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Know the Methods to Detect Breast Cancer Early

Breast Cancer

Breast cancer is the most common cancer in American women. Detecting breast cancer early and getting treatment at the right time are the most crucial strategies to prevent deaths from this disease. There are methods to detect breast cancer early, when it is small and has not spread. When the disease is detected in an early stage, chances of successful treatment and better outcomes are high due to the availability of increased number of treatments, longer survival and improved quality of life.

The American Cancer Society recommends screening guidelines for the early detection of breast cancer. Screening tests help find breast cancer before any symptoms (like a lump that can be felt) appear.

Screening involves performing tests and exams to find a disease in people who don’t have any symptoms. Early detection means finding and diagnosing a disease earlier than if your waited for symptoms to start. Breast cancer found during screening tests will be probably smaller and still restricted to the breast. Breast cancer size and the range of spread are crucial factors in estimating the prognosis of a woman with this disease.

The American Cancer Society recommends mammography, clinical breast exam, and breast self-exam as early detection methods for women at average risk. Average risk women are considered as the women who don’t:

  • Have a strong family history of breast cancer.
  • Have a strong personal history of breast cancer.
  • Have a genetic mutation known to increase risk of breast cancer like in a BRCA gene and has not had chest radiation therapy before 30 years old.

The recommended detection methods for women at average risk are as follows:

  • Mammogram: Mammogram is the most important screening test for breast cancer. It is a low-dose x-ray of the breasts. Having regular mammograms can help detect breast cancer at an early stage, when the treatment is most effective.

    If your mammogram is normal, continue to get mammograms according to recommended time intervals. It helps the radiologists to compare your latest results with the previous results and can look for changes in your breasts. If your mammogram is abnormal, you will need more tests, mammograms, or exams to determine if the detected change is cancer or not. You will also be referred to a breast specialist or surgeon to diagnose the problems. They will do follow-up tests to diagnose breast cancer or to find that there is no cancer.

    Generally, regular mammograms aren’t recommended for women under 40 years of age, in part because breast tissue tends to be dense and it makes the mammograms less effective. For younger women with a family history of breast cancer and other risk factors, the American Cancer Society recommends mammograms for women ages:

    • Between 40 and 44 years of age should have a choice to begin screening mammograms yearly if they would like.
    • From 45 to 54 should do mammograms yearly.
    • 55 and over should continue getting mammograms every 1 to 2 years.

     
    While mammograms are the best cancer screening tests, women should understand that they are not 100% accurate in showing if a woman has breast cancer. They can give a negative result even if the breast cancer is present and a positive result even though there is no cancer in the breast. So, it is important that women who do mammograms know what to expect and understand the benefits and limitations of screening.

    Tips for getting a mammogram:

    • Try not to get your mammogram during your periods or the week before you get your period because your breasts may be tender or swollen then.
    • Don’t wear deodorant, perfume or powder on the day of your mammogram; these products will display as white spots on the X-ray.

  • Clinical breast exam and breast self-exam: Clinical breast examination is the examination done by a trained health professional of woman’s breasts before the woman herself notes it. It is performed to detect if there is any changes on the breast like skin changes, nipple discharge, lumpiness, or change in shape or size. There is only a little evidence showing that this method is effective for early detection of breast cancer who are already undergoing regular mammogram screening. For women who are not getting regular mammograms, this method may be useful. This method is not recommended for breast cancer screening among average risk women at any age.

    Regular breast self-exams or clinical breast exams are not recommended by the American Cancer Society as a part of a routine breast cancer screening schedule; but it doesn’t mean that these exams should never be done. In some situations, for women at average risks, healthcare providers still offer clinical breast exams along with offering counseling about the risk and early detection. Many women find it comfortable doing regular self-exams to keep track of the look and feel of their breasts. Keep in mind that there is a very little evidence showing that doing these exams routinely is helpful for women at average risk of breast cancer.

Women who are at high risk for breast cancer based on specific factors should get a mammogram and a breast MRI annually, starting age 30. Women who are considered at high risk are the one who have:

  • A first degree relative (parents, brother, sister, or child) with a BRCA1 or BRCA2 gene mutation and haven’t had any genetic testing themselves.
  • Any syndromes like Cowden syndrome or Li-Fraumeni syndrome, Bannayan-Riley-Ruvalcaba syndrome or have any first degree-relatives with any of these syndromes.
  • A known BRCA1 or BRCA2 gene mutation.
  • A lifetime risk of breast cancer of about 20% to 25% or greater according to risk assessment tools (mainly based on family history) and had chest radiation therapy between the ages 10 and 30.

A woman should be familiar with how her breasts usually look and feel and consult the doctor if there are changes such as:

  • A new lump or lumpiness, specifically one-sided.
  • Change in breast or nipple size or shape.
  • Unusual pain, specifically one-sided.
  • Nipple discharge.
  • Change in the breast skin.

There are risk factors for breast cancer that you can change and cannot change. Understanding these risk factors and taking steps to detect breast cancer early will help reduce your risk of developing breast cancer.

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Breast Cancer Awareness Month in October

Breast Cancer Awareness Month

October is observed as National Breast Cancer Awareness Month (BCAM). It started in 1985 as a campaign by the American Academy of Family Physicians, AstraZeneca Healthcare Foundation, CancerCare, and other organizations. The aim of this campaign is to encourage women to have mammograms for early detection of breast cancer. Today, many organizations are involved in this campaign and it has almost become a year-long event. In addition to raising awareness, BCAM’s goals also include raising funds for breast cancer research and support.

