It’s Breast Cancer Prevention Month. Midwives care for the whole woman, from pre-conception to well-care post-childbearing. Invasive breast cancer affects 1 in 8 women. It’s sobering to think that, in 2016, there are more than 2.8 million women with a history of breast cancer in the U.S (women currently receiving treatment and women who have finished treatment.) Throughout a woman’s life, normal breast changes occur. So how does a woman stay informed on what is normal and when to be concerned about changes in her breasts?
Most of the women we see in our practice choose to breastfeed and are successful. A breastfeeding mom experiences changes in breast shape, the feel of the exterior of the breast (engorgement before and then a smaller breast once the baby has nursed) and sometimes-painful knots – or plugged ducts. New moms who choose not to breastfeed or have barriers to breastfeeding may also experience changes in their breasts postpartum. Most of these changes are normal, and breast cancer while pregnant or lactating is extremely rare. Older women also experience changes, such as softer, fattier breast tissue, or mammograms that show calcifications.
It can be hard to tell what’s what and with national concern about, and awareness of, breast cancer, it’s helpful to review the basic anatomy of a woman’s breast. The National Breast Cancer Foundation has a wonderful video on female breast anatomy. Imagine if all women learned about this basic female anatomy in school, well before their risk factors increased? Female breasts are complex systems of lymph vessels and nodes, blood vessels, milk ducts, lobes and lobules, nerve endings, ligaments, connective tissue, and fat tissue. Check out the video to better understand how all of the elements work as one complex system.
Certain factors in a woman’s life increase risk, such as genetics; a mother, sister, or grandmother who has had breast cancer; alcohol consumption; a first child after the age of thirty; not nursing or nursing for less than a year; early menstrual onset; non-bio-identical Hormone Replacement Therapy (HRT); previous radiation exposure; poor diet, which increases risk of all cancers; obesity; and ethnicity—white women have a slightly higher chance of developing breast cancer, but African American women who are diagnosed young are at risk for a more aggressive, more advanced stage form of breast cancer.
Midwives encourage mothers to breastfeed, eat healthy, and limit alcohol consumption. But life isn’t just a series of neat checklists and all that we can do is our best with any given situation. If you know you have one or more of the risk factors, do your best to affect the other factors. Angelina Jolie very publicly chronicled her painful decisions about her risk of breast cancer, and then later her painful decisions regarding ovarian cancer risk. The mutation of her BRCA1 gene meant she had an eighty-seven percent higher risk of developing breast cancer and fifty percent chance of developing ovarian cancer, cancers that claimed the lives of her mother, grandmother, and aunt.
The basic tenets of breast cancer prevention that we recommend to the mothers we serve include:
- Regular breast exams. You know your breasts best. Pay attention to even subtle changes and don’t be afraid to ask your healthcare provider questions.
- A healthy lifestyle. Limit alcohol consumption, eat a diet heavy with fresh vegetables and fruits and limit fatty foods, exercise regularly—especially walking or yoga as they give cardiovascular benefits without stressing the immune system—and, if you are planning to have children and have no physical obstacles to successful lactation, plan to breastfeed for at least eighteen months.
- Clean air, clean water. Research suggests that toxins in our environment contribute to higher cancer rates. Rid your home of toxic cleaners and perfumes and use a good water filter to ensure a clean home and safe drinking water.
- If breast cancer or ovarian cancer run in your family, ask your doctor to run the BRCA1 test to check for mutations.
Many of us know women who have been affected by breast or ovarian cancer. Support the women in your community who have to undertake this painful journey. Womanhood is a sisterhood. We’re all in this together.