may prolong the life of women with specific breast cancers. It’s also helped many women survive the disease.

According to the Canadian Cancer Society’s breast cancer statistics, death rates have declined in every age group since at least the mid-1980s. The five-year survival rate for women with breast cancer is now 88%, and 75% live 10 years or more after diagnosis.

What’s even more inspiring is that women are being encouraged to take an active role in helping to prevent breast cancer, whether by learning about their risk, making lifestyle changes or raising awareness of the disease.

Prevention may be possible

The Canadian Breast Cancer Foundation quotes the World Cancer Research Fund as saying that a healthy lifestyle can prevent up to one-third of the most common cancers, breast cancer included. Working out regularly, eating a more balanced diet and a maintaining a healthier body weight can all lessen the risk. Other habits that may help:

  • Drink less alcohol. A study on alcohol consumption and breast cancer risk published in the Journal of the American Medical Association says consuming more than one alcoholic beverage a day can raise a woman’s risk.
  • Think twice about hormone replacement therapy (HRT). “Sure there are benefits to it,” says Mak, such as increased libido and more energy. “But it’s a big price to pay.” The Estrogen-Plus-Progestin Study conducted under the Women’s Health Initiative found breast cancer in women taking progestin and estrogen HRT was more prevalent and more advanced than in women who didn’t take it. Mak says new drugs have emerged that can help prevent bone loss – one reason women used to use HRT.
  • Stop smoking. And avoid it second-hand. In Smoking and Secondhand Smoke Raise Risk, BreastCancer.org quotes research linking long-term smoking to increased risk of breast cancer in the range of 35% to 50%.

Boost your breast awareness

  • Know your history. It’s important to keep a history of your family, says Dr. Mak, as 10% of cancers are inherited. If a close female relative such as your mother or sister had breast cancer early in life, you may want to consider genetic risk assessment. Your family doctor may be able to refer you to a special clinic for genetic testing for the BRCA 1 and 2 genes – which raise the risk of breast cancer by 75% and ovarian cancer by 20%. If the test shows you carry these genes, you can take preventive measures, such as close monitoring, medication or surgery.
  • Find out how dense your breasts are. Some research suggests a higher breast density slightly raises the risk of developing breast cancer. If a mammogram reveals this, talk to your doctor about more frequent screening.
  • Be breast-aware. Though health authorities are no longer recommending regimented breast self-exams every month, they do encourage women and men to be aware of their bodies. Discussing breast cancer facts and myths, the Canadian Breast Cancer Foundation advises: “Know what changes to check for and if you notice any unusual changes discuss them with a health care provider.” For women that means knowing what’s normal for them in terms of shape, texture and feel. The Canadian Cancer Society in Know your breasts says, “Get to know the whole area of your breast tissue – up to your collarbone, under your armpits and including your nipples – well enough to notice changes.”

Screening saves lives

While mammography is still the gold standard in breast cancer detection, it isn’t for everyone, or appropriate at any age. Instead, health authorities now recommend:

  • If you’re under 40, get a clinical breast exam from your doctor annually. Studies show that mammograms done at this age have a high rate of false positives (cases where suspicious tumours are found to be harmless). However, women under 40 should talk to their doctors about their risk and the benefits of mammography. If you and your doctor agree screening is best for you, either due to family history or other risk factors, an annual mammogram is likely best, says the Canadian Cancer Society. If an initial test shows your breast tissue is too dense for mammogram screening to be effective, your doctor may prescribe an ultrasound as an alternative.
  • If you’re 40 you may want to consider having a baseline mammogram to compare against when you begin regular screening, suggests Mak.
  • If you’re between 40 and 50, talk to your doctor about your risk profile. Regular screening has not shown to be of value in this age category, says Mak.
  • Mammograms every two years for women over 50. “If you’re 50 and above, [biennial] mammograms are very good as tumours usually grow slowly,” says Mak.
  • If you notice a lump, thickening, change of shape, nipple itching or discharge, or swelling or redness of the breast, have it checked by a doctor.

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