Breast cancer is the most common cancer seen in the American women. According to the CDC, each year more than 250,000 women in the U.S. are affected by breast cancer, and 42,000 women die from it. Breast cancer is commonly found in women who are 50 years or older, but it also affects younger women.Presently, there is no sufficient knowledge on the causes of breast cancer, the developments in the science of epigenetics shows that a while person may have a genetic predisposition for this disease, the external and internal environment play critical roles in how that gene is expressed.

Breast cancer is believed to be caused by genetic, hormonal, and environmental factors and risks increase with age. If breast cancer is detected early, more treatment options would be available, increasing the chances of survival and improved quality of life.

Thesymptoms of breast cancer include:

  • Change in breast size or shape
  • A new lump or swelling in the underarm or breast
  • Nipple discharge (including blood)
  • Pain anywhere in the breast
  • Change in breast colour

As some people do not show any symptoms at all, it is very important to self-examine your breasts regularly. If you notice any unusual changes, see your doctor right away to find out if it’s cancer.

Since 1993, the third Friday of October is observed as National Mammography Day to remind women that early detection is the best defence. In 2020, National Mammography Day falls on October 16. Mammography screening uses low-dose X-rays for breast imaging. Women in their early 40’s should have mammograms annually. Early detection is important for treatment at the earliest possible stage, which can improve outcomes. Mammograms can detect the signs of breast cancer years before the symptoms occur. According to the study conducted by Radiological Society of North America, women who have risk factors such as family history, personal history of breast cancer, or dense breasts, may benefit from beginning screening mammography at the age of 30.

The Breast Cancer Research Foundation was founded in 1993 and the pink ribbon was used to symbolize breast cancer at that time. Now, the pink ribbon is the symbol for breast cancer awareness. During Breast Cancer Awareness Month, numerous activities to promote awareness will take place across the country. Many famous buildings and landmarks will light up in pink to mark the campaign.

Breast Cancer Awareness Month is about increasing the awareness of the disease. Understand your risks and things you can do to lower them. Eat healthy, stay active, and don’t miss your annual screening.

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What are the risk factors for breast cancer?

breast cancerBreast cancer is a malignant tumor that develops from the breast cells. It is the most common type of cancer among women in the U.S. There are different types of breast cancer. The condition can be non-invasive or invasive and the cancerous cells can differ in terms of where they are located.

Most breast cancers are sporadic and develop if a person’s genes are damaged by chance after they are born. Environmental factors are the underlying cause of this type of cancer. So there is no chance of the person passing this gene to their children.

Inherited breast cancer is the less common type and makes up 5% to 10% of the cancers. It occurs when gene changes (mutations) are transferred from parent to child. Many of those mutations are in BRCA1, BRCA2, and PALB2 (tumor suppressor genes), which prevent the cells from growing out of control and turning into cancer.  If these cells have a mutation they can grow .

Some people showing a high risk of breast cancer may not develop it, while at the same time, people who do not show any risk factors can develop it. So understanding the risk factors that you cannot change and can be change is necessary to reduce your risk of developing breast cancer

Risk factors that you can change

  • Regular alcohol consumption.
  • Not having healthy foods.
  • Not being physically active.
  • Doing post-menopausal hormone therapy (PHT).
  • Being obese.
  • Being pregnant for the first time after the age of 30.
  • Not breastfeeding.
  • Use of birth control pills.
  • Exposure to chemicals such as paraben and phthalates that are present in cosmetics.
  • Exposure to chemicals in plastic products, in particular, bisphenol A (BPA).
 Risk factors that you cannot change

  • Being a women.
  • If you have already been diagnosed for breast cancer.
  • White women have more chance of developing breast cancer than women of other race.
  • Having a family history of breast cancer, especially for your mother, daughter, or sister.
  • For a person who has multiple relatives that are affected by breast or ovarian cancer especially before the age of 50.
  • Inherited risk.
  • Menstruation before the age of 11 and menopause after age 55.
  • If unusual changes occurs during a breast biopsy.
  • Exposed to radiation therapy to the chest as a child or young adult for another cancer.

Women should self-examine their breasts regularly and also perform mammogram screening starting at the age of 40. This will help in early detection of cancer and increase the chance of survival as there are more treatment options  available in the early stage. So, consider the risk factors you can change. Exercising regularly, maintaining a proper diet, and reducing stress and anxiety could help lower risk of breast cancer.

 

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9 Things You can do to Reduce your Risk of Breast Cancer

Breast Cancer

Breast cancer occurs when some breast cancer cells starts to grow abnormally and result in a lump or mass. Breast cancer is a malignant tumor that has developed from cells in the breast. The American Cancer Society predicted that in 2020:

  • Around 276,480 of women (new cases) will be diagnosed with invasive breast cancer.
  • Around 48,530 new cases of carcinoma in situ (non-invasive, the earliest form of breast cancer) will be diagnosed.
  • Around 42,170 women are expected to die from breast cancer.

In women, breast cancer is the second leading cause of cancer death in the U.S. (lung cancer is the first). It is estimated that 1 in 38 women will die from breast cancer.
The main factors that can increase the risk of having breast cancer are:

  • Environment
  • Not maintaining a healthy lifestyle
  • Not maintaining a healthy weight
  • Not following a healthy diet
  • Genetics
  • Getting older

Increased awareness about breast cancer can help to detect breast cancer early. It allows the patient to get better treatment, which reduces the risk of death.

