October is breast cancer awareness month, and medical professionals across the nation are asking us to “put our health first.”
Locally, doctors, nurses and other professionals are some of the best sources of information and resources to help you do that — and that includes oncologists/hematologists such as Cullman’s Dr. Sri Bathini of Clearview Cancer Institute (www.clearviewcancer.com) and Caroline Canestrari, director of Athens-Limestone Hospital Foundation (https://www.alh-foundation.org/).
When speaking about breast cancer awareness, Bathini has a clear message: “Screening.”
“Not all breast cancers are the same,” she said, “and every person’s cancer is different. … There is a lot of research, a lot of therapeutic options, but screening is the key.”
While many doctors now agree that age 40 is the time to begin annual screening, Bathini said, there are factors such as family genetics and other variables that might necessitate earlier screening for this “disease of aging.”
“Knowing your family history is very important,” Bathini said. “And talking to your family doctor about when you should begin screening. If we can find it early, we can fix it.”
Screening is also at the top of the breast cancer awareness priority list for Canestrari — so much so that the nonprofit she directs hosts an annual Canebrake Witches Ride — a communitywide event at which hundreds of women dress up as witches and “fly” about on decked-up golf carts or bicycles. Enhancing the event are food trucks, pop-up shops, photo opportunities and “more candy than some kids get during Halloween” at designated Candy Zones, she said.
Proceeds from the event raise money and awareness for the foundation’s “The Pink Elephant Project.” That initiative began in 2007 to provide mammogram scholarships to residents of Limestone County who don’t have health insurance, but today includes medical upgrades for new technologies that can detect breast cancer sooner.
This year’s Canebrake Witches Ride takes place at 3 p.m., Oct. 22, and while it’s located in that community, it’s open to everyone, with hundreds of “witches” and dozens of corporate sponsors hosting the event this year. The result, Canestrari said, is a sight to see.
“You can’t imagine the time these women put into creating these masterpieces. We’ll have over 200 witches and more than 25 sponsors — I can’t thank them all enough — and it’s all open to the community. Through this, we can spread more awareness about cancer and women’s health.
“It’s so much fun and it’s great for the kids, too.”
And all of this fun is for a singular cause: “Early detection is the key,” Canestrari said, echoing Dr. Bathini.
Beyond that early screening, other factors that influence risk are also in a person’s control, things such as diet and exercise, the doctor said.
“Moderation is the key to life,” Bathini said. “All the things you do for a healthy heart … can help reduce the risk of breast cancer.”
Breast cancer: the facts
The World Health Organization reports that roughly 2.3 million women were diagnosed with breast cancer in 2020. By the end of that year, there were nearly 8 million women alive who had been diagnosed with the disease in the previous half decade.
A breast cancer diagnosis inevitably leads to questions about the disease. The bulk of those questions undoubtedly are asked by the millions of women who are diagnosed with breast cancer. But millions more individuals, including friends and family members of recently diagnosed women, may have their own questions. Women can discuss the specifics of their diagnosis with their physicians. In the meantime, the following are some frequently asked questions and answers that can help anyone better understand this potentially deadly disease.
What is breast cancer?
“Breast cancer is cancer of the breast tissue,” Bathini said simply.
Cancer is a disease marked by the abnormal growth of cells that invade healthy cells in the body. Breast cancer is a form of the disease that begins in the cells of the breast. The National Breast Cancer Foundation notes that the cancer can then invade surrounding tissues or spread to other areas of the body.
Can exercise help to reduce my breast cancer risk?
The NBCF notes that exercise strengthens the immune system and women who commit to as little as three hours of physical activity per week can begin to reduce their risk for breast cancer. However, even routine exercise does not completely eliminate a woman’s risk of developing breast cancer.
Is there a link between diet and breast cancer?The organization Susan G. Komen, a nonprofit source of funding for the fight against breast cancer, reports that studies have shown eating fruits and vegetables may be linked to a lower risk for breast cancer, while consuming alcohol is linked to an increased risk for the disease. In addition, the NBCF reports that a high-fat diet increases breast cancer risk because fat triggers estrogen production that can fuel tumor growth.
Is there a link between oral contraceptives and breast cancer?
The NBCF reports that women who have been using birth control pills for more than five years are at an increased risk of developing breast cancer. However, the organization notes that risk is very small because modern birth control pills contain low amounts of hormones.
