Three winters ago, I found a lump in my breast. I was taking a shower on a Saturday morning and doing my monthly self-exam when I felt a hard, distinct lump on the upper left side of my left breast. I prodded and poked, but it didn't go away. My heart pounding, I climbed out of the shower and called my husband. I placed his fingers on my breast. "Can you feel that?"
He looked at me and nodded. Monday morning I called my obstetrician/gynecologist and scheduled a mammogram-my first. At 39, I'd been thinking of going in for a baseline, or first mammogram, but had been busy with my 6-month-old son.
Now a mammogram was my first priority.
Though I'd heard horror stories, my mammogram wasn't uncomfortable, and the technician was warm and gentle. The fear of what she might find was far worse. The radiologist came in to show me the films and to tell me that I needed a needle biopsy. He said the lump wasn't a cyst, a fluid-filled sac, and it didn't appear to be due to fibrocystic changes, which are considered a normal variation of breast tissue. While the lump didn't look cancerous, the radiologist explained that it's impossible to tell what it is without examining the breast tissue itself.
After considering my options and talking it over with my husband, I decided to have the lump removed with a minor surgical procedure called a lumpectomy. I figured if the lump was cancerous, the sooner it came out, the better. Even if turned out it wasn't, I didn't want to keep that hard grape-sized mass in my breast. I found myself touching it and worrying about it all the time.
My outpatient surgery took about an hour; I checked into the hospital in the morning and was home that afternoon. My breast was sore, both where the incision had been made and inside where the lump had been cut out, but otherwise I felt fine-especially when my doctor called to tell me the lump had been a fibroadenoma, a benign mass that only rarely becomes cancerous.
Chances are you've heard the frightening statistic "1 in 7"-that one in seven women will develop breast cancer during their lifetimes. Some risk factors, like family history, can't be changed, but others can.
You can reduce your risk of breast cancer in your 20s, 30s, 40s, 50s and beyond.
According to the Centers for Disease Control and Prevention, breast cancer is the second most commonly diagnosed cancer among American women. However, your chance of developing it in your 20s is relatively low-less than 0.5 percent of women will get breast cancer before the age of 39. Here's how you can help keep that risk low:
Check out your family history. The biggest risk for breast cancer has to do with your genes. If you have certain genetic mutations, called BRCA1 or BRCA2, you're at much higher risk for developing the disease. "Somewhere between 20 and 30 percent of those women will have breast cancer by the age of 40, and 50 percent will have it by the time they're 50," says breast cancer specialist Suzanne Mahon, DNSc, RN, clinical professor of hematology/oncology at Saint Louis University School of Medicine. "Over a lifetime, it's about a 95 percent risk."
A simple blood test can tell you whether you carry one of the mutations, but it's expensive, costing about $3,100. There are also significant emotional and psychological consequences of testing to consider as well as the risk of discrimination by insurance companies if you do have the genetic abnormality.
In any case, you should definitely examine your family history. "Women really need to inquire about anyone with breast cancer, especially before the age of 50," says Mahon. If your family history is significant, talk to someone with an expertise in genetics to help determine your individual risk.
Maintain a healthy weight. Staying trim doesn't just look good-it helps reduce your risk of breast cancer, says Dr. William Wood, professor and chairman of the department of surgery of Emory University Hospital in Atlanta. "We know that obesity causes more cases of breast cancer, and also it influences how well someone can physically cope with the cancer." If you're already at a healthy weight, great; if you have extra pounds, work on losing the excess now while you're young.
Eat a variety of fruits and vegetables. Researchers are studying the effects of diet on breast cancer risk. According to the National Cancer Institute, it's not yet proven that a low-fat diet or a diet rich in fruits and vegetables will prevent breast cancer, but a diet rich in beta-carotene may decrease your risk. Eat a healthy diet that includes foods high in beta-carotene such as broccoli, carrots, tomatoes, squash, peaches, apricots and cantaloupe.
Check your breasts. Your doctor will perform a breast exam at your annual checkup, but you should do regular monthly breast exams as well. Circle the calendar and examine your breasts at the same time every month-one week after your period starts. That's when you'll have the lowest level of hormones that produces nodularity, or lumpiness, making your breasts easier to examine.
Have a baby (if you want to!) If you become a mom before the age of 30, your risk of breast cancer is also somewhat lower. Your breasts complete their development after a first pregnancy, which makes them less sensitive to carcinogens, or cancer-causing substances, says Mahon.
Continue to check your breasts every month, and if you notice anything unusual, have your doctor check it out immediately. Maintain your healthy diet, and:
Watch your alcohol intake. Go easy on the margaritas-alcohol consumption increases the risk of breast cancer. "One drink a day is OK," says Wood. "Two drinks a day puts you at an increased risk, and three drinks a day puts you at 50 percent more risk."
Get moving! Being thin isn't enough-if you're a couch potato, you're also at slightly higher risk to develop breast cancer. Maintain a healthy weight and try to get at least 30 minutes of moderate physical activity every day to reduce your risk of breast cancer and other diseases. It's a great habit to have early on.
Consider switching birth control. While higher-dose oral contraceptives of the past were associated with a small increased risk of breast cancer, today's pills contain a lower dose of hormones. The available data, however, suggests a slightly increased risk, so consider whether the benefits of the pill outweigh the risk of taking it. If you have a family history of breast cancer, for example, you may want to choose a different form of birth control.
When you reach your 40s, your risk of developing breast cancer increases. "Getting older is a risk factor you can't change-it's somewhat related to the number of total ovulatory cycles that a woman has over a lifetime," says Mahon. Your risk is a bit higher if your first menstrual period is before the age of 12, and if you have a relatively late menopause.
Get a baseline mammogram-and annual ones thereafter. At 40, schedule your first mammogram. If you know you have a high hereditary risk or known mutation, though, you may start with a baseline as early as age 25.
Stay active. Keep up your healthy eating habits and maintain a regular exercise program. Strength-building exercise like lifting weights helps you maintain muscle tone and increases the number of calories your body burns even at rest, and aerobic exercise burns calories and improves your cardiovascular fitness as well.
Skip the soy? Researchers aren't sure whether soy, which has a pseudo-estrogenic effect, can increase a woman's risk of developing breast cancer. If you have significant risk factors, you may want to avoid this food.
You're most likely to develop breast cancer after the age of 50; according to the Centers for Disease Control and Prevention, 75 percent of breast cancer cases occur then. Your risk gradually increases as you age; if you live to be 90, you have a 1 in 7 chance of developing the disease.
The same advice applies to older women as to younger, but annual mammograms are even more important now because of the heightened risk. In addition to the above advice:
Question hormone replacement therapy. Just as taking the pill may cause a small increase in the risk of breast cancer, postmenopausal women may increase their risk by taking HRT, or hormone replacement therapy. Women should consider the risks and benefits of HRT before going on the regime-if you have a significant family history of breast cancer or have had breast abnormalities before, HRT may not be worth the risk.
The bottom line? Embracing a healthy lifestyle throughout your life is the best strategy to help you avoid developing breast cancer, but regular self-exams and mammograms after the age of 40 are also important. They make you more likely to discover symptoms of breast cancer earlier, making it easier to treat and cure.
Kelly James-Enger is a former lawyer, a mom of two and a freelance writer.
See more of Kelly's stories here.