While it seems like breast cancer is more prevalent than ever before — and that it’s affecting younger and younger women each year — there’s actually quite a bit of hope to be had for women of all ages. With that said, it’s true that this is an increasingly common diagnosis — “One in eight women will be diagnosed with breast cancer, and five to ten percent of those are due to genetic factors,” says Tara Scott, MD, a triple board-certified OB/GYN, functional medicine and integrative medicine doctor, CMO and founder of Revitalize Medical Group in Fairlawn, Ohio, who tells FitOn that many patients are younger than before. That’s why breast health self-awareness is so important.
Dr. Scott believes diet, lifestyle, and environmental factors play a role in this uptick but that we have tools to prevent, detect, and mitigate breast cancer with incredible success thanks to research, education, and developments in the medical field.
Let’s start a new practice now: breast health hygiene. Taking care of our breasts as part of a 360 approach to our health and wellness. We’ve got our skincare dialed, our exercise routine on lock… but what about our breast care routine? Ahead, two all-stars in the women’s health field (including Dr. Scott) share the best way to get this ball rolling.
When Should You Start Your Breast Health Hygiene Practice?
For years, women believed they should wait until age 40 (some even understood it to be age 50) to start getting annual mammograms — but experts say that breast health self-awareness should start as early as your teen years. “I am seeing more and more women getting breast cancer, and younger as well,” says Dr. Scott.
Sophia L Fu, MD, MS, FACS, Director of Breast Surgery at Good Samaritan Hospital, Saint Francis Hospital, and Mercy Hospital in New York agrees. “It is best to start ‘breast self-awareness’ at an early age, starting in the teen years,” says Dr. Fu. “This is done by knowing what is going on in one’s breasts from month to month so that it clues you into seeing your doctor sooner.”
What Are Some Ways You Can Practice Breast Health Hygiene?
There are a handful of simple ways you can adjust your routine and lifestyle to focus on the two most important parts of breast health: prevention of breast disease, and early detection of any problems.
And what’s extra exciting is that these methods of detection and prevention have improved significantly over the past years. “We have improvements in screening techniques and modalities to identify cancers at earlier stages, and thus we have a better prognosis with our modern treatment strategies,” says Dr. Fu. “3D mammography, MRI, Molecular Breast imaging (offered only at Mercy Hospital), and contrast mammography are all additions to how we screen and diagnose breast cancer and other breast diseases.”
Monthly Checks (Early Detection)
It starts with monthly checks, as Dr. Fu noted. It’s a little different from what you may already be familiar with. “Things to look for are similar to what we used to call ‘breast self-exams,’ which we don’t recommend anymore, as it has not been shown to make a difference,” she explains.
Get to know their look and shape. Spend time in the mirror, checking yourself out. The goal is to — essentially — know your boobs like the back of your hand. This way, you can identify any visual changes. “Visual signs that may indicate something more serious include skin changes, dimpling of the skin, nipple retraction, nipple discharge,” says Dr. Fu.
From there, you may be able to check in with your doctor (more on that in a moment). “Physical findings that may indicate something more serious include lumps, swollen lymph nodes in the axilla, clavicle area, or neck,” says Dr. Fu. “Knowing what is going on in one’s breasts from month to month so that it clues you into seeing your doctor sooner.”
Physician Visits and Genetic Testing (Early Detection + Prevention)
Seeing your doctor regularly — including your OBGYN — can help with both early detection and prevention methods. It’s important to keep thorough records and revisit family history, (particularly with the general category of cancer). “Knowing one’s family history of cancers, particularly breast, ovarian, pancreatic, melanoma, advanced prostate, male breast cancer, colon, or gastric, is important to see if earlier screening or genetic testing is needed,” says Dr. Fu.
Most women won’t think to start these visits until their mid to late 40s, but Dr. Fu urges you to get a check-up early, particularly if you do have a family history of cancer. “Seeing a breast surgeon or specialist at the age of 25 to have a formal risk assessment is recommended to identify your risk category and specific recommendations for you as an individual on when to start screening and what screening studies are best for you,” she says.
So what about the BRCA gene test? Due to the accessibility of at-home genetic tests, this has become a more popular topic as of late. That said, Dr. Scott explains that only 5 to 10 percent of breast cancer cases are due to genetics. “If breast cancer runs in your family, yes, I think getting tested and having that knowledge allows you to be proactive. If not, I don’t recommend it.”
There’s a lot of merit to these tests, though. “Genetic testing has made a huge impact in how we screen for and treat breast cancer and other related cancers, and in a great number of people, saving them a possible future cancer diagnosis by performing risk-reducing mastectomies or oophorectomies to ‘prevent’ cancer from even happening,” says Dr. Fu.
Hormone Checks (Prevention)
Another form of prevention, Dr. Scott explains, is getting your hormones to their healthiest levels. This is a bit more nuanced and best executed with the help and supervision of your physician.
“Hormonal issues [are linked] to a potential risk of cancer,” says Dr. Scott. “We have long agreed in the medical community that estrogen feeds breast cancer. So if you have a condition that involves high estrogen (like endometriosis, fibroids, or heavy periods), you could potentially be at an increased risk,” she says.
What do you do in this case? She recommends getting a lab workup to review with your doctor. “Testing hormones in those situations and determining if your levels are high or unbalanced is recommended.” She explains that this is more of an integrative approach, and as a medical professional, this is how she works with patients for cancer prevention.
Breast-Centric Healthy Lifestyle (Prevention)
Both experts emphasized specific healthy lifestyle choices (such as diet, BMI, and overall lifestyle) that mitigate the risk for breast cancer. This is referred to as “adjusting modifiable risk factors,” says Dr. Fu. (Fun fact: all of these will also help with hormone regulation… and great overall health).
Diet
Both experts recommend an overall healthy diet for overall health and cancer prevention. Incorporate fiber and vitamin D, and limit red meat and dairy when possible to optimize your breast health nutrition.
BMI
The doctors advise keeping a healthy body weight and BMI for medical purposes in this instance. Somewhere below 27 BMI (25 in some cases) is ideal. Dr. Fu explains that “obesity has been shown to be associated with increased risk for breast cancer.”
Lifestyle
The healthy lifestyle choices that work for nearly every health condition also apply here. Diligence in this area can go a long way! The docs urge you to not smoke, limit your alcohol intake to one to two drinks per week, and to exercise.
They both recommend 150 minutes of moderate-intensity exercise per week (and to check in with your physician and or cardiologist to get clear for takeoff).
What About Bras?
There’s been some back and forth over whether or not bras are indicated in breast health (or if they could even lead to breast cancer). Dr. Scott says not to worry about any of that. “This study published by the American Association for Cancer Research looked at bras and breast cancer and found that no aspect of a bra — wearing, not wearing, underwire, or wire-free — contributed to breast health. However, I do recommend wire-free for comfort.” So go for comfort if you wish, but don’t stress about your favorite underwire push-up causing cancer.
Positive News About Breast Health
“There are continually improving techniques and treatment strategies in breast cancer,” shares Dr. Fu. As such, there’s more hope for patients than ever before. “The overall prognosis is better than any other cancer,” she says. “The five year survival rate for all stages combined is 93 percent, and for stage I, it’s 99 percent.”
She says some of this comes down to being “in the era of individualized treatment,” which is “tailored to each individual based on tumor biology.” This is done via specific types of testing that could spare patients superfluous, aggressive treatment. “Genomic testing has helped to identify the behavior of each individual’s tumor so we know whether chemo may be beneficial, saving a lot of women unnecessary chemotherapy they would have gotten in the past,” says Dr. Fu. In addition to limiting chemotherapy, Dr. Fu explains that radiation has also been scaled back. “We have been able to limit the radiation doses and who needs radiation with more research data.”
These advances in modern medicine have obviously been massively beneficial and have allowed for more direct, less invasive treatment (and prevention!). Even surgeries have improved. “We have improved our lymphedema rates by decreasing axillary surgery and using newer techniques to map out axillary lymphatics and potentially reconnecting them to re-establish the drainage from the arms,” says Dr. Fu.
The Bottom Line
There’s more hope than ever before. Combining prevention and early detection strategies can ensure you give yourself the best chance at not just healthy breasts but a healthy body (and life!). So, incorporate breast health self-awareness into your self-care routine, and spread the word!
