Breast Cancer Awareness: Think Pink

October is breast cancer awareness month and so for the rest of the month I will be on a pink kick!

Five years ago, I was lying in my bed doing a self-breast exam and noticed a lump in my left breast. You are doing this exam to make sure there is nothing abnormal going on, but you aren’t actually expecting to find an abnormality. So, when you do, it’s like… an unreality feeling stops you in your tracks. I tried to shake those immediate panicked thoughts off. I will give it a few days I said to myself. Maybe it is just some kind of crazy thing that’s going on with my body (based off where I was with my menstrual cycle). It will go away.

But it didn’t. And let me tell you, being an oncology nurse did me no favors. I went to my mother. I laid on her bed and put her hand over my breast, “Do you feel that? What do you think about that?” My mom (probably knowing the impending panic that was brewing on the inside of me) offered a less extreme possibility, “maybe it’s a cyst?”

I made an appointment to see my primary care doctor. All the while I kept hoping I would wake up one morning and this looming lump would just not be there anymore. My doctor ordered an ultrasound. Based off the ultrasound it was recommended that I have a mammogram.

At that time, I worked with a medical oncologist who I really admired, Dr. Nithya Ramnath. I brought my mammogram results to work with me and asked Dr. Ramnath for her opinion. Turns out her husband is a surgeon who happens to be friends with a phenomenal and highly sought-after surgical oncologist in the Breast Care Center at the University of Michigan. Dr. Ramnath sent an email and the very next day I got a call to schedule an appointment with Dr. Lisa Newman.

A month later I was having a lumpectomy. Dr. Newman is a beast of a surgeon and very thoughtful with her approach. Instead of just slicing my boob right where the lump was she made a non-consequential incision along the bottom line of my areola, “that way you won’t have any visible scars” she told me. Five years later and there is essentially no sign that any of this even ever happened. Dr. Newman has since left U of M. She is now c hief of breast surgery at Cornell in New York. As I said, she is a beast. I’m so glad God aligned everything so that she was my surgeon when I needed one.

My pathology came back as a benign breast tumor and I was told that I would not need to have any further follow-up until I start having regular mammograms. I feel so very grateful to God and forever indebted to Dr. Ramnath for sending that email.

I still check my breasts regularly.

Breast cancer is the second most common cancer in women (after skin cancer). Woman living in the United States have about a 12%, or a 1 in 8, lifetime risk of being diagnosed with breast cancer. Men can also get breast cancer.

Breast cancer happens when normal cells in the breast change and grow out of control. Knowing how your breasts normally look and feel is an important part of breast health. Finding breast cancer as early as possible gives you a better chance of successful treatment. But knowing what to look for does not take the place of having regular mammograms and other screening tests. Screening tests can help find breast cancer in its early stages, before any symptoms appear.

There are some things you can do that might lower your risk.

Get to and stay at a healthy weight. Increased body weight and weight gain as an adult are linked with a higher risk of breast cancer after menopause. Before menopause your ovaries make most of your estrogen, and fat tissue makes only a small amount. After menopause (when the ovaries stop making estrogen), most of a woman’s estrogen comes from fat tissue. Having more fat tissue after menopause can raise estrogen levels and increase your chance of getting breast cancer. Also, women who are overweight tend to have higher blood insulin levels. Higher insulin levels have been linked to some cancers, including breast cancer. The link between weight and breast cancer risk is pretty complex.

Be active. Many studies have shown that moderate to vigorous physical activity is linked with lower breast cancer risk, so it’s important to get regular physical activity. The American Cancer Society recommends that adults get at least 150 minutes of moderate intensity (anything that makes you breathe as hard as you do during a brisk walk) or 75 minutes of vigorous intensity activity (which causes an increased heart rate, sweating, and a faster breathing rate) each week (or a combination of these), preferably spread throughout the week.

Limit or avoid alcohol. Alcohol also increases risk of breast cancer. Even low levels of alcohol intake have been linked with an increase in risk.

Some studies suggest that breastfeeding may slightly lower breast cancer risk, especially if it’s continued for 1½ to 2 years.

Some birth control methods use hormones that might increase breast cancer risk.

Using hormone therapy after menopause can also increase your risk of breast cancer. So, talk to your health care provider about non-hormonal options to treat menopausal symptoms.

If you are a woman at increased risk for breast cancer (for instance, if you have a strong family history of breast cancer, a known gene mutation that increases breast cancer risk, the BRCA1 or BRCA2 gene, or you have had DCIS or LCIS), there are some additional things you can do to help lower your chances of developing breast cancer (for example taking medications called aromatase inhibitors which lower estrogen). You should have a conversation with your health care provider to see if this is right for you.

You can read more about breast cancer risk and prevention here.

Regular high-quality screening mammograms and clinical breast exams (an exam done by a health care provider) are the most sensitive ways to screen for breast cancer.

Different experts have different recommendations for screening. The most recent breast cancer screening recommendations from the United States Preventive Services Task Force (USPSTF) for women who don’t have symptoms of breast cancer and who are not at a high risk of the disease is to get a screening mammogram every other year from ages 50 to 74. The recommendation also says women can choose to begin getting mammograms every other year in their 40s.

In October 2015, the American Cancer Society released a new guideline for breast cancer screening in women at average risk of breast cancer. The guideline says women ages 40-44 can choose to have an annual mammogram and recommends that all women begin having yearly mammograms at age 45 and continue to do so through age 54. Beginning at age 55, women can change to having mammograms every other year or continue having them every year

At U of M the current recommendation remains for women to start at age 40 with yearly mammograms.

So, no matter what, starting at the age of 40, it’s important to talk to your health care provider about the benefits and drawbacks of screening.

If you’re under 40 but have a relative who was diagnosed with breast cancer at a young age, you should also definitely talk to your health care provider.

Ladies do your self-checks, talk to your health care providers, get your recommended screening mammograms, take care of yourselves! Happy awareness month! All my love!