People should be aware of the things that can be controlled by themselves to prevent or lower the risk of breast cancer. Here are some things you can do to reduce your risk of breast cancer:

  • Eat healthy foods: It is important to avoid sugary beverages, fried foods, processed foods, and red meat and include dietary fiber and antioxidants, a variety of fruits and vegetables, and foods that contain healthy fat such as olive oil, avocado, nuts, etc. Your physician can recommend a proper diet chart for you to follow.
  • Avoid consuming alcohol on a regular basis: Studies show that regular consumption of alcohol increases the risk of developing breast cancer. It is reported that alcohol consumption can lead to rising estrogen levels and can damage DNA (breastcancer.org). If your alcohol consumption is more than a drink a day, then you should stop or cut it down to lower the risk of breast cancer.
  • Breastfeed as much as you can: Breastfeeding can help you to shed breast tissue, and this removes the breast cells with potential DNA damage, thus reduce the risk of developing breast cancer. It will also provides excellent health benefits for your child.
  • Stay physically active: The American Cancer Society suggests that adults get 75 to 150 minutes of vigorous-intensity or 150 to 300 minutes of moderate-intensity activity or both combined each week. Regular exercise can lower the risk of breast cancer.
  • Maintain a healthy weight: The risk of developing breast cancer will increase if you are obese. Having more fatty tissue can increase the level of estrogen and thus increase the chance of developing breast cancer. Also, being overweight can lead to higher insulin levels which is linked to breast cancer.
  • Avoid hormone therapy after menopause: It is also known as post-menopausal hormone therapy (PHT). Women use this therapy to ease symptoms of menopause like hot flashes and sweating. It increases the risk of breast cancer. Women who choose post-menopausal hormones should do it for the shortest time possible. To take best decision about this, talk with your healthcare provider.
  • Avoid smoking: Everbody knows the harmful effects of smoking. It lowers the quality of life and increase the risk of many diseases, including different types of cancer. Risk of breast cancer are higher among women who started smoking during adolescence.
  • Avoid the use of birth control pills: Using birth control pills have both risks and advantages. Women who take birth control pills have an increased risk of breast cancer. If you stop using the pill, the risk is reduced.
  • Screening mammograms: Women are advised to have mammogram screening starting at the age of 40 to detect cancer early when it is more treatable. If something is found in the mammogram, more tests may be needed to confirm whether it is cancer or not. Early detection improves the opportunity for better treatment options.

Women with a family history of cancer should take proper steps to protect themselves. Maintain a healthy lifestyle, and don’t forget to self-examine your breasts regularly. If you notice any changes, consult a doctor without any delay. Symptoms of breast cancer include pain, swelling, redness or thickening of skin. Following these stesps can lower your risk of developing breast cancer and improve quality of life.

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Metastatic Breast Cancer: Risk, Symptoms and Treatment

Metastatic Breast Cancer

Metastatic Breast Cancer (Stage IV) is the cancer that has metastasized, which means that it has travelled to other parts of the body, most commonly the liver, lungs, brain, and bone. Cancer spreads through the bloodstream or lymphatic system, the large networks of nodes and vessels that works to remove viruses, bacteria, and cellular wastes products.

According to breastcancer.org, nearly 30% of women diagnosed with early-stage breast cancer will develop metastasized breast cancer. Some people are diagnosed with metastasized breast cancer when they are diagnosed for breast cancer for the first time, and this is called “de novo metastatic”, meaning the cancer in the breast was not detected before it spread to other parts of the body.

A patient who completes treatment for early or locally advanced breast cancer has the chance of developing metastasis breast cancer after years. This is sometimes called a “distant recurrence”. It happens due to breast cancer cells that remained after the treatment of early breast cancer. Breast cancer cells that were always present, were inactive and could not be detected but begin to grow again for some unknown reason.

The Risk

In 2020, it is estimated that there will be more than 168,000 women living with metastatic breast cancer in the U.S. (www. komen.org). Men also can get metastatic breast cancer.

The risk of developing metastasis breast cancer varies from person to person after the breast cancer treatment. It depends on:

  • The characteristics of the cancer cells.
  • How the cancer grows, which means is it faster growing or a slower growing cancer?
  • The stage at the time of original diagnosis.
  • The treatment for the original cancer.

Symptoms

The symptoms of metastatic breast cancer may vary depending on the location it spreads. It can spread to bone, lungs, brain, and liver.

Metastasis in the bone can show symptoms such as:

  • Severe pain
  • Fractures
  • Decreased alertness due to high calcium levels
  • Swelling

Metastatic breast cancer most often spreads to spine, pelvis, ribs or the long bones in the hands and legs.

Metastasis in the lungs can show symptoms such as:

  • Difficulty in breathing
  • Persistence cough
  • Chest pain
  • Fatigue

Metastasis in the brain can show symptoms such as:

  • Headache
  • Changes in speech or vision
  • Seizures
  • Vomiting or nausea

Metastasis in the liver can show symptoms such as:

  • Jaundice
  • Nausea
  • Fatigue
  • Swelling of the feet and hands
  • Weight loss or poor appetite
  • Fever
  • Itchy skin or rash

Diagnosis

Tests for diagnosis of metastatic breast cancer are performed only when the doctor thinks that the cancer may have spread. The doctor will check the patient’s tumor size, lymph node spread and the specific symptoms the patient is having. The most common tests performed are:

  • MRI scan
  • Ultrasound scan
  • Chest X-ray
  • Bone scan
  • CT scan
  • PET scan (positron emission tomography)

The test depends on the medical history and symptoms of the patient. That means, if the doctor thinks that the cancer may have spread to patient’s abdomen, the patient may have an ultrasound scan. All these tests are relatively non-invasive and does not require hospital stay. Before any tests, patient will be given special instructions.

Treatment

Metastasis or Stage 4 breast cancer cannot be cured. However, it can be treated to focus on extending and improving the quality of life. The treatment plan depends on many factors including the biology of the tumor, the area where cancer has spread, the symptoms, and past breast cancer treatments. The main forms of treatment in this stage include:

  • Chemotherapy
  • Radiation therapy
  • Hormone therapy
  • Targeted therapy
  • Surgery
  • Pain management
  • Clinical Trials

Metastatic breast cancer is considered incurable. However, advances in treatment coupled with state migration due to improved imaging and diagnostics have resulted in significantly longer survival in the last few years. When the disease is under control and the patient is feeling good, taking break in treatments can make a huge difference to their quality of life.

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Types of Breast Cancer and Their Symptoms

Breast Cancer

Breast cancer is a disease that occurs due to uncontrolled breast cell division. According to breastcancer.org, on average, a woman has 1 in 8 chance of developing breast cancer over an 80-year old lifespan. On the other hand, 7 in 8 women have no chance of developing breast cancer.

The breast is made up of lobules (milk glands), ducts and connective tissue. The milk glands produce milk, the ducts carry the milk to the nipple, and the connective tissue surrounds and connects everything together. Breast cancer usually begins in the lobules or ducts.

Breast cancer type depends on which cells in the breast become cancerous. According to cancer.org, 81% of breast cancers are invasive, which means the abnormal cells have broken through the walls of the glands or ducts from where they originated and have grown into the surrounding breast tissue. Breast cancer was referred as a single disease earlier, but now it is considered a group of diseases depending on the type of tissue in which cancer originates. The cancer would differ based on risk factors, presentation, response to treatment, and outcomes.

Invasive Breast Cancer Symptoms:

  • You can feel a lump or mass in the breast.
  • Even if there is no lump, swelling occurs on all areas or different parts of the breast.
  • Nipple/breast pain.
  • Nipple turning inward.
  • Nipple discharge.
  • Skin irritation.
  • The nipple or breast skin appears red, scaly or thickened.
  • A lump or swelling may occur in the underarm lymph nodes.

Different kinds of breast cancer show different kinds of symptoms. For instance, invasive ductal carcinoma (IDC) is formed in the milk ducts and the cancer cells grow outside the ducts into other parts of the breast tissue. This may cause a distinct breast lump that you can feel. In invasive lobular carcinoma (ILC), which is formed in milk-producing glands, there is thickening in the breast, and the cancer cells spread from milk glands or lobules to the surrounding breast tissues.

The common types of breast cancer

  • Invasive lobular carcinoma: The cancer cells that originates from the lobules spread to the nearby breast tissues and also to other parts of the body.
  • Invasive ductal carcinoma: This disease starts in the milk ducts and spreads to the fatty tissue of the breast outside the ducts. It accounts for 80% of invasive breast cancers.
  • Ductal carcinoma in situ: This is the most common type of non-invasive breast cancer. It is characterized by cancerous cells that are restricted to the lining of the milk ducts and have not spread through the duct walls into surrounding breast tissue. If the ductal carcinoma in situ lesions are left untreated, it will become invasive breast cancer over time because cancer cells may break through the duct and spread to close-by tissue. Most cases are detected with a mammogram.

    Symptoms:

    • Does not cause any symptoms.
    • Rarely, you can feel a lump in the breast.
    • Rarely, nipple discharge.


  • Lobular carcinoma in situ: Lobular carcinoma begins in the lobules but does not spread through the wall of the lobules to the surrounding breast tissue or other parts of the body. It is not actually cancer, but for about 25% of women, its presence will lead to the development of breast cancer at some point. Frequent screening is required.

    Symptoms:

    • Normally does not cause any symptoms and cannot be seen in a mammogram.
    • Usually found when a doctor is doing a breast biopsy to investigate an unrelated breast lump.
    • The breast cells will appear abnormal when examined under a microscope.



    • Rare Types of Breast Cancer

  • Inflammatory breast cancer: This often starts in soft tissues of the breast. It causes the lymph vessels in the skin of the breast to become blocked. The breast become firm, tender, itchy, red and warm due. This increases blood flow and build-up WBC.

    Symptoms:

    • Rarely causes breast lumps and may not appear in mammogram or ultrasounds.
    • Breast become firm, tender, itchy, red and warm.
    • Heaviness, burning or aching in one breast.
    • Inverted nipple.
    • Swollen lymph nodes under the arm and or above the collarbone.



    A self-breast exam, clinical breast-exam, ultrasounds or even mammogram may not detect this type of breast cancer. However, the changes to the surface of the breast caused by inflammatory breast cancer can be seen by the naked eye.

  • Metastatic breast cancer: Also known as stage IV or advanced breast cancer. It is the breast cancer that has spread to other organs of the body. It can affect commonly lung, liver, bone and brain.

