What you can do to prevent and detect breast cancer from your twenties and up.
Breast health isn’t talked about as much as it should be—when was the last time you discussed your monthly breast self-exam with your friends at brunch? But here at Coveteur, in honor of Breast Cancer Awareness Month, we thought we’d start the conversation.
So we reached out to one of our favorite experts on the topic to get suggestions about what we should be doing in our twenties, thirties, forties, fifties, and beyond to prevent breast cancer. Right off the bat, her answers were enlightening.
“My approach is more that choices and behaviors of our youth affect us later in life, and breast health doesn’t just matter at 40,” Anjali Malik, MD, a breast imaging radiologist at Washington Radiology in Washington, D.C., and a medical advisor for Bright Pink, tells us. “So to make suggestions for each age is tough because I believe we should start early.”
In other words, she told us she’d be happy to make specific suggestions for 25-year-olds to follow, but that she’d basically recommend the same things for 45-year-olds (other than yearly mammograms, which come into play at the age of 40, unless you’re high-risk).
Malik doesn’t mince her words here: “The top two risk factors for breast cancer are being female and aging, both of which are nonmodifiable risk factors,” she says. “So it’s important to control modifiable risk factors to reduce your risk for the development of breast cancer, and to start early in life to have the biggest impact.”
And so, we broke her suggestions down by category instead of year, because, according to Malik, age is just a number and good health is in style whether you’re 20 or 50.
Knowledge Is Power
First and foremost, ask your parents the tough questions. It might not be fun to talk about cancer, but it’s necessary. “Know your family history of cancer—not just breast cancer, but also ovarian, colon, pancreatic, and thyroid,” Malik says.
Armed with this knowledge, you can go to your next doctor’s appointment better prepared. “Talk to your doctor about your risk factors,” she suggests. “This can help determine if you need genetic testing or need an early, high-risk screening protocol.”
Health Is Wealth
Much like knowing where you came from can serve you, so too can taking care of yourself in the present day. This might not always be fun, but especially if your risk factors are high, that might mean you don’t indulge quite as heavily in bottomless brunch.
“Refrain from or reduce alcohol consumption, which increases the risk for the development of breast cancer,” Malik says. “No amount has been shown to be safe.”
You Are What You Eat
What you put in your body has an effect on your overall health. For starters, “take a look at what you eat,” Malik says. “High-fat diets and processed meat increase the risk for multiple types of cancer.”
The safest way to go is vegetarian or even vegan, she says: “Consider a plant-based or plant-predominant diet.” And don’t forget the oatmeal, chia seeds, broccoli, and other fiber-rich foods. “Fiber can reduce cancer risk,” Malik says.
Regardless of the way you eat, “maintain a healthy weight,” Malik says. “Fat cells produce estrogen, and that estrogen increases the risk of breast cancer.”
And contrary to popular belief, soy is A-OK. In fact, Malik says: “Eat soy! Early and frequent exposure to soy is not only safe, it’s healthy and possibly helpful.”
Though this isn’t a tip for everyone, if you’re already planning on having a child or children, hop on it. “If it’s available to you, think about family planning early,” Malik says. “Pregnancy before the age of 30 can be protective, while pregnancy after the age of 30 increases breast cancer risk.”
Plus, after childbirth there are even more benefits: “Breastfeeding is protective when done for six months, either consecutively or between multiple pregnancies,” Malik says. “Hopefully that helps on the sleepless nights!”
Find a Doctor You Trust
Get the details about hormone replacement therapy, Malik recommends. “Have an open and honest conversation with your doctor about hormone replacement,” she says. “If you’re at high risk for the development of breast cancer, then HRT may not be right for you.
“On the other hand, if you are at high risk for osteroporosis or have severe postmenopausal symptoms, you might benefit from HRT,” she adds. Either way, finding a doctor who can really give you the full picture will be vital.
We hear it starting in high-school health class: Give yourself a monthly breast exam. If you do it every month, you’ll know what is and isn’t normal. “Know your normal so you can know when your breasts have a change,” Malik recommends.
“Mid-cycle monthly exams” are the best time to perform a self-exam, “when our breasts are least influenced by hormones,” Malik says. “If you feel something, wait a week, then feel again to see if there has been a change.”
“A full breast exam goes from the underarm to the breast bone, and the collar bone to below the breast,” she adds. If Paula Abdul can do it, we can too.
Mammograms Every Year, Like Clockwork
“Make sure you’re getting annual mammograms starting at 40 if you are average risk,” Malik says. “Though some of the guidelines suggest otherwise, we know this saves the most lives, reducing mortality by 40 percent.”
If you have a worrisome family history, you can start earlier than that. Mammograms can start earlier “with known genetic mutation, family history of premenopausal breast cancer, or high risk, so it’s important to know family history and have risk assessment or genetic testing before age 30,” Malik says.
“Early, high-risk screening may include mammograms, ultrasounds, and MRIs,” Malik adds. With all things being equal, it makes most sense to start with mammograms. “Mammograms are X-rays, and they’re the best universal screening tool because they are widely available, quick and easy to perform, and cost effective,” she says.
Consider Other Imaging Options
But sometimes it makes more sense to go with something other than a mammogram. “Ultrasounds can be used for women with dense breast tissue,” Malik says. “MRI is the most sensitive imaging tool, but it’s expensive, has some risk, and takes time to perform, so it’s reserved for high-risk screening, such as for women with BRCA mutations.”
Your doctor can guide you to the best imaging option for you. But if they suggest thermography, red flag: “Thermography is not appropriate for breast cancer screening, is not FDA approved, and is generally considered pseudoscience,” Malik says.
[Editor’s Note: As ever, we are not doctors or medical know-it-alls. And everybody is different, so make sure to check with a doctor before trying anything new.]
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