Breast Cancer Awareness: Facts and Tips for Reducing Risk

October is Breast Cancer Awareness Month, a global and annual campaign to help increase awareness and promote early detection of breast cancer. Breast cancer is a common cancer affecting hundreds of thousands of women every year. According to the American Cancer Society (ACS), other than skin cancer, breast cancer is the most common cancer for American women, with 1 in 8 receiving the diagnosis. Over 42,000 Americans die each year from breast cancer. 

As noted by the Centers for Disease Control and Prevention (CDC), approximately 264,000 cases of breast cancer are diagnosed in women annually. Most breast cancers are found in women over 50 years old. Men also get breast cancer, but it’s far less common. About one out of every 100 breast cancers diagnosed in the U.S. is found in a man. 

Overall death rates in the U.S. from breast cancer have declined over time, resulting from more people being screened with better screening technology such as 3-D mammography (breast tomosynthesis)—an imaging test that combines multiple breast X-rays to create a three-dimensional picture of the breast—and improved treatments. There has been a 42% decline in breast cancer deaths over the last 30 years. However, there is a persistent mortality gap between Black women and white women. ACS data indicates that, although breast cancer rates among Black and white women are close, mortality rates are quite different, with Black women having a 41% higher death rate from breast cancer. Breast cancer remains as the second leading cause of cancer death among women overall and the number one leading cause of cancer death among Hispanic women. Screening (mammogram) and early detection are critical in providing the best chance of successful treatment. 

Breast Cancer Symptoms

There are different symptoms of breast cancer, and some people have no symptoms at all. Symptoms can include:

• New lump in the breast or underarm
• Thickening or swelling of part of the breast
• Irritation or dimpling of breast skin
• Redness or flaky skin in the nipple area or the breast
• Pulling in of the nipple or pain in the nipple area
• Nipple discharge other than breast milk, including blood
• Any change in the size or the shape of the breast
• Pain in any area of the breast

Keep in mind that these symptoms can happen with other conditions that are not cancer. If you have any of these symptoms, be sure to discuss them with your doctor.  

Risk Factors

Other than tobacco use, which is known to cause cancer throughout the body, the most important cancer risk factors that can be changed are body weight, diet, and physical activity. The American Cancer Society notes that at least 18% of all cancers diagnosed in the U.S. are related to excess body weight, physical inactivity, excess alcohol consumption, and/or poor nutrition, which can all be prevented. 

Risk factors you can’t change:

• Getting older. The risk for breast cancer increases with age. Most breast cancers are diagnosed after age 50.
• Genetic mutations. Women who have inherited changes (mutations) to certain genes, such as BRCA1 and BRCA2, are at higher risk of breast and ovarian cancer. This may put you at high risk, and cancer prevention options should be discussed with your doctor. 
• Reproductive history. Starting menstrual periods before age 12 and starting menopause after age 55 expose women to hormones longer, raising their risk of getting breast cancer.
• Having dense breasts. Dense breasts have more connective tissue than fatty tissue, which can sometimes make it hard to see tumors on a mammogram. Women with dense breasts are more likely to get breast cancer.
• Personal history of breast cancer or certain noncancerous breast diseases. Women who have had breast cancer are more likely to get breast cancer a second time. 
• Family history of breast or ovarian cancer. A woman’s risk for breast cancer is higher if she has a mother, sister, or daughter (first-degree relative) or multiple family members on either her mother’s or father’s side of the family who have had breast or ovarian cancer. 
• Previous treatment using radiation therapy. Women who had radiation therapy to the chest or breasts (for instance, treatment of Hodgkin’s lymphoma) before age 30 have a higher risk of getting breast cancer later in life.
• Exposure to the drug diethylstilbestrol (DES). DES was given to some pregnant women in the United States between 1940 and 1971 to prevent miscarriage. Women who took DES, or whose mothers took DES while pregnant with them, have a higher risk of getting breast cancer.

Risk factors you can change:

• Not being physically active. Women who are not physically active have a higher risk of getting breast cancer.
• Being overweight or having obesity after menopause. Older women who are overweight or are obese have a higher risk of getting breast cancer than those at a normal weight. Being overweight or obese after menopause can increase a woman’s breast cancer risk by 30–60 percent. That’s because fat cells make estrogen after menopause, and higher levels of estrogen are associated with a higher risk of breast cancer after menopause.
• Taking hormones. Some forms of hormone replacement therapy (those that include both estrogen and progesterone) taken during menopause can raise risk for breast cancer when taken for more than five years. Certain oral contraceptives (birth control pills) also have been found to raise breast cancer risk.
• Reproductive history. Having the first pregnancy after age 30, not breastfeeding, and never having a full-term pregnancy can raise breast cancer risk.
• Drinking alcohol. Studies show that a woman’s risk for breast cancer increases with the more alcohol she drinks.

Key American Cancer Society recommendations for cancer prevention:

• Avoid tobacco products. Smoking increases the risk of cancer, and certain chemicals in tobacco products may lead to uncontrolled cell growth within a person’s body. Smoking is linked to a higher overall cancer risk.
• Achieve and maintain a healthy weight throughout life. Keep your weight within the healthy range and avoid weight gain in adult life.
• Be physically active. Women who get regular physical activity have about a 10–20 percent lower risk of breast cancer than women who don’t. You don’t need an intense exercise routine to get the benefits. Activity equal to walking 30 minutes a day can lower your risk. 
• Limit sedentary behavior such as sitting, lying down, watching TV, and other forms of screen-based entertainment.
• Maintain a healthy diet. Limit red and processed meats, sugar-sweetened beverages, and processed foods. Be sure to include:

• Foods that are high in nutrients in amounts that help you get to and stay at a healthy body weight
• A variety of vegetables—dark green, red and orange, fiber-rich legumes (beans and peas), and others
• Fruits, especially whole fruits in a variety of colors
• Whole grains

• It is best not to drink alcohol, or consume it only in limited quantities. People who do choose to drink alcohol should have no more than one drink per day for women or two drinks per day for men.

By understanding your risk, getting regular screenings, and doing your best to maintain healthy lifestyle choices, you can decrease the risk of developing or dying from cancer. These healthy behaviors are also linked with a lower risk of developing heart disease and diabetes. 

For further information on breast cancer, visit The American Cancer Society and the Centers for Disease Control and Prevention.