Feeling inundated with the amount of breast cancer info available this time of year? Everywhere you look, there's a pink product or breaking news report. It can be hard to figure out what's new, necessary and helpful. That's why Landcruisers asked top experts to weigh in on some of the less-discussed (but highly pertinent) topics you can use to prevent cancer, spot problems and handle— or help others cope with—a diagnosis.
Online stories are scariest.
"The Internet is a clearinghouse for breast cancer gloom and doom," says Elisa Port, MD, chief of breast surgery at Mount Sinai Hospital in New York and author of The New Generation Breast Cancer Book. That's because people with good outcomes tend to move on with their lives, so a newly diagnosed woman may be more apt to see negative stories. Also, try not to get caught up in how your neighbor treated her cancer. "Two people with similar cases may require different treatments," says Dr. Port.
80% of lumps are benign.
You think you've found a lump in your breast. Now what? "Repeat to yourself, Most lumps are not cancer," says Deborah Lindner, MD, chief medical officer of the nonprofit Bright Pink. This is especially true if you're 30, as fewer than 1 in 228 women at that age will develop breast cancer in the next 10 years. At age 40, that number increases to 1 in 69. (Your risk is higher if you have a family history.) Try this if you find a lump: Document its location by drawing two circles to represent the breasts, fill in the nipples, then draw where on the circle you felt the lump as well as the size. Set the paper aside and after two to three weeks, check the lump again. If it's remained the same or grown, call your doctor. If it's gone, there's likely nothing to worry about, says Dr. Lindner. "Cancerous masses don't wax and wane," she says. "If it is cancer, waiting a few weeks won't worsen your prognosis, but it could help you potentially avoid needless tests." (Menopausal women, though, shouldn't hold off on seeing a doc: For them, it's less common for a harmless lump to appear suddenly.)
Breast cancer isn't typically lethal unless it spreads.
The cancer doesn't become deadly until it travels—or metastasizes—outside the breast or to a vital organ like the lungs, says Marc Hurlbert, PhD, executive director of the Avon Foundation Breast Cancer Crusade. Breast cancer is staged on a scale of 0 to IV based on tumor size, whether lymph nodes have cancer cells and any signs of metastasis. In order to detect abnormalities when they are small and confined to the breast, the American Cancer Society recommends starting yearly mammograms at age 40. Other groups, like the U.S. Preventive Services Task Force, suggest starting every-other-year mammos at 50. Talk to your doctor about which protocol is best for you.
SMART DETECTION STRATEGY: As your physician examines your breasts during an annual checkup, ask her to describe what's "normal" as well as anything you should look out for. Write down what she says.
Dealing with the disease requires specific support.
If You're the Patient: Join a support group or see a therapist. "This can help you take back control," says Tim Pearman, PhD, director of supportive oncology for the Lurie Comprehensive Cancer Center at Northwestern University. Plus, it may improve survival rates: An Ohio State University study found that breast cancer recurrence rates were lower in women who attended support groups compared with those who did not. Organizations like Cancer Support Community (CancerSupportCommunity.org) and Susan G. Komen (Komen.org) offer various options. It's also common for breast cancer patients to struggle with anxiety, depression or even post-traumatic stress disorder, so consider reaching out to the American Psychosocial Oncology Society for a therapist referral. (Call 1-866-APOS-4-HELP; treatment may be covered by insurance.)
If Your Friend Was Recently Diagnosed: Make specific offers to help. Say "Can I bring dinner over this Tuesday?" instead of "Let me know if you need me." And don't be afraid to broach difficult subjects, especially with a loved one in a later stage of cancer. If a friend has always wanted to, say, visit Niagara Falls, ask her if you can help make that happen.
If You're a Caregiver: Remember: You need help, too. Check out Imerman Angels (ImermanAngels.org), a nonprofit that matches individuals with other caregivers in similar situations.
Finding out you are BRCA-positive can be empowering.
Having a BRCA mutation (a flaw in the tumor-suppressing genes) may seem incredibly scary, but the knowledge allows you to take early action to avoid getting cancer and needing chemotherapy and radiation, says Dr. Lindner, who is BRCA-positive herself. That could mean additional screening, medication, prophylactic mastectomy or ovary removal. More news: Before, you needed permission from your insurer to test for BRCA, otherwise you'd pay up to $4,000 out of pocket. But earlier this year, a company called Color Genomics began offering an affordable BRCA test for $249. The results are just as reliable and you only need a doctor's prescription, says Dr. Lindner. (Testing isn't recommended for the general population, only those with a family history of breast or ovarian cancer. Some insurance plans will cover if you qualify.)
Soy may not be all that bad.
Experts used to fear that soy might mimic the activity of estrogen in the body, increasing hormone levels and breast cancer risk. But the soy that may be a concern isn't dietary soy (like edamame, tofu and soy milk), it's supplemental soy (or soy protein isolates), often found in packaged bars. What's more, the dietary soy may actually have a protective effect. One study of more than 9,000 breast cancer survivors found that women who consumed 10 mg or more of soy per day had a 25% lower risk of recurrence. So don't avoid soy; just opt for dietary sources of it and always read ingredient lists on snack products to check for soy protein isolates.
Does Cup Size Increase Chance of Cancer?
Having large breasts doesn't boost your breast cancer risk, but it can make a lump harder to feel, so it's important to attend screening appointments. Breasts that feel lumpy in texture (the consistency of oatmeal) are common, and in many cases, harmless, especially before menstruation. Tell your doctor if you notice a hard mass that doesn't move around, as it could be concerning.
Density isn't related to how firm your breasts are but rather how much fatty tissue they have. About 47% of women have dense breasts, and research in the Annals of Internal Medicine found that about half of these women have a heightened risk of breast cancer. If your breasts are dense—the only way to tell is a mammogram—you may need added tests like an MRI or ultrasound.
You can have innie or outie nipples, but how raised they are plays no part in health. What you should look for: redness, discharge and any appearance change, including shape or symmetry. These warning signs should be examined promptly.
SOURCES: Harold Burstein, MD, clinician, breast oncology center, Dana-Farber Cancer Institute. Susan C. Harvey, MD, director of breast imaging, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions.