by Senequa Malone, Jaelyn Copeland, and Shon Mack, with contributions from Shayna Bryan | Interns and UAB Community Health and Human Services students
(This article is based on a discussion from WWL’s Monday Night Wellness Watch. [Link to the livestream recording coming soon!])
October is Breast Cancer Awareness month. Breast cancer is one of the most prevalent cancers out there. According to the CDC, it is the second most common cancer in women (after some skin cancers) and the second leading cause of cancer death in women (after lung cancer). About 1 in 8 women will be diagnosed with some kind of breast cancer in her lifetime. No one is exempt from a breast cancer diagnoses. It affects men and women, old and young.
Today we’re going to learn about what breast cancer is, what the risk factors are, how you can reduce your risk, and how it affects Women of Color in our community.
What is Breast Cancer?
Breast cancer is a type of cancer that starts in the breast. Cancer starts when cells begin to grow out of control. There are many different types of breast cancer, these depend on where in the breast the cancer cells are located. The breast is made up of 3 parts:
- Lobules (glands that produce milk)
- Ducts (connect glands to nipple)
- Connective tissue (fat that surround the breast and makes up a large part of the volume)
Most breast cancers begin in the lobules or ducts. When the cancer spreads to other parts of the body, it is said to have metastasized.
How common is Breast Cancer? What about dying from Breast Cancer?
Every person has breast tissue, so everyone one is capable of developing breast cancer. It is most common in women, but men can develop it too. The lifetime risk is of getting breast cancer for a woman is 13% and the risk of dying from breast cancer is 2.6%. The 5-year survival rate post diagnosis is 90%. The number of new cases of breast cancer is going slightly up (0.5% per year), but death is going down (1% per year). This is likely due to early detection and better screening. Men are 100 times less likely to develop breast cancer, but that number is not zero. While rare, men are diagnosed and die from breast cancer every year
What are the risk factors for Breast Cancer?
- Being born a woman
- Being older
- Obesity
- Family history
- 15% of women with breast cancer have a family member with it
- Early menstruation (starting before age 12)
- Late menopause (starting after age 55)
- Having dense breast tissue
What are dense breasts?
Breast density is a term that describes the relative amount of different types of breast tissue (glandular, connective, and fat tissue) as seen on a mammogram. Dense breasts have relatively high amounts of glandular tissue and fibrous connective tissue and relatively low amounts of fatty breast tissue.
Only a mammogram can show if a woman has dense breasts. Dense breast tissue cannot be felt in a clinical breast exam or in a breast self-exam. Nearly half of all women age 40 and older who get mammograms are found to have dense breasts.
Whether your breasts are dense is often due to genetics, but other factors can influence it. Factors associated with lower breast density include increasing age, having children. Factors associated with higher breast density include having a high body-mass index and using postmenopausal hormone replacement therapy.
Is there any way to reduce our risk of Breast Cancer?
Factors we can change include:
- Maintain a healthy weight
- Be regularly physically active
- 150-300 minutes of moderate intensity per week (or about 20-30 minutes a day)
- Eat a healthy diet
- Vegetables, whole grains, unsaturated fat
- Perform monthly breast self-exams
- 40% of diagnosed breast cancers were detected by women who feel a lump
- Start at age 20 to become familiar with your “normal”
- Monitor regularly for changes
- Consume alcohol moderately, or not at all
- Women who have 2-3 drinks a day have 20% higher risk than non-drinkers
- If you have children, breastfeed if you are able
What about Breast Cancer risk among African American women?
African American women have a 31% breast cancer mortality rate – the highest of any U.S. racial or ethnic group. While the reasons behind this disparity are numerous and complicated, the issue is real and there are at least some solutions everyone agrees on: more screening, more self-exams, and more access to treatment for African American women.
New Cases of Breast Cancer per 100,000 People
| Area | All Groups | African American Women |
|---|---|---|
| National | 121.4 | 124.3 |
| Alabama | 128.8 | 126.1 |
| Jefferson County | 130.5 | 128.7 |
Deaths due to Breast Cancer per 100,000 People
| Area | All Groups | African American Women |
|---|---|---|
| National | 19.9 | 27.1 |
| Alabama | 21.4 | 27.5 |
| Jefferson County | 25.6 | 28.4 |
How do I perform a Breast Self-Exam?
