Breast Cancer Awareness Month

October is Breast Cancer Awareness Month. It has turned everything pink. The boys soccer team in my town wore pink socks in support. And you may have noticed some of Berlin’s police officers sporting pink t-shirts under their blue uniforms this month in support of Breast Cancer Awareness month. It is almost hard to believe that there was a time when this would not have been discussed in public. It was a taboo subject almost until the advent of the pink ribbon as a symbol, which plunged breast cancer awareness to the forefront.

Breast cancer is not a new disease. It has been around for over 3500 years. It was first documented by the Egyptians. Although only referred to as bulging tumors without a cure, we do know that eventually untreated breast cancers will become tumors that will be visible. In 460 BC, Hippocrates further described breast cancer as a humoral disease as his theory then was that our bodies were made up of four humors- blood, phlegm, black bile and yellow bile.

Hippocrates theory was maintained until the 17th century when more physicians began to develop their own theories. One study done on the rate of breast cancer among nuns lead to the theory that a lack of sex was to blame. Another study in Prussia of married women seemed to prove that too vigorous a sex life was to blame. There were other theories such as sedentary lifestyle, ingestion of curdled milk and the popular depressive disorder theory.

Surgery as a form of treatment was around as early as the mid 1700's. Of course the mortality rate was high due to blood loss, infection and lack of proper nutrition post-operative, which we now understand is extremely important to proper would healing. By the mid 1800's William Halstead had developed the radical mastectomy, which was the primary treatment of breast cancer for nearly 100 years. Radical mastectomy involves removing all breast tissue, lymph nodes in the armpits and at that time all chest muscle. After this some physicians discovered that removing ovaries helped to reduce breast tumors so this also became part of the treatment. Once ovaries were removed it was understood that the adrenal glands were then taking over and those were also removed. Thankfully for us medicine has evolved and we have a much better understanding of cancer and how to treat it.

We have come a long way in our knowledge of all cancers. Today with mammograms, genetic testing and education we have seen a decline in breast cancer and death from this disease. In 2010 over 200,000 women were diagnosed with breast cancer and more than 40,000 died from the disease. There has been a decline in mortality since 2000 and this is attributed to education and advanced treatments.

The American Cancer Society recommends monthly breast exams and yearly mammograms for women over the age of 40. Mammograms are a simple procedure taking 20-30 minutes. It is an x-ray of the breast giving a view of a lump that may be too small for a women to feel on breast exam. Typically two x-rays, or views, are taken of each breast. It is recommended that you use the same facility each year so that x-rays can be compared from year to year. If this is not possible you can have your x-rays sent to whatever facility you are currently using. Women in their 20's and 30's should perform self breast exams monthly and if you have a history of breast cancer in your family discuss it with your physician, a baseline mammogram before age 40 may be recommended.

There are risk factors with breast cancer. Some are factors that we have no control over such as family history of breast cancer, gender; as it is found in women more than men, ethnicity, higher in white women than African-American women. Women with dense breast tissue have a higher risk and also may have MRI's or ultrasounds since dense tissue makes finding lumps on x-ray more difficult.

Some factors we can control are alcohol consumption. It has been shown that women who drink 2-5 alcoholic drinks per day have 1 ½ times the risk compared to women who do not drink or drink less than one alcoholic beverage a day. Being over weight or obese also increases your risk. After menopause fat tissue releases estrogen once your ovaries stop producing. The more fat tissue to more estrogen and the greater the risk of breast cancer. Exercise has been proven beneficial in all areas of our health and breast cancer is no exception. A study recently showed that walking 2.5 hours a week reduced the risk of breast cancer by 18%.

However we divvy up the numbers what is at the heart of breast cancer is our mothers, sisters, wives and friends. It is the woman you pass in the grocery store or the woman who teaches your child's class. It is not some random disease and it is not incurable. Take care of yourself, follow the guidelines for breast health and talk to your physician about your breast health.