October is Breast Cancer Awareness Month. While some risk factors we can't control, there are many others we can thanks to early testing and modern day treatments.
Dr. Diana Bitner, nationally recognized menopause specialist from Spectrum Health, says that while some risk factors such as family history can't be changed, there are many other risk factors that patients can have control over such as:
- Weight
- Age of having children
- Breastfeeding (decreases)
- Activity
- Alcohol intake
- Smoking
- Vitamin D intake
Risk assessment is becoming more important to help find those women who would benefit from early testing or risk reduction medication or surgery.
The overall goal is to see women reduce their risk when possible. However in women who have high risk which is out of their control, the goal is to reduce the risk of invasive cancer by early detection, use of medication, or performing risk reduction surgery.
Scoring systems are used to help identify who would benefit from genetic testing, medication such as tamoxifen, or meet criteria for a high-risk screening MRI. Breast cancer risk scores are all a little different, are not perfect, and have been studied for degree of accuracy in large groups of women who are followed over time.
For example, The Tyrer-Cuzick Version 8 model is able to give a five year, 10 year, and lifetime risk of developing breast cancer. The chart can be used to help decide whether to recommend genetic testing or screening MRI testing, and is the screening tool most often used at the Spectrum Health High Risk Breast Cancer Clinic.
The Tyrer-Cuzick Model
The Tyrer-Cuzick Model provides personal risk and risk of carrying a high risk genetic mutation. The model asks about a patient's:
- Current Age
- Age at menarche (first period) (higher risk < 12)
- Height
- Weight
- How many full term pregnancies
- Age at first childbirth (higher risk > 30)
- Age at menopause (higher risk > 55)
- HRT use
- Prior breast biopsy
- Ovarian cancer
- Breast density (higher risk covering > 75% of breast)
- Ashkenazi descent
- Age at diagnosis of first and second degree relatives with breast or ovarian cancer and male relatives with breast cancer
Other historical risk factors not assessed in the model: prior chest radiation for Hodgkin’s Lymphoma before 30-which is an indication for high risk screening with MRI.
Genetics cannot be changed but lifestyle choices can be changed. Even for women who don't show signs of or have breast cancer, here are some recommendations on how to lower the risks:
- Get screening mammograms, know your breast density.
- Know your family history and genetic background, consider doing the Risk Assessment model.
- Know other significant risk factors such as radiation exposure.
- Don’t smoke.
- Fewer than seven alcohol drinks per week.
- Exercise regularly: more than 150 minutes per week.
- Lower sugar intake, avoid diabetes or pre-diabetes, get tested if high risk!
- Eat a diet rich in cruciferous vegetables such as cauliflower, broccoli, and cabbage.
Dr. Diana Bitner's office is located at 3800 Lake Michigan Drive Northwest, Suite A. To schedule an appointment with her, call (616)-267-8225.
All information was provided by Dr. Diana Bitner, her blog. Read more.
