That's big news—and it's partly thanks to the fact that experts understand more than ever before what raises your breast cancer risk and what all women can do to help beat the odds. "Just knowing you have certain risk factors ups the chances of catching cancer early if you're more vigilant about screenings," says Therese Beavers, MD, medical director of the Cancer Prevention Center at the M.D. Anderson Cancer Center in Houston. And there are risks you can control. In this special report, we give you the tools to take charge of your breast health.
When I started talking to my coworkers at Landcruisers about my family history of breast cancer, I was surprised to learn that I was far from alone: Nearly half of us have a mother, grandmother and/or aunt who has battled the disease, and one staffer was recently diagnosed herself. We all had lots of questions, so we turned to SHARE (Self-Help for Women With Breast or Ovarian Cancer) to help us gather experts for some answers—Barbara Brody
When I do self-exams, how do I know if a lump is normal or not? Dana, 26, assistant health editor
Maura Dickler: Many women's breasts are naturally lumpy, but if you know what your breasts feel like, you'll start to get a sense of what's normal for you. That's why I recommend that women do regular breast self-exams, even though some recent studies have shown they may not reduce your risk of dying from the disease. Ideally, you should do them at the same time every month while lying down and while standing in the shower. If you notice any changes—new lumps, thickening or dimpling of the skin, redness, or a nipple that has become inverted—get it checked out.
Is there any correlation between breast cancer and other types of cancer? Sarina, 40, design director
Shivani Nazareth: In general, no. The exception would be if you carry a genetic mutation that predisposes you to developing several types of cancer. For example, people who carry a BRCA2 gene mutation are at risk for breast and ovarian cancer as well as pancreatic cancer.
Many women in my family have had breast cancer, but they're all BRCA-negative. What does that mean for me? Davida, 32, lifestyle director
Nazareth: Although mutations to the BRCA1 and 2 genes are the most well-known, they aren't the only ones that can predispose you to breast cancer. There are other gene mutations that your relatives might consider getting tested for, but they could also be carrying one that hasn't been identified yet. Research on which genes are related to breast cancer is ongoing, so my advice is to check in with a genetic counselor once a year to see if there's anything new that you should know about. In the meantime, talk to your doctor. She may recommend that you start mammograms 10 years before the age at which your youngest relative was diagnosed.
I have a family history of breast cancer, thyroid cancer and brain cancer, but none of my relatives had genetic testing. Should I consider it? Crystal, 24, assistant features editor
Nazareth: Ideally, it's best to test the people in your family who have had cancer before testing anyone else. The goal is to first identify the problematic gene before checking to see if anyone else is carrying it. If that's not possible, I recommend sitting down with a genetic counselor to review your family history in more detail. There are some rare genetic mutations that predispose you to several types of cancer; in counseling you'll get more information that will help you decide if you should get tested for any of them.
Since my mom had breast cancer, should I see a specialist for check-ups, or is going to my regular ob-gyn OK? Barbara, 31, health editor
Dickler: Generally speaking, it's fine to just keep seeing your ob-gyn regularly, as long as you like her and feel that she is adequately examining you. If your risk is extremely high, however—like if you've tested positive for a BRCA gene mutation—then it may be worth talking to a breast specialist.
What's the one thing all women should do to lower their risk? Suzan, 64, business coordinator
Deborah Axelrod: You can't control all risk factors, but there are some important ones you can—like maintaining a healthy weight (especially after menopause) and limiting alcohol. Studies have shown that excess fat and alcohol can act like estrogen and fuel the growth of certain breast cancers. Many women stopped using hormone therapy (HT) after the Women's Health Initiative study linked it to a small but significant increase in breast cancer risk. If you do go on HT, don't use it any longer than necessary. I also highly recommend getting regular exercise.
What's the main point you hope we take away from this discussion? Ellen, 42, executive editor
Dickler: Cancer is scary, but it's not our biggest health threat. Heart disease is still the number-one killer of women, so take care of your whole body—not just your breasts! It's also important to know that when breast cancer is caught early (and it usually is these days), it's highly curable.
A landmark study found that women who worked out as young adults had a 23% lower risk of breast cancer. Strenuous is best, but anything that makes you break a sweat helps.
Limit your radiation exposure
Ask if you can get an MRI or ultrasound instead of an X-ray or CT scan, an X-ray technique that uses particularly high levels of radiation.
Cut back on red meat
Eating three or more servings a week has been linked to an increased risk of breast cancer. Limit each serving to 4 oz or less (about the size of your palm).
You're not producing as much estrogen, which reduces your risk, says Carolyn Runowicz, MD, director of the Comprehensive Cancer Center at the University of Connecticut.
