1. Maintain a healthy body weight (BMI less than 25) throughout your life.
Weight gain in midlife, independent of BMI, has been shown to significantly increase breast cancer risk. Additionally, and elevated BMI has been conclusively shown to increase the risk of post-menopausal breast cancer.

2. Minimize or avoid alcohol.
Alcohol use is the most well established dietary risk factor for breast cancer. The Harvard Nurses’ Health study, along with several others, has shown consuming more than one alcoholic beverage a day can increase breast cancer risk by as much as 20-25 percent.

3. Consume as many fruits and vegetables as possible.
Eat seven or more servings daily. The superstars for breast cancer protection include all cruciferous vegetables (broccoli, cabbage, brussels sprouts, cauliflower) ; dark leafy greens (collards, kale, spinach) ; carrots and tomatoes. The superstar fruits include citrus, berries and cherries. Note: it is best to eat cruciferous vegetables raw or lightly cooked, as some of the phytochemicals believed to offer protection against breast cancer are destroyed by heat.

4. Exercise regularly the rest of your life.
Many studies have shown that regular exercise provides powerful protection against breast cancer. Aim for 30 minutes or more of moderate aerobic activity (brisk walking) five or more days a week. Consistency and duration, not intensity, are key!

5. Do your fats right!
The type of fat in your diet can affect your breast cancer risk. Minimize consumption of omega-6 fats (sunflower, safflower, corn and cottonseed oils), saturated fats and trans fats. Maximize your intake of omega-3 fats, especially from oily fish (salmon, tuna, mackerel, sardines, lake trout and herring). Consume monounsaturated oils (canola, olive oil, nuts/seeds, avocados) as your primary fat source, as these foods have potential anticancer properties. Specifically, canola oil is a good source of omega-3 fats; extra virgin olive oil is a potent source of antioxidant polyphenols, including squalene; and nuts and seeds provide you with the cancer protective mineral, selenium.

6. Do your carbs right!
Minimize consumption of the high glycemic index, “Great White Hazards” – white flour, white rice, white potatoes, sugar and products containing them. These foods trigger hormonal changes that promote cellular growth in breast tissue. Replace these “wrong” carbs with whole grains and beans/legumes. Beans/legumes because of their high fiber and lignan content are especially special.

7. Consume whole food soy products regularly, such as tofu, tempeh, edamame, roasted soy nuts, soy milk and miso.
Only consume organic, non-GMO (genetically modified) soy. Epidemiologic studies have shown a positive association between soy consumption and reduced breast cancer risk.

8. Minimize exposure to pharmacologic estrogens and xeno-estrogens.
Do not take prescription estrogens unless medically indicated. Lifetime exposure to estrogen plays a fundamental role in the development of breast cancer. Also avoid estrogen-like compounds found in environmental pollutants, such as pesticides and industrial chemicals. Buy organic produce if you can afford it; otherwise, thoroughly wash all non-organic produce. Minimize exposure to residual hormones found in non-organic dairy products, meat and poultry.

9. Take your supplements daily.
A multivitamin, 500-1,000 mg of vitamin C in divided doses, 200-400 IUs of vitamin E as mixed tocopherols, and pharmaceutical grade fish oil. Also take 200 mcg of the mineral selenium or eat one to two Brazil nuts as an alternative. If you have a chronic medical condition or take prescription drugs, consult your physician first.

10. Maintain a positive mental outlook.
Engage in self-nurturing behaviors regularly. Develop rich, warm and mutually beneficial relationships with family and friends. Get adequate sleep (7-8 hours per night). The mind-body associations with breast cancer are significant.

Do you know?

Breast cancer is the most common type of cancer in North American women. It is a leading cause of cancer death, second only to lung cancer. Simply being a woman and getting older puts you at risk for breast cancer.

What puts me at risk?

