No one should drink a lot of alcohol. Drinking more than one drink per day (for women) and more than two drinks per day (for men) has no health benefits and many serious health risks, including breast cancer. Many studies show that drinking alcohol increases the risk of breast cancer. A pooled analysis of data from 53 studies found for each alcoholic drink consumed per day, the relative risk of breast cancer increased by about seven percent.
Research shows that women who had two to three alcoholic drinks per day had a 20 percent higher risk of breast cancer compared to women who didn’t drink alcohol.
Estrogen levels are higher in women who drink alcohol than in non-drinkers, which may increase the risk of breast cancer.
Drinking alcohol can reduce blood levels of the vitamin folic acid. Folic acid plays a role in copying and repairing DNA. Low levels of folic acid may make it more likely that errors occur when cells divide, which can cause cells to become cancerous. Such errors can lead cells down a pathway to become cancer.
However, drinking in moderation has some health benefits like lowering the risks of heart disease, high blood pressure and death. It is important to note that drinking excessive alcohol has no health benefits, only health risks.
No one knows more about your body than you do – not your partner, not your parents, not even your doctor. So when you talk with a health care provider about your health, remember that you have valuable information to share. You know about changes in your body and about any problems you may be having. Share that information. Open and honest communication between you and your doctor is one of the best ways to make sure you get the care you deserve.
To get the most out of each doctor’s visit, try following these guidelines:
Be prepared. It is often helpful to gather information about your health concerns — from the library (books and medical journals), trusted Internet sites, etc. The more you know, the more comfortable you will be talking to your doctor.
Organize your questions ahead of time. You should be able to talk openly and honestly with your doctor about breast health and breast cancer to make sure all of your questions are answered. To help you get started, Susan G. Komen® has a series of 17 Questions to Ask the Doctor topic cards on a variety of breast cancer issues. Each card contains important questions to discuss with your doctor. Space is provided for you to jot down the answers. Also, be sure to bring a voice recorder to capture your conversation so you can refer back to your doctor’s responses. These questions will help your doctor understand and address your specific concerns. You can download and print these cards to take to your next doctor’s appointment at www.komen.org/questions.
Tell your story. When your doctor comes in, ask if you can take a few minutes to briefly explain your situation and concerns. Be as specific as you can. Then, give the doctor your list of questions and ask them.
Give feedback. If your doctor’s responses were helpful, say so. This kind of feedback will encourage your doctor to talk with you, listen to you and continue to help you. Doctors are just like anyone else; they want to do their job well. That means doing whatever they can to help you stay healthy or to get better. Remember, although doctors may know a great deal about breast health and breast cancer, they may not truly understand or be aware of all that you are going through. You can help your doctor help you by sharing your feelings and concerns.
In the past, many women used menopausal hormone therapy (MHT), also known as hormone replacement therapy, to relieve hot flashes and other symptoms of menopause. But studies show that use of estrogen plus progestin increases the risk of both developing and dying from breast cancer. Although MHT is approved for the short-term relief of menopausal symptoms, the U.S. Food and Drug Administration (FDA) recommends women use only the lowest dose that eases symptoms for the shortest time needed.
When women take these hormones (estrogen plus progestin), their risk of having an abnormal mammogram increases within the first year of use and their risk of breast cancer increases within the first five years of use. The risk of breast cancer goes up slightly each year a woman takes estrogen plus progestin. One large study found women who use estrogen plus progestin for five or more years (and are still taking it) more than double their breast cancer risk.
When women stop taking MHT, the risk of breast cancer starts to decline. After about 5 to 10 years, the risk returns to that of a woman who has never used MHT.
While most people diagnosed with breast cancer do not have a family history of the disease, a family history of certain types of cancer (breast, ovarian or prostate) can increase your risk of breast cancer. This increased risk may be due to genetic factors (known and unknown), shared lifestyle factors, or other family traits.
Women who have a sister or mother who was diagnosed with breast cancer before age 40 have almost twice the risk of women with no family history of breast cancer.
A history of prostate cancer in a father or brother may also increase a woman’s risk of breast cancer, especially if the prostate cancer was found at a young age.
Breast cancer screening for women at higher risk
There are special breast cancer screening guidelines for some women at higher risk. If you have a higher risk of breast cancer, talk with a doctor about which screening options are right for you. You may need to be screened earlier and/or more often. Additionally, if you have a higher risk of breast cancer, there are some options that may help lower your risk, including:
Understanding what factors in your personal health history might affect your risk can help you work with your doctor to address any concerns you may have and develop a breast cancer screening plan that is right for you.
High bone density, age at first period, age at menopause, current or recent use of birth control pills and menopausal hormone use all are linked to blood estrogen levels which can impact breast cancer risk.
Women who have had ovarian cancer appear to have an increased risk of breast cancer.
Women who have an inherited mutation in the BRCA1 or BRCA2 gene have an increased risk of both breast and ovarian cancer.
