Contraceptives and Menopause
Are You at Risk?
Here are key questions to ask yourself to understand your own risk for breast cancer.
Courtesy of Prevention.com
Did you begin menstruating at or before age 12? Early onset of menstruation means longer lifetime exposure to estrogen, which could increase your risk of breast cancer.
Did you have your first child after age 30? Never having children or giving birth at a later age nearly doubles the risk of breast cancer. (On the other hand, breastfeeding at any age lowers risk.)
Are you taking oral contraceptives, or have you in the past? Although overall the incidence of breast cancer is not higher among women taking the Pill, the risk does rise slightly for young women, especially for those who went on oral contraceptives before age 21 and continued with it for more than 10 years. For women who carry BRCA1 gene mutations, taking the Pill also may increase risk.
Did you go through menopause at or after age 55? Breast cancer risk rises by about 3 percent for each year of delayed menopause. "Delayed" means onset after age 55, the average age of menopause for women in the United States.
Have you used hormone replacement therapy, or are you on it now? According to several studies, women who are on HRT for more than 5 years have a higher risk of breast cancer. The risk declines over time once HRT stops.
Are you overweight? Women who gain weight after age 18 are twice as likely to develop breast cancer after menopause as women who maintain their weight throughout their lives. Regardless of when the extra pounds begin to appear, being overweight increases breast cancer risk. Where the body stores the extra fat can be a risk factor, too. For instance, research has shown that women whose waistlines exceed 36 inches are 34 percent more likely to develop breast cancer than those whose waistlines are less than 28 inches.
Do you drink more than two alcoholic beverages a day? Moderate alcohol consumption can cause a modest increase in breast cancer risk. With heavy drinking, defined as four or more alcoholic beverages a day, risk nearly doubles. Some researchers believe that even a small amount of alcohol--say, one drink a day--can elevate risk slightly, by about 3 to 4 percent. According to one analysis, the lifetime risk of breast cancer is 1 in 7 for heavy drinkers, 1 in 11 for nondrinkers.
What You Can Do Now
Find Out Your Risk At your next annual gynecologic exam, ask your doctor to calculate your breast cancer risk. Several Web sites now offer risk assessment calculators; one is the official Web site of the National Surgical Adjuvant and Bowel Project (NSABP) Breast Cancer Prevention Trial (BreastCancerPrevention.org).
Examine Your Breasts If you are at average risk, do a breast self-exam every month, ideally starting at age 20. Follow up with a clinical breast exam at least every 3 years between ages 20 and 39, then every year starting at age 40. Also get a mammogram every year starting at age 40.
Get Screened If you are at high risk, talk with your doctor about which screening tests you need and at what intervals.
Discuss Preventive Options If you are at high risk, ask your doctor whether you'd be a candidate for tamoxifen therapy. Or you may want to consider enrolling in a clinical trial of another chemopreventive drug.
Maintain a Healthy Weight Make every effort to maintain a healthy weight. As you get older, this may mean eating fewer calories and getting more exercise.
Eat Nine a Day Eat at least five servings of fruits and vegetables a day, and do your best to get nine.
Stay Fit Find ways to become more physically active in every aspect of your life--on the job, at home, and in your leisure time.
Stop Smoking If you smoke, stop.
Take Your Genes into Account If your mother, sister, or daughter has breast cancer, seek genetic counseling before deciding whether to undergo genetic testing. If genetic testing reveals that you carry the BRCA1 or BRCA2 gene mutation, talk with your doctor about your options for managing your breast cancer risk. You could take tamoxifen or enroll in a clinical trial. Another possibility is preventive surgery (prophylactic mastectomy and/or oophorectomy).
Excerpted from The Answer to Cancer (Rodale Inc., 2004) by permission of the publisher. For more information, link to AOL’s shopping channel, The Answer To Cancer. Some statistics presented here have been updated from American Cancer Society’s Breast Cancer Facts & Figures 2005-2006 as well as the University of Connecticut Health Center.
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