Lose the baby weight
Women who gained more than 36 pounds and didn't lose it were 60% more likely to develop breast cancer after menopause, say researchers at Georgetown University.
Don't drink too much alcohol
Just 4 oz a day (about half a glass) can raise your risk 9%. Cap it at three drinks a week; if you're high-risk, ask your MD if you should abstain altogether.
Starting at 40, all women need a mammogram yearly. If you're under 50 or have dense breasts, get a digital one if possible (it's slightly more accurate than traditional X-rays).
Studies show that women who exercise regularly throughout their lives lower their breast cancer risk. Exercise may help suppress excess estrogen, which can fuel tumor growth.
Some can mimic estrogen and you never know how much you absorb. Avoid herbicides when gardening. If you need an exterminator, pick one that uses all-natural products.
…50s & 60s
Watch the scale
Women who gained 22 pounds or more after menopause were about 20% more likely to develop breast cancer. Those who shed 22 pounds or more cut their risk by 57%.
…if you're 60 or over. While research suggests that brief stints on hormone therapy to relieve menopausal symptoms are OK in younger women, it's best to avoid it past age 60.
Don't miss a year…
…of getting a mammogram. Risk goes up as you age—more than 75% of breast cancers are diagnosed after age 50. Yet ironically, we tend to get less vigilant as we get older.—Linda Marsa
Last October, during National Breast Cancer Awareness Month, I was diagnosed with breast cancer. First I cried, then I got angry, then my journalist skills kicked in. Still in a zombie-like state of shock, I called everyone I knew for doctor recommendations and spent hours searching the Internet for resources and advice. Soon I had shelves of books, folders full of newspaper clippings, and countless URLs for informative websites. The more I learned, the stronger I felt.
If you've been recently diagnosed—or if your mother, sister, friend or neighbor has been—then I'm sure you have tons of questions about diagnosis, treatment and prognosis. Maybe you don't even know where to begin. Even though everyone's experience is different, here's what I wish someone had told me.
STEP 1: Scream, yell and vent
Feel free to cry, throw things, and tell everyone or no one about your diagnosis. But I do recommend telling your spouse, mother and best friend as soon as possible—you're going to need their support.
STEP 2: Call your insurance company
Ask them to go over your coverage. Are referrals required for all the doctors you'll need to see? Will they pay for a second opinion? Do they offer any special services for people diagnosed with cancer?
STEP 3: Do your homework
Yes, all the info can be overwhelming, but you'll feel more in control once you know what's out there. A good place to start: "What to Do Next," an online brochure that you'll find at bcaction.org (click on "Get Informed/Newly Diagnosed"). My other go-to sites for trustworthy info: the American Cancer Society ( cancer.org), Dr. Susan Love Research Foundation ( susanlovemd.com), Susan G. Komen for the Cure ( komen.org) and CancerCare ( cancercare.org). Just don't do your research right before going to bed or you'll never fall asleep!
STEP 4: Get a copy of your pathology report
It contains key info about your breast cancer (the type, the size, the stage, etc.) so you can do some research before meeting with a surgeon. To learn how to read yours, go to getbcfacts.com and click on "About Breast Cancer/Detection and Diagnosis/Understanding Your Pathology Report."
STEP 5: Find a breast surgeon
Ask your primary care doctor for referrals, or call a cancer center near you (find one at facs.org/cancerprogram/howto.html) and ask which doctors mainly focus on breast cancer surgery. You can also go to castleconnolly.com and search the database of cancer doctors. Choose one who's board-certified in general surgery and has treated a large number of breast cancer cases.
STEP 6: Get a second opinion
A second doctor may suggest different surgery or treatment options, or simply validate the first doctor's opinion—either way, it's worthwhile. Don't worry about offending anyone; it's common practice, and health insurance usually covers it when cancer is suspected or diagnosed. Make sure the second doctor gets a copy of your lab reports, records and films before your visit.
STEP 7: Ask lots of questions before making any big decisions
For help generating your list, go to cancer.net/patient and click on "Cancer Types/Breast Cancer/Questions to Ask the Doctor."
STEP 8: Talk to someone who's been there
Check out the "Sound Off" message board at komen.org. It helped me many times when I had questions about the strange taste in my mouth from chemo or how to deal with my hair falling out. To speak to a survivor on the phone, call the Breast Cancer Network of Strength (800-221-2141) or SHARE (866-891-2392).
STEP 9: Get support
Not all support groups are about sitting around and commiserating: My doctors at the Comprehensive Breast Center in New York, for example, offer group yoga and cooking programs. Ask at your hospital or Gilda's Club ( gildasclub.com or 888-GILDA-4-U). For a list of specialized support groups (for Jewish women, African-American women, etc.) visit womansday.com/cancersupport—Bethany Kandel