ACOG Co-Sponsors National Breast Cancer Awareness Month In October

Main Category: Breast Cancer
Also Included In: Women's Health / Gynecology;  Cancer / Oncology;  Pregnancy / Obstetrics
Article Date: 03 Oct 2007 - 3:00 PDT

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The American College of Obstetricians and Gynecologists (ACOG) is pleased to again serve as a national co-sponsor of National Breast Cancer Awareness Month (NBCAM). ACOG supports NBCAM efforts to raise awareness about early detection and mammography screenings during October and throughout the year.

"During NBCAM, women should take advantage of available resources that can help them assess their personal cancer risk and recognize the signs and symptoms that may signal a problem," said ACOG President Kenneth L. Noller, MD. "Women should also work with their ob-gyns to reduce their risk factors and increase opportunities for early detection. Now is a good time to schedule your mammogram and clinical breast exam, learn how to perform a breast self-exam, and make lifestyle changes that can help prevent cancer," he added.

ACOG urges women to use this month to put their health front and center and offers the following information on breast cancer and breast health:

Breast Cancer: What You Should Know

The American Cancer Society estimates that women have a 1 in 8 lifetime chance of developing breast cancer. It is the second most common cause of cancer death in women, and the main risk factors are being female and age. Family history, personal history of certain cancers, no pregnancies or pregnancy later in life, early menarche, late menopause, obesity, alcohol intake, and use of hormone therapy can also increase a woman's risk.

With an estimated 178,480 new cases of breast cancer in 2007 and more than 40,000 deaths, there is reason for concern. Encouraging women to be vigilant and to do what they can to reduce their individual risk may help allay fears about the disease.

When caught early, odds of survival are high-5-year survival rates are as high as 98%. Advances in early detection and treatment have led to a 2.3% annual decrease in mortality from 1990 to 2002. During NBCAM, ACOG encourages women to become familiar with their bodies, learn more about breast cancer, and reduce the risk factors that they can change (such as obesity and a sedentary lifestyle).

Breast Self-Exams: The Right Way

When it comes to breast cancer, early detection is one of the keys to survival. One way that women can keep an active tab on their breast health is by performing a monthly breast self-exam (BSE). BSEs help women establish a baseline for what is normal for them. That way, something abnormal can be more readily detected and reported quickly to a doctor. NBCAM is a great time for women to check their technique to make sure that they're performing their BSE correctly. Here are a few tips:

- Plan your exam a few days after your period, or at the same time of the month if you do not have periods.

- Always perform your BSE in good lighting.

- Stand or sit in front of a mirror. Placing your arms at your sides, look for dimpling, puckering, or redness of the breast skin, discharge from the nipples, or changes in breast size or shape. Look for the same signs with your hands pressed tightly on your hips and then with your arms raised high.

- Using one hand, keep the fingers flat and together and gently feel your breast without pressing too hard. Examine both breasts using one of three methods:

Circle-Starting at the top of your breast, move your fingers slowly around your breast in smaller and smaller circles until you have examined all of the breast tissue.

Lines-Begin in the underarm area. Move your fingers down to the bottom of your breast, then back up closer to the nipple. Use this up-and-down pattern all the way across your breast.

Wedge-Starting at the outside edge of your breast, slowly work your way in toward the nipple, doing one wedge-shaped section at a time. Examine the entire breast this way.

Lowering Breast Cancer Risk Through Healthy Living

Women can play an active role in reducing their risk by adopting healthy lifestyle habits.

- Weight Management: Breast cancer is often related to prolonged exposure to estrogen, and excess fat tissue promotes excess estrogen. So, it's a good idea to control estrogen levels by maintaining a healthy weight or shedding extra pounds.

- Alcohol Consumption: While moderate alcohol consumption can be beneficial to a person's health, studies have shown that women who drink two or more alcoholic beverages a day are more than 20% more likely to develop breast cancer than women who drink less. ACOG recommends that women limit consumption to less than two alcoholic beverages a day.

- Hormone Therapy: Although hormone therapy (HT) is often the most effective treatment for alleviating symptoms of menopause, use of HT that has both estrogen and progestin has been linked to a slightly increased incidence of breast cancer. Therefore, ACOG recommends that women use the lowest dose necessary to relieve symptoms for the shortest amount of time possible.

- Nutrition: Eating a well-balanced diet with a variety of fruits, vegetables, proteins, high-fiber foods, and foods low in fat is beneficial for maintaining overall health and well-being. The USDA's food pyramid (www.mypyramid.gov) is a helpful guide for building a healthy diet based on the government's recommended daily allowance of essential nutrients.

When Breast Cancer Runs in the Family

Breast cancer strikes women of all ages, races, and ethnicities. While simply being a woman increases the chances of developing the disease, those with a family history of breast cancer are at higher risk.

Women with first-degree relatives-mother, sister, or daughter-diagnosed with breast cancer, particularly at a young age, have a higher risk than those with no family history of the disease. Familial risk is sometimes caused by an inherited mutation of the breast cancer susceptibility genes, BRCA-1 and BRCA-2. Women with a BRCA mutation have an estimated 50% to 80% lifetime risk of breast cancer and represent approximately 5% to 10% of all breast cancer cases. They are also at increased risk for ovarian cancer.

High-risk women now have several options for lowering their chances of cancer:

- Early mammography: High-risk women can consider beginning yearly mammograms and annual or semi-annual clinical breast exams between the ages of 25 and 35 (women are generally advised to begin mammography screening at age 40). They should also perform regular monthly breast self-exams.

- Tamoxifen: Widely used to treat breast cancer, tamoxifen helps some high-risk women stave off its occurrence. Research has shown a 49% decrease in breast cancer for high-risk women who took the drug compared with those who didn't. However, postmenopausal women using tamoxifen should be closely monitored for endometrial abnormalities and should have at least one gynecologic exam every year, as the drug has been linked to an increased risk of endometrial cancer in this population. Tamoxifen is not recommended for use for more than five years. Women who experience any abnormal vaginal symptoms, such as bloody discharge, abnormal bleeding, staining or spotting, should contact their doctor right away.

- Raloxifene: Originally approved to prevent or treat osteoporosis, raloxifene was recently approved by the US Food and Drug Administration for breast cancer prevention in postmenopausal women with osteoporosis or at high risk for invasive breast cancer. Studies have shown it equals tamoxifen's effectiveness in preventing breast cancer but with less risk of uterine cancer. Raloxifene may cause an increased risk of blood clots and stroke, and potential side effects include hot flashes, leg cramps, swelling, and flu-like symptoms. Premenopausal women should not use raloxifene.

- Prophylactic surgery: Removal of both breasts before cancer develops is another option. Though cancer can still develop in any small amounts of breast tissue not removed during the surgery, a recent study found a 90% risk reduction in women with a family history who had prophylactic surgery. Additionally, because BRCA also increases the risk of ovarian cancer, women may consider the surgical removal of their ovaries to reduce the chances of developing breast and ovarian cancer.

Women should talk to their ob-gyns about treatment options and carefully weigh the risks and benefits to make the decision that is right for them.

More information on breast cancer and ways to get involved in NBCAM in your community can be found at http://www.nbcam.org

The American College of Obstetricians and Gynecologists is the national medical organization representing over 51,000 members who provide health care for women.

American College of Obstetricians and Gynecologists