Breast cancer prevention: is it possible to prevent the disease?

Prevention of breast cancer is carried out in all civilized countries, since - according to the World Health Organization - among oncological diseases affecting women from 25 to 70 years old, breast cancer is in first place (25% of all cancers).

According to the American Cancer Society, out of 100,000 females in Belgium, breast cancer is diagnosed in 111 women, in the USA – 110, in Denmark – 105, in France – 104, in the UK – 95, in Germany and Italy – 91, in Australia – 86, in Switzerland – 83. In Hungary, this figure is 76.4, and in Poland – 66.3. In Ukraine, out of 100,000 women, breast cancer is diagnosed in 62. But the survival rate of Ukrainian women with this diagnosis is much lower than in Europe or the USA. The main reason is late seeking of medical help…

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Breast Cancer Prevention: Consider Your Risk Factors

Science does not have sufficiently complete and absolutely reliable data on the causes of breast cancer to date. Although scientists have managed to discover its connection with gene mutation, which is provoked by both external and hormonal factors (since all processes in women's mammary glands occur on a hormonal basis).

It has been precisely established that approximately 20-25% of cases of this disease are related to the so-called “familial breast cancer”, which is hereditary and occurs due to mutations in the BRCA1 or BRCA2 genes.

So if a woman has a history of breast or ovarian cancer (or breast cancer in men) in her family, the risk of having a malignant breast tumor reaches 87% (and a 50% probability of developing ovarian cancer). Not wanting to share the fate of her mother Marcheline Bertrand (who died of ovarian and breast cancer at age 56) and her maternal grandmother Lois June Bertrand (who also died of ovarian cancer at age 45), Hollywood actress Angelina Jolie, having undergone an oncogenetic analysis, decided on the most radical form of breast cancer prevention – surgical removal of both breasts (contralateral mastectomy).

Age plays a significant role among breast cancer risk factors. Research by the Institute of Cancer Research UK shows that almost half (47%) of breast cancer cases are diagnosed in women aged 50-69, and the incidence rate begins to rise rapidly after 35-40 years. However, women under 30, as a rule, do not encounter such a diagnosis.

In addition, the probability of developing this pathology is increased in women with early menarche (before 11 years) and early menopause (before 45 years); who have never given birth or gave birth for the first time after 30 years; who have not breastfed or who stopped breastfeeding too early (before 9-12 months); as well as in women who have had multiple abortions.

There is a real risk of developing oncological neoplasia with increased production of estrogen, under the influence of which breast tissue cells undergo cyclic changes. For example, Israeli researchers have found that luminal subtypes of breast tumors occur exclusively against the background of estrogen imbalance. And some doctors even say that long-term use of hormonal contraceptives plays a significant role in this.

Risk factors for breast cancer include the presence of such diseases in a woman as nodular forms of fibrous mastopathy, phyllodes (leaf-shaped) fibroadenoma and intraductal papilloma, since these neoplasms can turn from benign to malignant.

It should also be taken into account that in 27% of cases, the oncological diagnosis was made in women who suffered from obesity. In this regard, the British Cancer Institute recommends that all women normalize their body weight, which will help avoid the terrible diagnosis in at least 5% of cases.

Breast cancer prevention: what should you do?

According to the forecast of specialists from the Institute of Oncology of the Academy of Medical Sciences of Ukraine, the diagnosis of breast cancer by the end of 2020 may become a reality for almost 17% of our women.

There are no guarantees that the disease can be avoided, but it is possible to try to detect it at an early stage. Doctors strongly recommend not to neglect such a simple method of preventing breast cancer as regular self-examination of the breast - monthly, during the first week after the end of the next menstruation.

The most suitable place is in the bathroom. Before taking a shower, you need to stand up straight, raise your left hand up (you can support your head), and gently feel your left breast with the palm of your right hand - from the armpit to the midline of the chest. The upper outer and inner quadrants of the mammary gland are examined especially carefully. Similar actions are performed with the right gland. You also need to gently feel the armpits (there are lymph nodes there) and near the collarbones.

During such an examination, the following may be detected: changes in the usual size and shape of the gland; the presence of a lump in the tissues of the gland; skin changes of various nature (redness, peeling) on the entire mammary gland or in certain areas; discharge from the nipple; swelling of the lymph nodes in the armpit area.

If you have seen or felt any of the above, see a mammologist immediately! In addition, to prevent breast cancer, women under 35-40 years old need to undergo an ultrasound once a year, and after 40-45 years old - an annual mammogram.

Free radicals are known to initiate the degeneration of healthy cells, so the body needs antioxidants to prevent breast cancer. Antioxidants are found in green tea, seafood, cabbage (all types), citrus fruits, onions, tomatoes, blueberries, peaches, plums, and nuts. It makes sense to give up animal fats, which will help reduce the concentration of estradiol in the blood and is especially useful for preventing breast cancer in women before and after menopause.

Animal fats should be replaced with unsaturated fats from vegetable oils (sunflower, olive, corn). And it is advisable to replace a significant portion of meat in the diet with legumes, which contain isoflavonoids and, due to this, have antioxidant and anti-cancer properties.

Prevention of recurrence of breast cancer

Prevention of breast cancer recurrence is required for those who have already been diagnosed with breast cancer, or for women with non-invasive tubular, medullary or lobular carcinomas.

In this case, there is only one principle of prevention: constant observation by the attending physician and strict adherence to an individually prepared examination schedule, which includes such activities as annual mammography; periodic (once every six months to a year) clinical examination of the mammary glands; ultrasound or MRI examination of the breast (if prescribed by the attending physician).

A radical, but quite adequate option for preventing recurrence of breast cancer is preventive mastectomy (which we have already discussed, mentioning Angelina Jolie). First of all, this concerns those patients who have previously undergone radio- and chemotherapy for a cancerous breast tumor, but the pathological process has resumed, or the disease has spread to the second mammary gland.

Breast Cancer Prevention Program

The key link in the fight against breast cancer is its early detection, which means more successful treatment and increased survival. First of all, the program for preventing breast cancer implies a system of mammographic screening – that is, examination of population groups that do not show visible symptoms of the disease, but are at risk of its development. In economically developed countries, 70% of the female population is covered by screening, and thanks to this, the mortality rate from breast cancer has decreased by 20%.

The world's largest non-governmental breast cancer prevention program has been implemented in the United States since 1982 by the non-governmental Susan G. Komen Breast Cancer Foundation. It raises funds to support breast cancer prevention and treatment for American women. In 2012-2013, this organization raised $15 million. Part of these funds went to pay for mammography for more than 15,000 American women without health insurance, to support and palliative care for more than 220,000 patients with this diagnosis, and to finance breast cancer research. In addition, a national hotline for breast cancer patients has been organized.

Since 2005, in Ukraine in October - in connection with the fact that October 20 is celebrated as World Breast Cancer Day - a thematic month has traditionally been held. Its goal is to disseminate information about this disease with an emphasis on the importance of detecting it as early as possible. After all, in Ukraine - with the current principles of health care financing and the absence of a breast cancer prevention program - this oncological pathology is diagnosed too late in most women.

The Bulletin of the National Cancer Registry of Ukraine (No. 14) notes that in 2012, 16,429 women were diagnosed with breast cancer, which is 67 women per 100,000 of the country's female population. Moreover, 77% of women were diagnosed with the disease at stages I-II, 13.3% at stage III, and 7.2% at stage IV. 7,558 women with this diagnosis died in 2012…

And the latest report of the International Agency for Research on Cancer (IARC) of the World Health Organization states that since the beginning of 2012, breast cancer has been diagnosed in 1.7 million women worldwide, which is 20% more than in 2008 (1.38 million). The global scale of mortality from this disease is constantly growing, and in 2012 alone, breast cancer took the lives of 552 thousand women. Western specialists associate the increase in the incidence rate with unfavorable changes in the lifestyle of modern women. And also with the fact that breast cancer prevention is ineffective and “clinical successes in the fight against this disease do not reach women living in many regions of the world.”