Can breastfeeding reduce breast cancer risk?
Breastfeeding and breast cancer are linked, though the NBCF notes that the role breastfeeding plays in lowering cancer risk depends on how long a woman breastfeeds. The World Cancer Research Fund International notes that evidence indicates that the greater number of months women continue breastfeeding, the greater the protection they have against breast cancer.
What are the types of breast cancer I might be diagnosed with?
There are many types of breast cancer, but some are more common than others. Invasive and non-invasive (also referred to as “carcinoma in situ”) are the two main subtypes of breast cancer.
According to the University of Pittsburgh Medical Center, the most common types of invasive breast cancer are invasive ductal carcinoma, which affects the inner lining of the milk ducts, and invasive lobular carcinoma, which originates from the glands that produce milk.
The UPMC reports that the most common in situ types are ductal carcinoma in situ, which is cancer that remains within the milk ducts, and lobular carcinoma in situ, which does not often develop into breast cancer though it is considered a risk factor for an invasive form of the disease.
The ACS notes that triple-negative breast cancer is an aggressive form of breast cancer that accounts for roughly 15 percent of all breast cancers. Triple-negative breast cancer can be difficult to treat.
Less common types of breast cancer, each of which account for between 1 and 3 percent of diagnoses in a given year, include Paget disease of the breast, angiosarcoma and phyllodes tumor.
Groups at elevated risks
The number of women diagnosed with breast cancer in 2020 exceeded 2 million. That figure, courtesy of the World Health Organization, underscores the significance of the threat posed by the disease.
Though no one is immune to breast cancer, researchers have concluded that certain groups have a higher risk of developing the disease than others. Women who recognize their personal risk for breast cancer may not be able to change certain factors that increase their chances of developing the disease. However, recognition of their personal risk could put women in position to lower that risk in other ways. According to the WHO, the following are some groups who are at elevated risk of developing breast cancer.
• Women: Johns Hopkins Medicine reports that less than 1 percent of all breast cancer cases occur in men. Though it’s still important for men to recognize they’re not immune to the disease, women must also recognize that nearly all of the more than two million annual breast cancer diagnoses across the globe are found in women.
• Women who meet the criteria for being overweight or obese: The nonprofit organization Susan G. Komen, which helps to raise funds for the fight against breast cancer, notes that women who are overweight or obese after menopause have a 20 to 60 percent higher risk of developing breast cancer than women who are not overweight or obese. The American Cancer Society reports that having more fat tissue increases breast cancer risk because it raises estrogen levels. However, the ACS notes the link between weight and breast cancer risk is complicated, so it’s worth it for women concerned about their cancer risk to open a dialogue with their physicians.
• Women who consume alcohol: The MD Anderson Cancer Center reports that alcohol consumption and breast cancer risk are linked. Though the precise cause of the link is unknown, one theory suggests that consuming alcohol can increase estrogen levels as well as the levels of other hormones associated with breast cancer. However, the MDACC warns that the risk is very low, particularly for women who limit their consumption to one drink or less per day. Routinely consuming more than one alcoholic drink per day is a cause for concern.
It’s vital that women recognize their risk for breast cancer. Though any woman can be diagnosed with breast cancer, certain factors, including some that can be avoided, can increase a woman’s risk for the disease.
Effects on the body
No woman wants to be diagnosed with breast cancer. A potentially fatal disease, breast cancer affects millions of women across the globe each year. Thankfully, survival rates for the disease have improved considerably in recent decades, and women now have a much greater chance of living for many years after successful treatment.
A 2017 study from the American Cancer Society found that the number of women who died from breast cancer dropped by about 40 percent in the quarter century preceding the study. A host of variables, including advancements in detecting and treating the disease and a heightened awareness of the need for screening, have contributed to that positive turn.
Though breast cancer treatment is highly effective, particularly when the disease is in its early stages at the time of an initial diagnosis, women may still experience some side effects of both the disease and the treatment their cancer care teams design. The following are some ways that breast cancer and treatment can affect a woman’s body in both the short- and long-term.
• Joint and muscle pain: According to Susan G. Komen, a nonprofit organization that helps to fund breast cancer research, aromatase inhibitors are hormone therapy drugs used to treat hormone receptor-positive breast cancer. Researchers have found that joint pain and muscle pain are common side effects of aromatase inhibitors. This pain might be most noticeable after sleeping or a period of inactivity. Fortunately, the damage to joints and muscles is not permanent.