Risk for developing breast cancer is individual. It depends on a combination of lifestyle and personal traits known as “risk factors.” The following risk factors are strongly related to the disease and can alert you and your physician to the need for careful follow-up:

• A family history of breast cancer, especially in your mother, sister(s), or daughter(s)
• Age — in general, the older you are, the greater your risk
• Never having borne a child
• Having your first child after age 30
• First menstrual period at an early age
• A history of benign breast disease that required biopsies
• Other breast conditions: lobular carcinoma in situ (LCIS) or atypical hyperplasia.

How can you determine your individual risk?

Just knowing these risk factors for breast cancer will not establish your individual risk. Researchers have developed a computerized formula known as the Gail model, that can evaluate your personal risk factors and predict your five-year and lifetime risk for developing breast cancer. This breast cancer risk calculation is fast and simple. If you would like to know your own predicted breast cancer risk, you can calculate it here.

Breast cancer is the second most common cancer in women, and is found in one in eight women in the United States. It is a group of diseases in which cells in the tissues of the breast become abnormal and divide without order or control. These malignant cells form too much tissue and become a tumor. The tumor can grow into nearby tissue or cells break away and enter the bloodstream or lymphatic system eventually affecting other organs. The spread of cancer is called metastasis.

Breast cancer is identified by different names, depending on where it starts in the woman’s breast. A woman’s breast is made up of breast tissue, blood vessels, nerves, ducts, lobes and lobules. The breast is made up of about 20 sections called lobes and these have smaller sections, which are the lobules. The lobules of the breast make the milk and the ducts are the tubes that carry the milk to the nipple. The lobes and lobules are connected by the ducts.

What is “ductal” breast cancer?

If a woman has “ductal cancer,” it means that the cancer starts in the ducts of the breast. Ductal cancer is the most common type and makes up about 86% of all breast cancers. On the other hand, lobular cancer, which starts in the lobules, makes up about 12% of breast cancers. The other 2% start in the surrounding tissues.

If the cancer grows outside the duct where it starts (meaning the cancer penetrated through the duct), it is called infiltrating or invasive ductal cancer. Mastectomy (removal of the breast) is usually recommended by physicians for invasive ductal carcinoma. If the cancer does not grow outside the duct it will be called intraductal carcinoma or ductal carcinoma in situ, which may be also be termed precancer.

What causes breast cancer?

Scientists do not know the exact cause of breast cancer but they have identified high risk factors for this disease. The most significant are:

1. age,
2. family history, and
3. personal history:

Age:
Breast cancer risk increases with age. Over two-thirds of breast cancer occurs in women over age 50.

Family History:
Family history plays an important role. If a woman’s sister or mother has had breast cancer, the chances of getting breast cancer are doubled. Family genes increase the risk of breast cancer. They are called BRCA1 and BRCA2 but only account for 5-10% of all breast cancers. Women who have a family history of breast cancer, or who have a history of benign breast cysts are high risk. Lesser risks that may be genetic include starting menstruation before age 12, late age at menopause (after 55).

Personal History:
Personal history also plays a role in breast cancer risk. This can include exposure to environmental contaminants, remaining childless or having the first child after age 30. More recent findings also show that a diet high in fat may increase the chance of breast cancer development.

What is the difference between flat and round breast tumor masses?

Malignant tumors do vary in size, shape, and the rate of dividing cells. The most common type of breast cancer starts in the lining of the ducts called ductal carcinoma. Another less common type of breast cancer, lobular carcinoma, arises in the lobules at the end of the ducts. When the type is diagnosed, it is determined if the cancer is invasive or non invasive. If it is invasive, it has grown into surrounding tissues outside the duct or lobule where it started. Invasive carcinoma is also called infiltrating ductal or lobular carcinoma. An invasive ductal cancer looks like or feels like a firm lump because scar tissue forms around the cancer cells. Invasive lobular cancer is flatter because the cells form finger projections into the surrounding tissues. Rather than feeling a hard round lump, it feels like a thickening. It is difficult for the surgeon to tell if all the lobular cancer is removed with surgery because of the small projections. Lobular cancers do grow to a larger size like you described before they are detected. There are other variations of invasive ductal cancer that are named according to the shape and characteristics of the cancer cells. Examples are tubular (cells look like tubes), papillary (cells stick out like papules or fingers), medullary (cells have same color as brain tissue), mucinous (cells make mucus). This detailed answer is intended to explain the difference between flat and round masses and why the surgeon did not get all of the mass with the first surgery.

What are the symptoms of breast cancer?

The most common symptom found by the woman herself or a health care provider is a painless lump in the breast. At times, a painful lump turns out to be cancer. The characteristics of a cancerous lump are: it is hard, not well defined, and is immovable. Occasionally, breast cancer appears as a lump in the armpit or axilla. One lump or several in the armpit can be a symptom of breast cancer, but can also be due to noncancerous conditions. Bleeding from the nipple is not a common sign of cancer but it can possibly indicate cancer, especially if it is from one side only. Only 4% of nipple discharge on one side is cancer.

A more difficult symptom to be found by the woman herself is a thickening of the tissue somewhere in the breast. Any change in breast size or shape can be due to either non-cancerous conditions or cancer. For example, if one breast becomes more pendulous or the nipples are at different levels, cancer is a possibility. Swelling or edema occurs where the tumor is which causes the ligaments in the breast tissue to pull on the overlying skin causing dimpling of the skin. This is highly suggestive of breast cancer.

Other symptoms that may indicate the possibility of breast cancer are a redness of the skin over a portion of the breast, dimpling of the skin, an orange peel appearance on the skin, redness or scaliness of the nipple, or nipple pain or retraction (turning inward). When the tumor spreads along the ducts, it may pull on the nipple, causing it to invert or turn inward. When tumor cells are multiplying rapidly, they need extra blood supply. A woman may notice more prominent veins running across the breast than usual.

If the early symptoms are ignored and the lump grows to a large size, the skin may become ulcerated, become infected and have a bad odor. This is called ulceration and fungation. In the most advanced cases, the normal lymph drainage is blocked, causing the entire arm to swell in a condition called lymphedema. It is most unfortunate if breast cancer advances to any of these of signs and symptoms. Women who do a breast self exam every month are able to detect changes in the density of the tissue much more easily than a woman who does not know her breast well.

Breast cancer can also be present with no physical symptoms, but still be detectable with a mammogram. A mammogram can detect a small tumor two years before a lump can be felt with breast examination. This is the reason that a mammogram every year at the age of 40 and over is so important for breast health.

The American Cancer Society’s guidelines for early detection of breast cancer improve the chances for early treatment and cure. They are:

1. Breast Self-Exam: Women age 20 and older should perform a breast self examination every month.
2. Breast Physical Exam: Between the ages of 20 and 39, women should have a clinical breast examination by a health professional every 3 years. After age 40, women should have a breast exam by a health professional every year.
3. Mammogram: An annual screening mammogram for women age 40 and older.

A yearly mammogram for women age 40 is the best screening device we have to date to identify breast cancer, even before any of the above signs and symptoms occur. A mammogram can detect a tumor less than 1/4 inch or 1/2 cm whereas a tumor usually cannot be felt until it is 1/2 inch or 1 cm. Also, a mammogram will detect deposits of calcium called calcifications that look like white dots on the x-ray. The calcifications cannot be felt, but many times are indications of a malignancy. Early detection is the key to longer survival and cure.

Medium : Marie Claire magazine
Publishing Date : February issue, 2009

Picture to the right is the artwork published in the February Issue of Marie Claire magazine. Titled with Pink For Hope, the article has the following content:

The breast cancer awareness programme was a four-days event organised by the NCI Cancer Hospital and SKIVA. The four-day Pink Care exhibition was held as first floor of One Utama Shopping Center and booths were set up to sell pink items at the Promenafde Stage. At the exhibition. there were cards for children to draw and write well wishes to NCI Cancer Hospital’s patients.

Get a copy now at your nearest magazine booths, and book stores.
For more info, visit Marie Claire’s official website, at: www.marieclaire.com.