Breast cancer survivors have an increased risk of getting a new breast cancer. If the first breast cancer was hormone receptor-negative, the risk may be higher compared to those survivors whose first breast cancer was hormone receptor-positive.
Those with a history of Hodgkin’s disease in childhood or early adulthood are about 8 to 25 times more likely to get breast cancer.
Some risk factors that are linked to breast cancer, like being a woman and getting older, are not things you can change. But other factors, like maintaining a healthy weight, may help lower your chances of getting breast cancer. Although not all the behaviors listed below lower the risk of breast cancer, they are good for overall health. Everyone should aim to:
Eat at least 2 ½ cups of fruits and vegetables every day. Studies have shown that eating vegetables and fruits may help lower the risk of some breast cancers. Studies have also shown that women with higher levels of carotenoids (found in carrots, sweet potatoes and squash) have a reduced risk of breast cancer compared to women with lower levels.
Choose 100 percent whole grain foods (such as 100 percent whole grain breads and cereals, brown rice, millet and quinoa).
Limit red meat and processed meat (choose chicken, fish or beans instead).
Eat “good” fats (polyunsaturated and monounsaturated fats). These are found in foods such as olive and canola oil, nuts and natural nut butters, avocado and olives.
Limit “bad” fats (saturated and trans fats). These are found in foods such as red meat, fatty deli meats, poultry skin, full fat dairy, fried foods, margarine, donuts and microwave popcorn
Not all breast cancers are the same. A biopsy is a test that removes cells or tissue from the suspicious area of the breast. It is needed in order to diagnose breast cancer. Once biopsied, cells are sent to a lab for a pathology report. The following information will usually be available on this report if the cells studied are cancerous:
Lymph Node Status: If lymph nodes were removed, a pathology report will show if the lymph nodes contain cancer cells.
Tumor Margins: When breast cancer is removed by surgery (during a surgical biopsy, lumpectomy or mastectomy), a rim of normal tissue surrounding the tumor is also removed. This rim is called a margin. It helps show whether or not all of the tumor was removed.
Positive (involved) margins: Contain cancer cells.
Close margins: Cancer cells approach but do not touch the edge of the biopsy.
Negative (not involved, clear or clean) margins: Do not contain cancer cells
Tumor Grade: For invasive breast cancers, the shape is noted and a grade is assigned. Tumor grade relates to the structure of the cells. It is different from tumor stage. This determines how different the cancer cells look from healthy cells. In general, the more the cancer cells look like normal breast cells, the lower the grade and the better the prognosis.
Grade 1: Cells look most similar to normal and are not growing rapidly.
Grade 2: Cells look somewhat different than normal.
Grade 3: Cells look very abnormal and may be spreading/growing rapidly.
Non Invasive vs. Invasive:
Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer (stage 0).
Invasive breast cancer (also called infiltrating cancer) means the cancer cells inside of a milk duct or lobule have broken out and spread to nearby tissues
Tumor Size: Tumor size is most often reported in centimeters or millimeters. The best way to measure tumor size is under a microscope. In general, the smaller the tumor size, the better the prognosis.
Diagnosis: This is the most important part of the pathology report. It gives the final diagnosis and may include information on the cancer such as tumor size, type, grade, hormone receptor status and HER2/neu status.
Hormone Receptor Status: Hormone receptors are proteins found inside some cancer cells. When hormones (estrogen and progesterone) attach to these receptors, they make cancer cells grow. Knowing the hormone receptor status will help guide your treatment.
Estrogen and Progesterone Receptive-positive (ER+ and PR+) tumors have many hormone receptors and there are treatments that prevent the cancer cells from getting the hormones they need to grow may stop tumor growth. .
Estrogen and Progesterone Receptive-negative (ER- and PR-) tumors have few or no hormone receptors and are not treated with hormone therapies.
HER2/neu Status: (human epidermal growth factor receptor 2) is a protein that occurs on the surface of some breast cancer cells.
HER2/neu-positive (HER2+) tumors have many HER2/neu genes inside the cancer cells (also called HER2/neu over-expression), which causes a large amount of HER2/neu protein on the surface of the cancer cells. About 15-20 percent of breast cancers are Her2+. These breast cancers tend to be more aggressive than other tumors. There are treatments that specifically target HER2/neu and block the ability of the cancer cells to receive the signals that cause them to grow.
HER2/neu-negative (HER2-) tumors have few HER2/neu genes inside the cancer cells and little or no HER2/neu protein on the surface of the cancer cells and are not treated with HER2-targeted therapies.
Triple Negative: If all three statuses are negative (ER, PR, and HER2/neu) then the patient’s cancer is Triple Negative Breast Cancer. The current standard of treatment for these cancers is some combination of surgery, radiation therapy and chemotherapy. These cancers tend to be very aggressive and recur (come back) early.