Set a schedule and do it regularly. A good time to start is 3-5 days after your period it ends, then continue to perform a BSE every month.
- Remove your clothing and take a good look at yourself in the mirror. If you’re never done something like this before, it can feel a little silly and embarrassing at first, but it’s very important to become familiar with your own body and what is normal for you, so you can detect changes.
- Breasts come in all shapes and sizes (many women have one breast larger than the other), so once you know what is normal for you, when you perform these exams you’re going to be looking for anything that stands out as different or unusual
- Look for any distortion of the shape, dimpling, puckering, or odd bulging.
- How’s the color? Are there any areas of redness, a rash, or parts that look swollen? Is the nipple in its normal positions or has that changed, is it inverted? Is there any discharged? It could look “watery, milky, or yellow fluid or blood”.
- Raise your arms, and look for the same things. Does this position aggravate any soreness or pain in your breasts?
- Next lie down flat on your back and place one arm behind your head. With the other hand, use the pad of your fingers to press firmly around your breast tissue. Cover the entire breast from top to bottom, side to side — from your collarbone to the top of your abdomen, and from your armpit to your cleavage.
- Use a pattern to make sure you cover your entire breast. Two common patterns are to start in the center and make your way outwards in circles, another is to go top to bottom across the breast like you’re mowing the lawn.
- If you do feel a lump, don’t worry, stay calm, and make an appointment with your regular physician.
- Most lumps are benign (non-cancerous). There are many benign breast conditions that can cause lumps that resolve on their own.
What about Mammograms?
A mammogram is an X-ray picture of the breast. Doctors use a mammogram to look for early signs of breast cancer. Regular mammograms are the best tests doctors have to find breast cancer early, sometimes up to three years before it can be felt.
- Women ages 40-44 should have the choice to start annual breast cancer screening with mammograms if they wish to do so, particularly if they have family history of breast cancer
- Women ages 45-54 should get mammograms every year
- Women 55 and older should switch to mammograms every 2 years, or can continue yearly screening.
Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer. All women should be familiar with the known benefits, limitations, and potential harms linked to breast cancer screening.
Sources and References:
African American women and breast cancer. Breast Cancer Prevention Partners (BCPP). (2021, July 22). Retrieved October 28, 2021, from https://www.bcpp.org/resource/african-american-women-and-breast-cancer/.
Breast cancer information and support. Breastcancer.org. (2021, October 27). Retrieved October 28, 2021, from https://www.breastcancer.org/.
Breast cancer statistics. Susan G. Komen®. (2021, October 6). Retrieved October 28, 2021, from https://www.komen.org/breast-cancer/facts-statistics/breast-cancer-statistics/.
Breast cancer: Breast cancer information & overview. American Cancer Society. (n.d.). Retrieved October 28, 2021, from https://www.cancer.org/cancer/breast-cancer/.
Centers for Disease Control and Prevention. (2021, September 20). Breast cancer. Centers for Disease Control and Prevention. Retrieved October 28, 2021, from https://www.cdc.gov/cancer/breast/.
Centers for Disease Control and Prevention. (n.d.). USCS data visualizations – CDC. Centers for Disease Control and Prevention. Retrieved October 28, 2021, from https://gis.cdc.gov/Cancer/USCS/.
Dense breasts: Answers to commonly asked questions. National Cancer Institute. (n.d.). Retrieved October 28, 2021, from https://www.cancer.gov/types/breast/breast-changes/dense-breasts.
Mayo Foundation for Medical Education and Research. (2021, October 14). Swollen lymph nodes. Mayo Clinic. Retrieved October 28, 2021, from https://www.mayoclinic.org/diseases-conditions/swollen-lymph-nodes/symptoms-causes/syc-20353902.
Moore, J. X., Han, Y., Appleton, C., Colditz, G., & Toriola, A. T. (2020). Determinants of mammographic breast density by race among a large screening population. JNCI Cancer Spectrum. https://doi.org/10.1093/jncics/pkaa010
Price, D. (2021, October 7). Black women and the breast cancer disparity explained. The Birmingham Times. Retrieved October 28, 2021, from https://www.birminghamtimes.com/2021/10/black-women-and-the-breast-cancer-disparity-explained/.
State Cancer Profiles. (n.d.). Retrieved October 28, 2021, from https://statecancerprofiles.cancer.gov/.
Wilkinson Wellness Laboratory 