• Fatigue: Breastcancer.org reports that breast cancer causes changes in the body that can lead to fatigue. That fatigue could be linked to cytokines, which are proteins released by certain breast cancers that researchers suspect cause fatigue. Breast cancer also can alter hormone levels in the body and cause inflammation, and each of those effects can contribute to fatigue.
• Skin changes: The MD Anderson Cancer Center reports that certain changes to the skin are hallmarks of inflammatory breast cancer, a relatively rare yet aggressive form of the disease. Redness or another change in the skin color of the breast, swelling on one side and/or a rash that appears suddenly are changes in the skin that can appear due to breast cancer. Dimpling of the skin over the breast is another change in the skin that can result from breast cancer.
• Libido and fertility: Breastcancer.org reports that some breast cancer treatments can lower a woman’s libido, which is her desire for sex and intimacy. This side effect is possibly a byproduct of other effects of treatment that can affect a woman’s mental state, including anxiety, depression, weight changes, fatigue and difficulty sleeping. In addition, the National Cancer Institute notes that certain types of chemotherapy can cause infertility. Though the Centers for Disease Control and Prevention reports that most cases of breast cancer are diagnosed in women over 50, women can still get the disease at any age. Women who hope to have children after a breast cancer diagnosis are urged to discuss that goal with their cancer care teams so their course of treatment does not adversely affect their ability to give birth.
Breast cancer affects a woman’s body in various ways. Though many effects are temporary, women can still discuss strategies to overcome them as they navigate their way through treatment.
Healthy habits can help
Cancer is a formidable disease that the World Health Organization reports is the leading cause of death worldwide. Figures vary, but organizations such as the WHO and the American Cancer Society estimate that around 9.5 million people die from cancer every year.
No type of cancer causes more deaths in women across the globe than breast cancer. Though the five-year survival rate for breast cancer patients has increased by a significant margin in recent decades, a 2019 study published in The Asian Pacific Journal of Cancer Prevention reported a significant increase in breast cancer mortality rate in the 25-year period preceding the study. The researchers behind the study theorized that the spike in mortality rate could be due to an increase in incidence and prevalence of breast cancer.
Like all cancers, breast cancer cannot be prevented. However, various healthy habits could help women reduce their risk for the disease.
• Avoid alcohol. The ACS reports that alcohol consumption is a clear risk factor for breast cancer. Risk increases with the amount of alcohol a woman consumes. For example, a woman who consumes one alcoholic drink per day has a 7 to 10 percent higher risk of getting breast cancer than a woman who abstains from alcohol. Drinking two to three drinks per day could increase risk by around 20 percent.
• Establish and maintain a healthy weight. Being overweight or obese increases breast cancer risk, particularly among postmenopausal women. According to the ACS, after menopause women get most of their estrogen from fat tissue. Fat tissue increases estrogen levels in the body, which in turn increases a woman’s risk for breast cancer. Elevated levels of insulin in the body, which is common among individuals who are overweight, also has been linked to higher breast cancer risk. Establishing and maintaining a healthy weight cannot prevent breast cancer, but it can help women reduce their risk for the disease.
• Maintain a physically active lifestyle. A sedentary lifestyle increases a person’s risk for various conditions and diseases. Women who live such a lifestyle are at elevated risk for breast cancer. The ACS notes that sedentary behavior such as sitting, lying down, watching television, or engaging with screen-based forms of entertainment that do not require physical activity can increase breast cancer risk, especially for women who spend most of their work day sitting down. A more physically active lifestyle that includes routine exercise can help women reduce their breast cancer risk.
• Adopt a nutritious diet. Eating right is another way for women to reduce their breast cancer risk. Vegetables, fiber-rich legumes such as beans and peas, fruits across the color spectrum, and whole grains are some components of a healthy, nutrient-rich diet that can help lower breast cancer risk. Women also can avoid certain foods, such as red and processed meats and refined grains, to lower their breast cancer risk.
Though there’s no guaranteed way to prevent breast cancer, women can embrace various healthy habits to lower their risk for the disease.
Article originally published in The Cullman Times. Original reporting by Tom Mayer.