ASK any woman what disease she's most afraid of, and chances are she'll say breast cancer. "Almost everyone knows someone who did everything `right' and still got breast cancer," says Victoria Seewaldt, MD, who is co-leader of the breast and ovarian cancer program at the Duke University Comprehensive Cancer Center. "That can make women feel like they have no control."
While you can't control your genes, there are powerful steps you can take to protect yourself. But experts say there's a lot of confusion about what really matters. Here's what they want you to know about...
* Lifesaving screenings
1. Clinical breast exams are as important as mammograms. Mammograms starting at age 40 are crucial (get them earlier if you have a family history of the disease), but they are an imperfect screening tool, especially in women who have dense breasts.
That's why an annual clinical breast exam from a doctor is a must. "This is especially important for detecting inflammatory breast cancer (a rare but aggressive type that can make the breast swollen and red), which often doesn't show up on mammograms," explains Katherine B. Lee, MD, a breast specialist at the Cleveland Clinic Breast Center.
On the other hand, ductal carcinoma in situ (DCIS), the earliest form of breast cancer which is limited to the milk ducts, is most often found on mammograms. So both screenings are equally important.
2. Breast self-exams really can help. It's good to do them at the same time every month but don't stress out if you don't have them penciled into your planner. What self-exams do is help you become familiar with what's "normal" for your breasts. So when something's off, you'll know and can bring it to your doctor's attention. After all, you know your body better than any doctor does.
3. Don't panic if you get called for a mammogram "redo" or have calcifications. Many women over 40 have calcium deposits (calcifications) in their breasts, and most of them are benign. "It's part of the aging process of the tissue," explains Dr. Lee. These can show up as white spots on a mammogram - they tend to be harmless if they are large, coarse, solitary spots but suspicious if the tiny flecks cluster together in a linear pattern. Most radiologists can distinguish between the two, and only the suspicious ones warrant a biopsy. Although the period between the initial and follow-up mammograms can be anxiety-filled - a common reason some women delay their follow ups, says research at the Dana-Farber Cancer Institute in Boston - most of the time the callback turns out to be nothing.
* How Diet and Exercise Lower Your Risk
4. Active women are less likely to develop and die from breast cancer. Regular exercise has consistently been associated with a lower risk of breast cancer. "Any type of exercise is likely to help by lowering estrogen levels," Dr. Seewaldt explains. What's more, a new study from the University of South Carolina suggests that women with high aerobic fitness levels (based on their endurance on a treadmill exercise test) have a 55% lower chance of dying from breast cancer than their lessfit peers. So get moving!
5. Get your folate. While experts say that an overall healthy diet may help prevent breast cancer, a growing body of research suggests that getting enough of the B vitamin folate (in leafy green vegetables, beans and fortified cereals) may help mitigate the increased risk associated with drinking alcohol (Having two or more drinks a day, ups breast cancer risk by about 25%).
Go easy on the alcohol, but "if you have one drink daily, getting plenty of folate from your diet or a multivitamin may help," says Claudine Isaacs, MD, director of the clinical breast cancer program at Georgetown University Medical Center.
6. Being overweight is riskiest after menopause. Of course, staying at a healthy weight throughout your life lowers your risk of just about everything, including heart disease, type 2 diabetes and arthritis. But when it comes to breast cancer, it's the post menopause pounds that are particularly dangerous.
"In postmenopausal women, one of the most significant sources of estrogen comes from body fat," explains Dr. Isaacs. "So if you're overweight, you have higher amounts of circulating estrogen, which could stimulate breast cancer growth." And it doesn't take much: Losing even 10 pounds may help lower your risk.
7. Lumpy breasts don't mean a higher risk of cancer. Many women have cysts in their breasts that come and go throughout their manstrual cycles (which are also known as fibrocystic changes). Feeling any kind of lump or bump can be scary, but these types of cysts don't typically lead to cancer, Dr. Seewaldt points out. Still, it's especially important for women who have fibrocystic breast to do breast self-exams and get annual clinical breast exams so any lump that is out of the ordinary can be thoroughly checked out.
1. Breast cancer risk is not 1 in 8 for all women. That stat applies to lifetime risk, assuming you live to 85 or beyond. At age 40, the average woman has a 1 in 69 chance of getting breast cancer in the next 10 years; at 50, the risk rises to 1 in 42; at 60, it's 1 in 29; and at 70, it's 1 in 27. Statistically speaking, women are at most risk for breast cancer in their 70s and 80s - but that's when breast cancer has the highest cure rate because women in that age group usually get a less aggressive and more treatable form of the disease.
2. A family history doesn't mean you will definitely get it. Only about 20% to 30% of people who develop breast cancer have a family history of the disease.
3. If it's caught very early breast cancer has more than a 90% survival rate in the U.S. At stage 0 and stage I (a tumor is 2 cm or less and hasn't spread beyond the breast), the five-year survival rate is now 100%, according to the American Cancer Society (ACS).
4. Many factors affect your risk. Family history isn't the only thing that matters: Other factors include when you first got your period, if or when you have children and how active you are. Discuss details of your lifestyle and medical history with your doctor so she can make sure you are getting the right screenings at the right time.