As a family health provider, I like to talk to my patients about the importance of breast cancer awareness. Breast cancer is a significant health concern, affecting 13% of women, according to the World Health Organization. In 2022 alone, 2.3 million women were diagnosed, with approximately 670,000 deaths reported worldwide. The general risk of getting breast cancer during a woman’s lifetime is about 1 in 8.

Risk Factors

Several factors can contribute to breast cancer risk, with family history being one of the most significant. Risk factors include:
• Family history, especially if a first-degree relative, like a mother or sister, has had breast cancer. That can double or triple your risk.
• Genetic factors: People who inherit a genetic mutation, such as BRCA1 and BRCA2, have a higher breast cancer risk that could be as high as 80%.
• Being female: While breast cancer does occur in men, 99% of cases are in women, making gender the strongest risk factor.
• Hormonal factors: Your age at the onset and cessation of menstruation can also influence your risk. The duration of estrogen exposure is a key factor driving this risk. If you begin menstruating before age 12 or experience menopause after age 55, your risk increases by approximately 20–30%.
• Smoking increases the risk of breast cancer. I tell my patients that smoking doesn’t do anything good for anyone. Stopping smoking is the number one best thing you can do for your health.
• Lifestyle factors: Obesity, alcohol consumption, and lack of physical activity can increase your risk of breast cancer. The increase can be up to 60% for obesity, and even one alcoholic drink per day can increase risk by about 7–10%. Lack of exercise can increase risk by about 20–30%.

Prevention

There are several things you can do to help prevent or lessen the risk of getting breast cancer.
• Mammograms: Get a mammogram starting at age 40. If you have a family history of breast cancer, talk to your provider about when to start getting mammograms.
• Breastfeeding: Research suggests that breastfeeding can lower the risk of breast cancer by about 4.3% for every 12 months of breastfeeding. It also reduces the likelihood of developing more aggressive forms of breast cancer, like triple-negative breast cancer, by up to 20%. One more reason to breastfeed.
• Childbearing: Women who have given birth have a 7% lower risk of breast cancer. In fact, women who have children before the age of 30 have a risk reduction of about 10–15% compared to those who have children later. This is thought to be associated with the hormonal changes that occur during pregnancy.
• Pay attention to your body: It’s important to know your body and have self-awareness. Report any changes to your provider.

Signs and Symptoms

Recognizing breast cancer early is key to effective treatment. What I tell my patients in clinic is to be aware of your body. If you notice something is different and you’re concerned about it, get it checked out.
Common signs and symptoms include:
• Look for changes: Make a habit of looking at yourself in the mirror before hopping in the shower. Do your breasts look the same on both sides? Are they equal? Do you notice any changes?
• Breast changes: Watch for thickening of the skin, particularly areas where the skin looks similar to that of an orange and appears dimpled or pitted. This can be a sign of inflammatory breast cancer, a serious and aggressive form of breast cancer.
• Itchy rash: An itchy rash on your breast that won’t go away after trying medicated creams and allergy meds is another sign of inflammatory breast cancer. Because it seems like a simple skin rash, it can get missed. If it isn’t going away, get it checked out.
• Nipple discharge or changes: Any unusual fluid from the nipple, particularly if you are not breastfeeding, should be checked by a healthcare provider. If you notice a change in your nipple’s appearance, such as nipple inversion or skin pulling, you should report it. It doesn’t mean it is breast cancer, but it does need to be checked.
• Lumps: Normal breast tissue is not smooth and flat. We all have natural bumps and lumps in our breasts. It can be hard to tell what lumps are normal and which ones aren’t. The new guidelines say that a breast exam by a trained professional generally is better than doing one for yourself.

Importance of Mammograms

Getting regular mammograms reduces the risk of death from breast cancer, making them the most effective tool for early breast cancer detection.
The value of mammograms lies in their ability to detect cancer before it is physically noticeable, often catching it at a stage where it is easier to treat.
The current mammogram recommendations from the U.S. Preventive Services Task Force suggest that women with an average risk of breast cancer begin mammograms at age 40, continuing every two years until age 74. For those with a family history or other risk factors, annual mammograms may be recommended.
I’ve had patients tell me that they don’t want to get a mammogram due to the radiation. I assure them that it is a very low-dose radiation exposure, and studies show that the benefits far outweigh the risks.
If you find mammograms to be uncomfortable, it’s helpful to schedule your mammogram outside of menstruation to avoid breast tenderness.

What to Do If You Have Concerns

Being aware of changes in your body, getting regular mammograms, making lifestyle choices, and seeing your healthcare provider will all help in managing the risk of breast cancer.
If you notice any symptoms, experience unusual changes in your breasts, or have a family history of breast cancer, it’s important to see a healthcare provider. Not every symptom will be a sign of breast cancer, but it’s best to get it checked out. Timely detection is crucial since lumps and other symptoms may only appear in the later stages of breast cancer.

Learn more about Dr. Amy Jones.

Dr. Amy Jones

About Perham Health 

Perham Health is a 25-bed Critical Access Hospital with three primary care clinics, a 96-bed nursing home, home health care agency, adult day services, memory care assisted living, and senior housing.  The medical staff consists of 24 physicians, a nurse midwife, 14 advance practice clinicians, and three chiropractors. Visit perhamhealth.org to learn more.