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Tuesday, January 7, 2014

Resolving To Decrease Your Breast Cancer Risk


Your lifetime risk of getting breast cancer, if you are an American woman, is 12% or about 1/8 women. The risk may be even greater if you have known family history or the If you want to know your individual lifetime risk of breast cancer you could calculate it with the Gail Model of risk. Currently the recommendation is that if your score on the Gail Model is a one year risk of 1.7% or greater you should discuss breast cancer prevention with your gyno. All the best new resolutions are to do what is positive for health, and lots of posts contain risk factors for breast cancer, but few talk about how to reduce those risk factors, such as the medical treatments including tamoxifen which can lower life time breast cancer risk. Some things are not modifiable, early first period is probably associated with overall estrogen exposure and may in fact incur increased breast cancer risk in your life. Having children early decreases your risk of breast cancer, but if you wait until after you are 35 to have a baby, your risk is as large as if you had never had a baby. Furthermore any protection against breast cancer from breastfeeding is also gone if you have a baby after the age of 35. And breastfeeding helps to prevent the most aggressive breast cancersMetabolic Syndrome increases breast cancer risk. Overall weight gain in adulthood, and increased calorie intake has been associated with increased breast cancer risk. But overall healthy diet and exercise in adolescence lowers risk of breast cancer. Some studies on breast cancer risk and alcohol intake as well as some studies on smoking and breast cancer have failed to show an association, But generally speaking, it is healthy to decrease tobacco and alcohol intake.The current recommendations are that no amount of alcohol is safe. And the studies that do show an association show that the more you drink per day the more risk you are. Hormone therapy with only estrogen may not increase breast cancer risk, however hormone therapy with estrogen and progesterone has shown increased risk in almost every study. We are not sure if hormone therapy increases actual risk or it's just harder to find the breast cancer if taking hormones. For instance low dose hormone replacement therapy can still cause increased breast density (thick breast tissue that reads all white on mammograms) for up to 5 years after you stop, that can obscure a developing breast cancer If you have obesity, dyslipidemia (bad cholesterol or high triglycerides) , increased blood pressure, expanding waist, actual diabetes or prediabetic state, you are increasing your risk of breast cancer. If you have several of these factors together, you are more at risk for breast cancer.At Women's Heath Practice we suggest getting tested for diabetes and beta cell dysfunction (prediabetic states) and then normalizing those factors to reduce your personal risk of breast cancer. And if you need to take tamoxifen, there may be compounds coming that are less risky, such as tamoxifen gel as studied at Northwestern University.

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