    Symptoms:

    • Sometimes it does not cause any symptoms.
    • May be found in lymph nodes in the armpit or can travel to anywhere in the body.
    • Can occur pain, nipple discharge, lump or thickening in the breast or underarm if the breast or chest wall is affected.
    • Can cause pain, fractures, constipation, decreased alertness due to increased calcium level, if bones are affected.
    • Can cause nausea, extreme fatigue, swelling of the feet and hand, if liver is affected.
    • Shortness of breath, coughing, chest wall pain, fatigue, if the tumor forms in the lungs.
    • Can cause pain, confusion, memory loss, headache, blurred, difficulty in speech, movements or seizures if cancer spreads to the brain, spinal cord and forms tumors.


  • Papillary carcinoma: The cancer cells are arranged in finger-like projections or papules. The condition is treated same like invasive ductal carcinoma. A routine mammogram can detect the development of papillary carcinoma.

    Symptoms:

    • A lump about 2 to 3 cm in size which can be detected during a breast self-exam.
    • 50% of papillary carcinomas occur under nipple, resulting in bloody nipple discharge.


  • Triple-negative breast cancer: This type of breast cancer does not have any of the receptors such as estrogen, progesterone and HER2 protein that are commonly found in other breast cancers. This means hormone therapy, a traditional breast cancer treatment, would not be effective. Instead, it would require chemotherapy, targeted therapy and radiation.

    Symptoms:

    • A lump or mass in the breast.
    • Breast pain or redness.
    • Nipple turns inward.
    • Nipple discharge.


  • Paget’s disease of the breast: This form of breast cancer causes eczema-like changes to the skin on the nipple and areola. It forms less than 3 percent of all breast cancers.

    Symptoms:

    • Eczema-like changes on the nipple and areola.
    • Nipple discharge.
    • Inverted nipples.
    • Painful and burning sensation especially in advanced stages of the disease.
    • Redness, lump, oozing, sores that do not heal.


  • Male breast cancer: Breast cancer can occur for men when malignant cells form in the tissues of the breast. It usually occurs in the 60-70 age group. About 1 percent of all breast cancers occur in men.

    Symptoms:

    • A lump or swelling which is often painless.
    • Skin dimpling or puckering.
    • Nipple retraction.
    • Redness or scaling of the nipple or breast skin.
    • Nipple discharge.

Some types of breast cancer don’t show any symptoms or may not be detected in a mammogram or ultrasound. It is very important to self-examine your breasts every day. If you find any changes, signs or symptoms in your breasts that worry you, consult your doctor as soon as possible.

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Celebrate World BreastFeeding Week 1-7 August

World Breastfeeding Week

Breastfeeding provides every child with the best possible start in life and is one of the most effective ways to ensure child health and survival. Every year, August 1-7 is observed as World Breastfeeding Week (WBW) to protect, promote and support breastfeeding. This global campaign helps to raise awareness about breastfeeding and urges action on themes related to the practice.

The theme of World Breastfeeding Week 2020 is: “Support breastfeeding for a healthier planet”. The theme of this year’s campaign highlights the links between breastfeeding and the environment/climate change. It primarily focuses on the impact of infant feeding on the environment/climate change and the imperative need to protect, promote and support breastfeeding for the health of the planet and its people.

Breastfeeding delivers health, nutritional and emotional benefits to both children and mothers. Many medical experts such as the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists recommend that breastfeeding exclusively (no formula, juice, or water) for 6 months is a must and breastfeeding for a year at least with other foods (such as vegetables, grains, fruits, proteins) should be started at 6 months of age.

The Lifelong Positive Health Effects of Optimal Breastfeeding are:

  • Mother: Helps with birth spacing, reduces risk of breast and ovarian cancers and lowers the risk of hypertension.
  • Infants/Babies/Children: Helps combat infectious diseases, decreases incidence and severity of diarrhea, lowers respiratory infections and acute otitis media, prevents dental caries and malocclusion, and increases intelligence.

Along with the many benefits that it provides for both mother and child, breastfeeding also set a major example of deep connections between human health and nature’s ecosystem. Breast milk is a natural, renewable food that is environmentally safe and green because it is produced and delivered to the consumer without pollution, packaging or waste. On the other hand, artificial feeding leaves a major environmental footprint that contributes to the depletion of natural resources, environmental degradation and greenhouse gas emissions that cause global warming and climate change (worldbreastfeedingweek.org).

Although breast milk is the ideal food for babies during the first 6 months of life, sometimes breastfeeding may not be possible. In these cases, artificial feeding can be done, where modified formulas adapted to the needs of infants – starter milk (suitable from birth to 6 months) and then follow-on milk (6 to 12 months) – are given.

Started in 1992, WBW is celebrated in remembrance of the 1990 Innocenti Declaration. Since 2016, WBW is aligned with the Sustainable Development Goals (SDGs) and in 2018, a World Health Assembly resolution endorsed WBW as an important breastfeeding promotion strategy. The World Alliance for Breastfeeding Action (WABA), a global network of individuals and organizations dedicated to the protection, promotion and support of breastfeeding, coordinates the global WBW campaign to enlighten, anchor, engage and galvanise action on breastfeeding and related issues.

While in some cases women are unable to breastfeed, others simply choose not to. Along with this year’s theme, WHO and UNICEF are calling on governments to protect and promote women’s access to skilled breastfeeding counselling, a critical component of breastfeeding support. The benefits of skilled breastfeeding counselling services are:

  • It ensures that mothers and families get support, along with the information, guidance, and the encouragement they need to nourish their babies optimally.
  • It builds confidence in mothers while respecting their individual circumstances and choices.
  • It can empower women to overcome challenges and prevent feeding and care practices that may interfere with optimal breastfeeding, such as the provision of unnecessary liquids, foods, and breastmilk substitutes to infants and young children.

According to the World Health Organization (WHO), “improving access to skilled counselling for breastfeeding can extend the duration of breastfeeding and promote exclusive breastfeeding, with benefits for babies, families and economies. Indeed, analysis indicates that increasing rates of exclusive breastfeeding could save the lives of 820 000 children every year, generating US $302 billion in additional income”.

Skilled counselling can be provided in a variety of settings (in health facilities or clinics, through home visits or community programmes, in person or remotely) by different people – including health care professionals, lactation counsellors and peer support providers. Especially, during this pandemic period, to make sure that the access to these essential services does not get interrupted we have to find new, innovative methods, so that the families continue to receive their breastfeeding counselling in a safe and effective manner.

To make this happen, UNICEF and WHO, in line with the policy actions advocated by the UNICEF-WHO-led Global Breastfeeding Collective, are calling on governments to:

  • INVEST
  • TRAIN
  • ENSURE
  • PARTNER
  • PROTECT

Celebrate #WBW2020 – Share your experiences and thoughts about the links between breastfeeding and environment/climate change on the WABA’s social media platforms

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Absolute Risk and Relative Risk of Developing Breast Cancer

Breast Cancer

Having several risk factors doesn’t mean that you are likely to develop breast cancer and having low risk factors doesn’t mean that you will never develop it. The term risk describes the number or percentage of the possibility for a certain event to occur. Understanding the risk factors can help you take certain preventive strategies.

Absolute risk describes the probability of an individual to develop breast cancer. When you say that 12% of U.S women or 1 in 8 U.S women will develop breast cancer over the course of a lifetime, it shows the absolute risk. Over an 80-year lifespan, on average, a woman has a 1 in 8 chance of developing breast cancer. On the other hand, the chance of not developing breast cancer is 87.2%, or about 7 in 8.

The younger you are, the lower the risk. For instance:

  • According to breastcancer.org, if your present age is 20, for the next 10 years, the chance of developing invasive breast cancer, is .06% or 1 in 1,732 which means that, 1 in 1732 women in the same age group can expect to develop breast cancer. It can also be said that, if you are in this age group, your chance of developing breast cancer is 1 in 1732.
  • If your present age is 30, for the next 10 years, your chance of developing invasive breast cancer is .44% or 1 in 228.
  • If your present age is 40, for the next 10 years, your chance of developing invasive breast cancer is 1.45% or 1 in 69.
  • If your present age is 50, for the next 10 years, your chance of developing invasive breast cancer is 2.31 or 1 in 43.
  • If your present age is 60, for the next 10 years, your chance of developing invasive breast cancer is 3.49% or 1 in 29.
  • If your present age is 70, for the next 10 years, your chance of developing invasive breast cancer is 3.84% i.e. 1 in 26.

So, this means that when you are younger, the risk of developing breast cancer is low and when you get older, the probability of developing breast cancer increases. That means the older you are, the higher your absolute risk of breast cancer. Remember that these numbers and percentages are averages for the whole population.

Your individual breast cancer risk can be higher or lower based on family history, gender, race, weight, reproductive history, and other factors.

For instance, considering family history, the absolute risk of breast cancer for women who have inherited mutations in the genes known as BRCA1 or BRCA2 is much higher. For women with a BRCA1 mutation, the risk of developing breast cancer is 72% by age 80. This shows that, out of 100 women who have this mutation, 72 of them can expect the chance of developing breast cancer should they live to age 80. The risk is a bit lower for the women who have BRCA2 mutation, it is 69%.

If you have breast cancer, absolute risk can also describe the chance of the outcome of a certain treatment, or the course of the disease. For instance, based on the characteristics of the breast cancer like stage, grade, other test results, your age and medical history, and the treatments you have, your doctor will tell you that your chance of disease-free survival or being alive with no evidence of breast cancer within 5 years is 90%. That means that your absolute risk of having breast cancer come back within 5 years is 10% or 1 in10.

In other words, 1 out of 10 women with similar characteristics and the same treatment plan have the chance of having breast cancer to come back within 5 years, and 9 out of 10 have no chance of recurrence.

Relative Risk provides the percentage or number by comparing one group’s risk of developing breast cancer to another group’s risk. Relative risk is the type of risk that research studies normally use to compare groups of women with different characteristics or behaviours to find out whether one group has a higher or lower risk of breast cancer than the other (either as a first-time diagnosis or recurrence).

Higher Breast Cancer Risk

Studies have shown that many women consuming two or more alcoholic drinks (means 12 ounces of regular beer, 5 ounces of wine, or 1.5 ounces of 80-proof liquor) per day have a higher risk of developing breast cancer.

