I was privileged to enjoy a spectacular weekend at the Kodiak Christian Ladies’ Retreat at Camp Woody last month. We had 72 amazing women from 11 different churches on the island. Some of the ladies brought their infants along, partly so they could continue breastfeeding them, and partly so the other women could enjoy holding the little ones. I realized once again how amazing motherhood is, especially considering that a mother’s breast milk is all the food a baby needs for the first six months of life.
October is Breast Cancer Awareness month. Breast cancer is the second leading cause of cancer deaths in women in the United States, and about one in eight women will develop breast cancer in their lifetime. Although the number of breast cancers diagnosed each year in the United States is decreasing, it still remains a cause of great suffering for many of our beloved sisters, wives, mothers, aunts, daughters or grandmothers.
Breast cancer screening has been shown to decrease the odds of dying from breast cancer by at least 20 percent. The incidence of breast cancer is highest in women ages 45-65, although women aged 40-45 are also at increased risk compared to women under 40. Screening can be done annually, but biannual screening only slightly diminishes benefits, according to many studies.
Mammography is the screening tool of choice, with addition of breast ultrasound and MRI as needed, especially for women with dense breast tissue. Mammography detects about 73 percent of breast cancer in women in their early 40s, and 85 percent of cancers when women are in their 60s.
Women can decrease their risk of breast cancer by eating less fat, maintaining a healthy body weight, limiting alcohol intake to one drink per day, and increasing physical activity. Immigrants coming to the United States tend to have lower incidence of breast cancer, but after a few generations, the incidence returns to the population’s incidence. This seems to indicate that the Western diet and lifestyle increases breast cancer risk.
Women who have children before the age of 35, and women who breastfeed for more than six months have a lower risk of breast cancer. A strong family history of breast or ovarian cancer can indicate a risk for genetic mutations, which is important information to share with your primary care provider.
Hormone replacement therapy for women after menopause was originally thought to be useful in decreasing heart attack and stroke risk, as well as osteoporosis, but certain hormones increase the risk of breast cancer. Many women now are no longer using hormone replacement therapy after menopause due to this increased risk. Hormones can be used for women in menopause to reduce symptoms such as hot flashes and mood changes, but long-term use beyond five years is now discouraged. Breast cancer incidence may be decreasing due to better screening programs and decreasing use of hormones in post-menopausal women.
The earliest signs of breast cancer may include a new breast lump or breast pain, swollen glands in the armpit, or breast skin redness, thickening or dimpling. Mammography detects most breast cancers at an early stage, making treatment easier and improving prognosis.
If you have not had a mammogram and you are a woman over 40, you should have a conversation with your primary care provider about the risks and benefits for you. The risk of radiation exposure from mammography is very small, although large doses of radiation can increase breast cancer risk. One disadvantage of screening is the chance of a false positive test, resulting in unnecessary anxiety and possibly biopsies.
Much progress in the diagnosis and treatment of breast cancer has been made in the last few decades, but we still have a long way to go. Let’s tell the women in our lives how much we love and appreciate them, and encourage them to take care of themselves.
“Let your fountain be blessed, and rejoice in the wife of your youth, a lovely deer, a graceful doe. Let her breasts fill you at all times with delight; be intoxicated always in her love” (Proverbs 5:18-19).