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Breast cancer prevention & screening : How to reduce your risk

Breast cancer prevention

Breast cancer prevention starts with healthy habits — such as limiting alcohol and staying active. 

If you’re concerned about developing breast cancer, you might be wondering if there are steps you can take to help prevent breast cancer. Some risk factors, such as family history, can’t be changed. However, there are lifestyle changes you can make to lower your risk.

What can I do to reduce my risk of breast cancer?

Research shows that lifestyle changes can decrease the risk of breast cancer, even in women at high risk. To lower your risk:

  • Limit alcohol.The more alcohol you drink, the greater your risk of developing breast cancer. The general recommendation — based on research on the effect of alcohol on breast cancer risk — is to limit yourself to less than one drink a day, as even small amounts increase risk.
  • Don’t smoke.Evidence suggests a link between smoking and breast cancer risk, particularly in premenopausal women.
  • Control your weight.Being overweight or obese increases the risk of breast cancer. This is especially true if obesity occurs later in life, particularly after menopause.
  • Be physically active.Physical activity can help you maintain a healthy weight, which helps prevent breast cancer. Most healthy adults should aim for at least 150 minutes a week of moderate aerobic activity or 75 minutes of vigorous aerobic activity weekly, plus strength training at least twice a week.
  • Breast-feed.Breast-feeding might play a role in breast cancer prevention. The longer you breast-feed, the greater the protective effect.
  • Limit dose and duration of hormone therapy.Combination hormone therapy for more than three to five years increases the risk of breast cancer. If you’re taking hormone therapy for menopausal symptoms, ask your doctor about other options.
  • Avoid exposure to radiation and environmental pollution.Medical-imaging methods, such as computerized tomography, use high doses of radiation.

What Is Breast Cancer Screening?

Breast Cancer Screening means checking a woman’s breasts for cancer before there are signs or symptoms of the disease. All women need to be informed by their health care provider about the best screening options for them. When you are told about the benefits and risks of screening and decide with your health care provider whether screening is right for you—and if so, when to have it—this is called informed and shared decision-making.

Although breast cancer screening cannot prevent breast cancer, it can help find breast cancer early, when it is easier to treat. Talk to your doctor about which breast cancer screening tests are right for you, and when you should have them.

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Breast Cancer Screening Recommendations

The USPSTF External recommends that women who are 50 to 74 years old and are at average risk for breast cancer get a mammogram every two years. Women who are 40 to 49 years old should talk to their doctor or other health care professional about when to start and how often to get a mammogram. Women should weigh the benefits and risks of screening tests when deciding whether to begin getting mammograms before age 50.

Breast Cancer Screening Tests

  • Mammogram

    A mammogram is an X-ray of the breast. Mammograms are the best way to find breast cancer early, when it is easier to treat and before it is big enough to feel or cause symptoms. Having regular mammograms can lower the risk of dying from breast cancer. At this time, a mammogram is the best way to find breast cancer for most women.
  • Breast Magnetic Resonance Imaging (MRI)A breast MRI uses magnets and radio waves to take pictures of the breast. MRI is used along with mammograms to screen women who are at high risk for getting breast cancer. Because breast MRIs may appear abnormal even when there is no cancer, they are not used for women at average risk.

What are the benefits and risks of breast cancer screening?

Mammography

Benefits

  • Imaging the breast improves a physician’s ability to detect small tumors. When cancers are small, the woman has more treatment options.
  • The use of screening mammography increases the detection of small abnormal tissue growths confined to the milk ducts in the breast, called ductal carcinoma in situ (DCIS). These early tumors rarely harm patients if they are removed at this stage, and mammography is the only proven method to reliably detect these tumors. It is also useful for detecting all types of breast cancer, including invasive ductal and invasive lobular cancer.
  • Mammography has been shown to decrease the number of deaths from breast cancer when it is used for screening.
  • No radiation remains in a patient’s body after an x-ray examination.

Risks

  • There is always a slight chance of cancer from excessive lifetime exposure to radiation. However, the amount of radiation from a mammogram is very small and the benefit of an accurate diagnosis far outweighs the risk.
  • The effective radiation dose for this procedure varies.
  • False positive mammograms may occur. Five to 15 percent of screening mammograms require more testing such as additional mammograms or ultrasound. Most of these tests turn out to be normal. If there is an abnormal finding, a follow-up or rarely a biopsy may have to be performed. Most biopsies are done with a needle and confirm that no cancer was present.
  • Based on statistical studies on the incidence of cancer over time, some researchers have suggested that cancer screening identifies both life-threatening diseases and diseases that would never have caused symptoms during the patient’s lifetime, a phenomenon called over-diagnosis. Over diagnosis of breast cancer is likely very small. Scientists are working on methods to classify abnormal cells according to their potential to cause harm; however, at this time, physicians have no way of distinguishing non-life threatening cancer cells from those that will cause advanced disease.
  • Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant.

Breast Ultrasound

Benefits

  • Ultrasound scanning is noninvasive (no needles or injections).
  • Occasionally, an ultrasound exam may be temporarily uncomfortable, but it is almost never painful.
  • Ultrasound is widely available, easy-to-use and less expensive than other imaging methods.
  • Ultrasound imaging is extremely safe and does not use any ionizing radiation.
  • Ultrasound scanning may give a clear picture of soft tissues that do not show up well on x-ray images.
  • Ultrasound imaging can help detect lesions in women with dense breasts that may not be visible on mammography.

Risks

  • For standard diagnostic ultrasound, there are no known harmful effects on humans. Interpretation of a breast ultrasound examination may lead to additional procedures such as follow-up ultrasound and/or aspiration or biopsy. Many of the areas thought to be of concern only on ultrasound turn out to be non-cancerous (benign).

Breast MRI

Benefits

  • MRI is a noninvasive imaging technique that does not involve exposure to ionizing radiation.
  • MRI has proven valuable in detecting breast cancer and finding cancers that are not seen on mammography or ultrasound.
  • The ability of MRI to detect breast cancer does not appear to be compromised by breast density.
  • MRI as an addition to mammography has been shown to be useful in evaluating women at high risk for breast cancer.
  • If a suspicious lesion is seen with MRI only, MRI can provide guidance for biopsy.

Risks

  • Many potential abnormalities seen on MRI prove to be benign (false positives).
  • MRI poses almost no risk to the average patient when appropriate safety guidelines are followed.
  • Although the strong magnetic field is not harmful in itself, implanted medical devices that contain metal may malfunction or cause problems during an MRI exam. Inform your doctor or the technologist prior to the exam if you have such a device.
  • There is a very slight risk of an allergic reaction if contrast material is injected. Such reactions usually are mild and easily controlled by medication. If you experience allergic symptoms, a radiologist or other physician will be available for immediate assistance.
  • Nephrogenic systemic fibrosis is currently a recognized, but rare, complication of MRI believed to be caused by the injection of high doses of gadolinium contrast material in patients with very poor kidney function.
  • Manufacturers of intravenous contrast indicate mothers should not breastfeed their babies for 24-48 hours after contrast medium is given.
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