  • Women who consume two or more alcoholic drinks per day have 50 % higher risk of developing breast cancer when compared to women who do not drink. This doesn’t mean that their risk of developing breast cancer is 50% for the lifetime, it means that the risk is 50 % higher when compared to non-drinkers. This percentage is how you are likely to see relative risk reported by the internet, television, and newspapers.
  • Women who consume two or more alcoholic drinks per day have a relative risk of 1.5 when compared to women who do not drink. This is the number that researchers and scientific papers would usually talk about relative risk. The number “1” is the baseline group i.e. the women who do not drink, since the risk remains the same for them. The .5 is the relative increase in the risk for the other group, it is expressing the 50% higher lifetime risk in another way (50%= .5).

    In other words, the women who have alcoholic drinks per day for two or more times, the risk of developing breast cancer is 1.5 times than women who don’t drink.

Here 50% risk is the risk relative to the people who do not drink. However, it does not tell a women about her lifetime risk if she drinks two or more drinks per day for the rest of her life. It is necessary to multiply the absolute risk of breast cancer (12%) for women in the general population by relative risk (1.5), since women in this group have 1.5 times the risk of developing breast cancer.

  • 12*1.5 = 18. This means that the absolute lifetime risk of developing breast cancer for a women, if she drinks two or more alcoholic drinks per day is about 18%, versus 12% for women who do not drink.

Lower Breast Cancer Risk

  • If you had early breast cancer and lumpectomy, the absolute risk of having the recurrence of breast cancer within 10 years is 35%.
  • According to a study that reviewed 17 clinical trials of radiation therapy after lumpectomy, if you have radiation therapy to the remaining breast tissue, the risk is reduced by about 46%.
  • Compared to a woman who had a lumpectomy alone, within 10 years, your risk of developing cancer is 46% lower if you have radiation therapy after lumpectomy.
  • Medical researchers might say, when compared to the women who do not have radiation therapy, your relative risk of developing breast cancer is 1 – .46=.54. The number “1” remains in the baseline group. Just because it shows the decrease in risk, .46 is subtracted from 1. That means, when compared to the women who have lumpectomy alone, you have 54% of the risk of developing breast cancer again in the same breast as they do within 10 years.
  • To know the difference what radiation therapy really make you to reduce the absolute risk of cancer recurrence in the same breast, you have to multiply the 10-year risk of recurrence without radiation by the relative risk i.e. .35*.54 = 19.
  • This means 19% of absolute risk or just under 1 in 5 of cancer recurrence in the same breast, if you have radiation therapy versus about 35% or just over 1 in 3, if you don’t have radiation therapy. So, fewer than 1 in 9 women can expect the recurrence of breast cancer in the same breast versus more than 1 in 3 women who do not have radiation therapy.

A relative risk of .5 means that your risk goes down by half or 50%, 1.88 means your risk goes up by 88% and 3.0 means your risk has become 3 times or goes up by 300%.

From this, it is obvious that lifestyle factors and treatment options can increase or decrease the risk of breast cancer. As mentioned earlier, when you get older, the risk of developing breast cancer goes up. So, it is better to understand the risk factors and monitor yourself even if your risk factors are low to prevent the occurrence of breast cancer.

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Misconceptions and Facts about Breast Cancer

Breast Cancer

Breast cancer occurs due to abnormal growth of some breast cells. According to U.S Breast Cancer Statistics, in 2020, about 42, 170 women in the U.S are expected to die from breast cancer. There are so many misconceptions out there about breast cancer and it’s important to understand the facts.

Misconception 1: If you don’t have a family history of breast cancer, you don’t get it.

Fact: Many people think that breast cancer is an inherited disease. But only 5-10% of people who have a family history of breast cancer are diagnosed with it. The vast majority who get breast cancer have no family history, with environment and lifestyle being the prominent causative factors.

Misconception 2: You can do nothing to reduce your risk of getting breast cancer.

Fact: In a vast majority of women with breast cancer, the condition is caused due to the factors such as environment and lifestyle. You can reduce your risk by leading a healthy lifestyle – maintaining a healthy weight, following a nutritious diet, avoiding too much alcohol, not smoking, and starting mammograms at the age 40.

Misconception 3: A mammogram can cause breast cancer to spread.

Fact: A mammogram is the x-ray of the breast that helps in early detection of breast cancer. Mammograms require a small dose of radiation and the risk of harm from this radiation is extremely low. Screening can find cancer before any symptoms appear.

Misconception 4: Only women get breast cancer.

Fact: This is a big misconception. According to nationalbreastcancer.org, each year, approximately 2,190 men will be diagnosed with breast cancer and it is estimated that about 410 will die. Men should do self-examination of their breasts to check whether there any changes are happening, and if there are changes, report them to their physician immediately.

Misconception 5: Antiperspirants and deodorants can cause breast cancer.

Fact: There is no evidence that the use of antiperspirants and deodorants can cause breast cancer.

Misconception 6: If you find a lump in your breast, it is cancer.

Fact: Not all lumps are cancerous. Some may form due to cysts or scar tissue. However, if you feel any changes in your breasts it is better to consult a physician. Other symptoms of breast cancer include pain, swelling, redness or thickening of skin.

Misconception 7: Too much sugar consumption causes breast cancer.

Fact: There is no such evidence that sugar causes breast cancer. Eating too much sugar can lead to obesity that can increase the risk of various cancer.

Misconception 8: Breast implants increase breast cancer risk.

Fact: The risk of breast cancer is same for women with or without breast implants. However, standard mammograms don’t always work well for women with breast implants, and so they need additional X-rays to fully examine their breast tissue.

Misconception 9: Birth control pills can cause breast cancer.

Fact: Studies in 1990s showed that taking birth control pills may slightly increase risk of breast cancer. However, since then, the pills produced contain much lower doses of the hormones linked to those risks.

Misconception 10: Coffee can cause breast cancer.

Fact: There is no link between caffeine and breast cancer. In fact, research shows that caffeine may lower your risk of breast cancer.

Misconception 11: All breast cancer is treated the same way.

Fact: Depending on the characteristics of the cancer and patient preferences, treatment for breast cancer may vary. Some breast cancers are small, yet aggressive. Some grow slowly and become life-threatening. So, for each patient, the treatments and outcomes are different.

Maintaining a healthy diet, restricting intake of fat and sugars, staying physically active, and performing routine breast self-exams are some of the things you can do to decrease your breast cancer risk. Also, don’t forget to self-examine your breasts regularly. If you find any unusual changes, report it to your doctor as soon as possible.

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Lifestyle Strategies that can help Prevent Breast Cancer

Breast cancer is one of the most common and complex diseases affecting American women. The American Cancer Society (ACS) estimated there would be 268,600 new cases of invasive breast cancer diagnosed in women in the US in 2019 and U.S. Department of Health and Human Services says that about 1 in 8 women born today in the U.S. is likely to develop breast cancer at some point of time. Currently, the average risk of a woman in the U.S. developing breast cancer sometime in her life is about 12%. Age, family history, genetics, and gender are the common risk factors for cancer and these are not within a person’s control. However, research shows that lifestyle changes can decrease the risk of breast cancer, even in women at high risk.

Adopting the following lifestyle changes can optimize your health and lower your risk of breast cancer:

Breast Cancer

  • Avoid the use of plastic containers and aluminum cans: Get rid of plastic containers and aluminum cans (BPA lining, phthalates, etc) from your life as much as possible. Never drink water from plastic bottles, especially if they’ve been sitting in the heat. This is because all plastics may leach chemicals if they’re scratched or heated, says a research. BPA, which is added to plastic to make it durable was discovered to be a powerful xenoestrogen, a synthetic chemical that mimics the natural estrogen in our bodies. With constant use of plastics, these xenoestrogens are stored in our fatty tissue (especially the breast) and can lead to cancer. Use glass jars and bottles.
  • Stop using products with synthetic chemicals and unknown elements: Get rid of all face, body, beauty, or fragrance products that contain synthetic chemicals and unknown elements. Parabens are a common and harmful ingredient found in beauty products such as makeup, moisturizer, shaving cream, shampoo, and spray-tan products. The FDA currently acknowledges several studies linking parabens, which mimic estrogen, to breast cancer, skin cancer, and decreased sperm count (www.byrdie.com/). As your skin absorbs whatever you apply on it, use natural and plant-based products whenever possible.
  • Keep a watch on your dietary choices: Research suggests that dietary factors could be responsible for 30–40%of all cancers. Eating a healthy diet can make a difference to your risk of developing breast cancer and enhance your overall well-being. Although no specific food can cause or prevent breast cancer, including certain items in your diet may help reduce your overall breast cancer risk. Mayo Clinic notes that “women who eat a Mediterranean diet supplemented with extra-virgin olive oil and mixed nuts might have a reduced risk of breast cancer. This is mainly because the Mediterranean diet focuses mostly on plant-based foods, such as fruits and vegetables, whole grains, legumes, and nuts. People who follow the Mediterranean diet automatically choose healthy fats, such as olive oil, over butter and eat fish over red meat”.
  • Substitute chemical cleaning products with natural alternatives: To avoid contact with harmful chemicals present in cleaning products, use natural alternatives such as baking soda, vinegar, citrus oil, lemon or sage infused vinegar, and so on.
  • Exercise regularly: Regular exercise is an important breast-healthy habit. A fredhutch.org report points out that research suggests that increased physical activity, even when begun later in life, reduces overall breast-cancer risk by about 10 percent to 30 percent. The ACS recommends getting at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous activity each week (or a combination of both).
  • Limit exposure to light, especially at night: Results of some studies imply that women who work at night (like doctors, factory workers, nurses, and police officers) have a higher risk of breast cancer compared to women who work during the day. Similarly, studies suggest that women who live in areas with high levels of external light at night (street lights) have a higher risk of breast cancer. It is believed that increase in risk is linked to melatonin levels, which tend to stay low in women who work at night or in those who are exposed to external light at night. Installing blackout shades on bedroom windows can help control excess light exposure at night. Use low-wattage or red bulbs in nightlights and install a low-wattage or red-bulb nightlight in your bathroom(s).
  • Breastfeed your baby for as long as possible: Plan to have your first child before your thirties and breastfeed your baby for as long as you can. Studies report that women who breastfeed their babies for six months or longer have a lower risk of breast cancer.
  • Avoid or limit hormone replacement therapy: Studies suggest that postmenopausal women who had hormone replacement therapy (HRT) may be more likely to develop or face increased risk of breast cancer. HRT was used in the past to help control night sweats, hot flashes, and other symptoms of menopause. On a safer side, it is best to use it at the lowest dose that works for you and for as short a time as possible. Talk with your physician for better options to manage postmenopausal symptoms.

Educating yourself about breast cancer and making positive changes in your lifestyle hold the key to staying healthy and minimizing your risks.