Health & Fitness

What Can Women Do To Lower Their Risk Of Dying From Breast Cancer?

By Helen Mrose MD PhD

While a woman can’t control certain genetic factors that put them at risk for breast cancer, there are actions they can take to reduce their risk. Controllable factors include:

• Weight control - obesity is linked to cancer.
• Breastfeeding - the longer, the better.
• Alcohol – avoid it, or minimize consumption.
• Minimize radiation exposure.
• Avoid hormone use after menopause.

Women who are at very high risk for breast cancer due to factors including heredity, history of pre-cancer or cancer on prior biopsy, or history of radiation exposure at a young age have options. They may choose mastectomy, removal of ovaries (decreases estrogen), medication that blocks estrogen receptors, or medication that block estrogen synthesis to reduce their risk.

Factors not proven to be associated with breast cancer include contraceptive use, diet, cigarette smoking, and abortion. There is controversy about whether pollution causes breast cancer. The reality is we do not know what causes most breast cancers. We do know that over 75% of women diagnosed with breast cancer have no family history of the disease.

Mammography does not prevent breast cancer, but it can lead to early detection—and help prevent death from advanced cancer. The goal of mammography is finding breast cancer while in its early, curable stage. I strongly recommend that all women have yearly mammography beginning at age 40, and continuing into old age if healthy (age is the greatest risk factor for breast cancer, other than being female). Many women ask whether there are any other screening tools that are better than mammography—or tools that can avoid exposure to radiation. Mammography is the only imaging tool that has been proven to reduce mortality from breast cancer in women. That said, there are other imaging tests that are sometimes appropriate in addition to mammography. Women with dense breast tissue may need breast ultrasound, since it can help the radiologist “look into” dense areas in a completely different way. Breast MRI is the most sensitive tool for detecting breast cancer, but it is difficult to do well and interpret, very costly, and difficult for many women to tolerate. Also, the false positive rate for MRI is high (it is sensitive but not specific). Molecular imaging (breast specific gamma imaging or BSGI) is another tool to investigate dense tissue, but it involves high radiation doses to the entire body. I do not recommend this tool for screening. Many women ask about thermography, which is a tool that detects heat differences in tissues. While the concept behind the technology is valid, the technology has not been developed sufficiently. Thermography has been shown to be vastly inferior to mammography, ultrasound and MRI. I do not recommend thermography. Even thermographers do not recommend using this technique without simultaneous mammography. Other imaging modalities are being studied, but none are widely available or proven to be effective screening tools.

It matters where a mammogram is done. The quality of the study, the amount of radiation exposure, and the quality of the interpretation vary considerably. It is important that prior mammograms be available for comparison. It is not important that the study be done on the same machine each year, be done at the same facility or read by the same radiologist. What is most important is the expertise and experience of radiologist directing the imaging and interpreting it. This may make the difference in saving your life.

For more information, contact Dr. Helen Mrose at the Bay Radiology Breast Imaging Center 410-544-3331 or visit them on the web at www.bayradiology.com.