Risk, Prevention and Screening
Some aspects of our lifestyle can be changed to reduce our risk of developing cancer. Some risks we can’t avoid. The important thing is to get the information we need to reduce the risks we can and manage the ones we can’t.
- Weight: Always try to keep weight within a healthy range. Being overweight can increase our risk for many cancers, including breast cancer, especially after menopause.
- Diet: Eat a lot of plant-based foods like fruits, vegetables, nuts and whole grains.
Physical Activity: Do something active you enjoy for at least 30 minutes a day to lower your risk of breast cancer. Activity also helps keep our weight down, a double plus.
- Alcohol intake: If you drink alcoholic beverages, keep it to below one drink a day. Even moderate amounts increase the risk of breast cancer.
- Breastfeeding: Breastfeed your children, if possible. Studies have shown that at least a year’s worth of breast feeding across all children has risk reduction benefits.
- Hormone replacement therapy: Take post-menopausal hormones for as short a time as possible, because both estrogen-only and estrogen-progestin hormone replacements increase the risk of breast cancer.
Healthy behaviors like the above should be started early in life. Research shows that youth and young adult years are critical for preventing up to 50 percent or more of breast cancers later in life.
Risks we can’t change
- Age: Our risk for breast cancer goes up as we age, especially after 60.
- Sex:Women get 99 percent of the breast cancer, but men can get it too, especially in families where breast cancer is prevalent.
- Family History: We need to know our family medical history because a strong family history of cancer, especially mother, sister, daughter, or male breast cancers can change recommendations for screening and preventive measures we may take.
- Surgical history: We’re at greater risk if we have a history of biopsies for certain high-risk, non-cancer breast diseases.
- Other unchangeable risks: first menstrual period before age 12, menopause later than 55, first childbirth after 35, no children, being tall (5 feet 8 inches or taller), having dense breasts, and having a history of benign breast disease, such as atypical hyperplasia.
Breast cancer screening
All of the radiologists who review your films are full-time Washington University Physicians who read only breast images, all of whom are affiliated with the internationally recognized Mallinckrodt Institute of Radiology. All radiology technologists on staff have advanced certification in breast mammography and have undergone rigorous training in breast anatomy and physiology, positioning and compression, as well as imaging of patients with breast implants.
Siteman provides all-digital breast imaging services including:
- Screening mammography.
- 3D mammography (tomosynthesis).
- Diagnostic mammograms.
- Breast ultrasound.
- Breast Magnetic Resonance Imaging (MRI).
- Minimally invasive breast biopsy.
Routine screening guidelines
- Between the ages of 20 to 39, you should have a clinical breast exam every three years and start breast self-exam. When you are familiar with your breasts, you are more likely to quickly recognize and report any changes to your healthcare provider.
- Regular yearly mammograms and clinical breast exams should start at age 40.
- The American Cancer Society recommends that some women, because of their family history, a genetic tendency or certain other factors, be screened with magnetic resonance imaging (MRI) in addition to mammograms. (The number of women who fall into this category is small: less than 2 percent of all the women in the United States.) Talk with your doctor about your history and whether you should have additional tests at an earlier age.
Guidelines for a significant family history of breast cancer
With a mother or sister with breast cancer, you should:
- Begin yearly mammograms and clinical breast exam 5 to 10 years before the age cancer was diagnosed in your family member.
- Have genetic counseling for a strong family history or a known inherited breast cancer gene.
- Ask your doctor about breast MRI with your mammograms.
Symptoms to watch for
Symptoms or changes in the breast that should be promptly reported to your doctor include:
- A breast lump or thickening that is different from surrounding tissue.
- Change in the size, shape or heaviness of one breast.
- Rapid change in the look of one breast, over the course of days or weeks.
- Redness or changes in the skin on the breast resembling an orange peel.
- Change in the color of the breast to red, purple, pink or a bruised appearance.
- Unusual warmth of one breast
- Bloody discharge from the nipple
- Peeling or flaking of the nipple skin
- Tenderness, pain or aching
- Enlarged lymph nodes under the arm, above or below the collarbone