Admit it: you’d feel a teeny bit better about my diagnosis if you learned I was a chainsmoker. Or maybe a heavy drinker, or surprisingly obese compared to my profile photo, right? I wouldn’t blame you – it’s easier for us to process someone else’s challenge when we can tell ourselves it can’t happen to us. I have a beloved Grandpa who died of cancer at 60, but since he was in fact a heavy smoker, I have always told myself that it couldn’t possibly increase my risk for anything because of my healthy habits. And while that may be true (that Grandpa’s cancer doesn’t affect my own risk) we know that this disease can certainly take anyone by surprise.
In today’s post I’m going to be sharing some research on risk factors for breast cancer and which ones I had, current screening guidelines (which may surprise you), signs of breast cancer and some updates about my own situation.
Risk factors for breast cancer (from the Public Health Agency of Canada, also here)
Biological Factors:
- age (83% of cases occur after age 50)
- family history of breast cancer (especially first degree relative – mother, sister, daughter – particularly at a young age)
- reproductive factors (early periods, late menopause, not having a baby or having first one after age 30)
- high breast density
- previous breast condition (biopsy showing noncancerous but abnormal cells)
Note that when it comes to hormones, birth control pills may be associated with a small increased risk (not so much for causing cancer but because the female hormones feed some types of tumours) but can reduce the risk of ovarian and endometrial cancers. Additionally, hormone replacement therapy (often used in menopause) can also increase breast cancer risk, but can decrease the risk of osteoporosis. The pros and cons should all be discussed with your doctor based on your situation. Also, having a greater number of children and breastfeeding can both actually reduce the risk of breast cancer too.
Environmental factors:
- body weight
- exercise
- diet
- alcohol consumption
- smoking
- environment (e.g., chemicals)
According to Health Canada, it is a misconception that breast cancer risk increases with the use of deodorant/antipersipirant, underwire bras or silicone implants – there is no scientific evidence to back any of these claims.
Looking at all the factors listed above, I would not be considered high risk. I mean, I only have two kids but I don’t think possible disease prevention is the best reason to continue adding to your family! I have been told my breasts are dense, so I have that biological factor working against me, and as I’ve shared before I will freely admit my diet isn’t the best (too many carbs/sweets, not enough fruits/veggies), but my body weight is healthy, I walk every single day, I don’t smoke and I barely drink. So why me? I’ll never know for sure.
Breast Cancer Screening (from Canadian Task Force on Preventive Health Care)
Here’s where you might be a bit surprised. I’m going to summarize these recommendations, but you can click the link above for full details. Generally speaking, these have been implemented by Canadian health care professionals, and they are based on the risk of mortality (dying from breast cancer) compared to the physical and physiological harm that can be caused by false positives (unnecessary biopsies, mental stress, etc.) in women who are not considered high risk (high risk being defined as having a personal/family history of breast cancer, carrying gene mutations like BRCA1 or BRCA2 or having a first-degree relative with these mutations, or women who had chest radiation therapy before age 30 or within the past 8 years).
- The task force recommends against women doing breast self-examinations to screen for breast cancer
- The task force recommends against clinical breast examinations (e.g., at your physical appointments) to screen for breast cancer
- For women 40-49, the task force recommends not screening with mammography (mammograms)
- For women 50-74 the task force recommends screening with mammography every 2-3 years
They do note that “women should be supported to make an informed choice on screening that is congruent with their own values and preferences” – so mammography is still an option for women under 50.
Personally I think women at any age should always be aware of what’s normal for their own bodies (and remember that some breast changes fluctuate with the monthly cycle, for example cysts that get larger and more tender before a period) so they can see their doctors if anything seems amiss.
Signs of breast cancer (from the Canadian Cancer Society)
Note that “breast cancer may not cause any signs or symptoms in its early stages”.
- lump in the breast or armpit
- change in size or shape of breast
- change to the nipple (e.g., starting to point inward)
- nipple discharge or blood
And no, I did not and still do not have any of these signs (remember the lump I felt and investigated wasn’t the tumour; that one was found in the course of investigating the benign lump that I could feel).
Now a couple of personal updates:
Massage
I have an amazing Registered Massage Therapist who has been coming to the house for years. Because I’m feeling particularly tense these days, I really wanted a massage, but wanted to double-check that there wouldn’t be an issue. I found this helpful information from the Canadian Cancer Society site, where they seemed to read my mind:
“Some people might worry that massage in the area of a tumour can increase the flow of blood and lymph fluid, causing cancer cells to break away and travel to other parts of the body. Recent evidence suggests that the speed of blood or lymph fluid circulation has nothing to do with the spread of cancer cells. Massage therapy is safe for people with cancer.”
In a study of breast cancer patients who received massage therapy, there was a decrease in anxiety and depression, a rise in dopamine and an increase in white blood cells that boost the immune system…which made me feel even more confident about booking my appointment, and I was so glad I did.
MRI
This happened today, and I was a bit anxious about the whole thing, because I went for an unrelated MRI the week before my diagnosis and I felt quite claustrophobic. (Remember when varicose veins were the most pressing medical issue I had? Actually you probably don’t, since I considered that “too personal” to share online. Ah, the good old days.) The one today was at a different hospital and I was told by a few people that it was much more spacious than the one I had been in previously, plus I had earmarked one of my Lorazepam pills for this day. (My lovely retired teacher friend Carol drove me, don’t worry.)
It was definitely a better experience, as the machine was indeed shorter but with a larger opening (less coffin-like) and this time I was actually lying on my stomach, with a cool mirror feature in the apparatus so even though I was looking down I could see the other end of the room, which helped a lot too. Plus, of course, I had taken the drugs.
Next steps: I see the surgeon on Friday to go over the results of the MRI. If he sees anything new and suspicious he will want to biopsy which will delay things another week. If not (fingers crossed) it will be time to set the date for surgery. I will let you know!
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