Breast Cancer questions.

Loads of questions, and I was going to do this as a video but, as usual, the subtitles weren’t great, so I actually am going to write it out just so that it is really clear. Because breast cancer affects so many women and families, it is a very emotional topic. It’s also a very big topic: literally books are written on this. I am going to just focus on the few things that you had questions about. There are few types of breast cancer but for the purposes of a general health education post like this, we are not going to break it down but keep this very general. And although men can get breast cancer, we are just focusing women’s risk in this particular post because all of the queries sent in were from – and about – women.

Let’s say from the outset: There is a line between educating and empowering people with the correct facts about their health and shaming patients that get ill. You can “do everything right” and still get ill. Absolutely. And people do vary about how much they prioritise looking after their health, for a number of reasons including things like time. Which is fine. In this post, we are laying out some facts v. fiction for people who have an interest.

So, back to the facts: Women are 100 times more likely to get breast cancer than men. Globally, the statistics are about 1 in 8 women have a lifetime risk. That’s the first risk: sex at birth.

What are some other risk factors you just can’t change? Age, ethnicity, density of breast tissue (not everyone has the same type of breast tissue), age of the first period (menarche) and age at menopause, and genetics. BRCA1/2 and a few rarer types of genetic causes account for just under 10% of breast cancers. For the other cases, the risk factors are more complex (multifactorial, meaning many things affect the risk). And for 40%, lifestyle factors do affect the risk of breast cancer – and other diseases (I’ll come back to this point – it’s important.)

So, I’m going to talk a little bit here about the risk factors for women who do not have known genetic cause for breast cancer.

What can you change to reduce your risk of breast cancer for that group of women, based on current evidence/studies?

• Reduce alcohol intake to low-risk levels

• Regular physical activity (regardless of weight/other factors)

• Maintain healthy weight after menopause

• If you are smoker, smoking cessation

What are the risk factors that you theoretically could change but realistically, you usually can’t?

Having children decreases your risk, the age at which you have children, and whether you breastfeed your children/how long are factors that affect your breast cancer risk (breastfeeding may reduce the risk for those women who have those modifiable risk factors). For most women, however, there are so many, many factors involved in having children/when to have children or deciding to breastfeed. For many women, the discussion on breast cancer risk factors may be happening after that period of their lives is done. HRT may increase risk but it is small for many women. For many women, the benefits outweigh this risk, so it’s worth talking your personal risk v. benefit through with either your GP or women’s health doctor or gynaecologist.

What likely affects your risk of breast cancer but lots more research needed to understand it better? This is where medicine is exciting: we are constantly learning. And breast cancer research is very active globally. Where you live in the world does seem to affect the risk, but this affect is likely due to so many other things that are different depending where you are in the world such as: age you get married/have children, whether or not you breastfeed, diet, physical activity. More research needed – and is being done.

A healthy diet is important. Full Stop. There is definitely lots of ongoing research about how diet affects breast cancer risk but overall, we all need a healthy diet – such as one that is rich in vegetables, high in fibre, low in animal fats and processed foods – to reduce risk of many diseases, including heart disease and diabetes. For example, while Vitamin D has not been proven to protect against breast cancer – we already know we need adequate vitamin D for healthy bones and a healthy immune system. There is a lot of fascinating research being done about how healthy diet can reduce cancer risk so it’s definitely something to be interested in and to follow. We need to realise that our health is not the absence of any one particular disease but overall physical, mental, emotional, and social well-being. It’s all connected.

Mythbusting: Here are a list of things that have NO affect on your breast cancer risk: hair dye, breast implants, electric blankets and whether or not you ever had a termination of pregnancy or miscarriage.

Lastly, regular self-examination and participation in recommended screening are important. You all know it, but I’m adding it here – because it’s important.

If you have concerns about your personal/family risk factors or any symptoms, talk to your GP.

The list of trusted resources for more information on the above:

To calculate if your drinking is “low-risk”

If you need help with smoking cessation

For EXPERT and NOT-FOR-PROFIT information the role of diet in preventing and recovering from cancer (and expert #nutribabble mythbusting!): Break Through Cancer

For more information on the national screening programme and self-exam of your breasts: