Breast Cancer Awareness

By Bernard Freeman

Make Yourself Your Top Priority

From the moment a person gets diagnosed with breast cancer, they are immediately surrounded with a care team.

Oncologists, surgeons, radiologists, nutritionists, oncology social workers, genetic counselors and mental health professionals work together to provide care.

However, that team can only do so much. Ultimately, a cancer patient needs to be committed to self-care throughout the treatment process and afterward to contribute to a successful outcome.

Take inventory

The University of California San Francisco Medical Center is in the process of researching whether self-care and lifestyle changes can improve survival rates and lessen some of the side-effects experienced during treatment. While they don’t yet have definitive results, they recommend:

• Developing good self-care skills. Take care of yourself the way you would your best friend, your spouse, your child.
• Eat well. Don’t jump from diet to diet and either deprive yourself or binge. Find ways to eat that are healthy and make you feel good about yourself.
• Drink plenty of water.
• Sleep well.
• Avoid cigarettes and excessive alcohol.
• Manage stress. What can you change? What do you need to adapt to?
• Move your body. Discover what sort of movement feels good and provides you with pleasure.
• Identify the things that make you feel bad and figure out how you might eliminate those things or make them less of a stressor.
• Discover your passions, those things which give your life meaning and stir your creativity.

Flexibility is also important. They write, “Lifestyle change is not a written prescription that never changes. It is a dynamic process that is often in crisis and flux throughout breast cancer diagnosis and treatment.”

Be a student

Breast Cancer Now is a British charity devoted to research and care. They have put together a self-care toolkit of videos, tips, phone apps to provide daily self-care tips, help lines and interviews with other survivors. Do your homework and find the resources that match with your lifestyle and learning style.

Breast Cancer Now’s toolkit is divided into the following self-care areas:

• Be kind to yourself.
• Manage diet and exercise.
• Look after your mental health.
• Uplift your body image and identity.

Survivors share several practical ways to do all of the above. Ann Silberman wrote an article for Healthline where she recommended doing such things as hiring a cleaning service, taking care of your hair or letting a stylist do it once a week, finding somewhere in nature where you can walk or sit and find peace, learning your limitations and communicating them to your loved ones, starting new hobbies or spending time doing ones you already love, and helping others.

Another place that can be your partner in self-care is a spa. Many massage therapists are trained in oncology massage, using protocols that can lessen the intensity of side-effects you experience. Consider finding a spa near you that offers oncology massage and set up regular appointments; you may even be able to purchase a subscription.

Every self-care plan will be unique. Build yours around your individual needs and the things that most bring you contentment and joy.

Breast Density a Flag for Cancer

Breasts can be classified as dense or fatty. Nearly half of all women over 40 have dense breasts.

Dense breasts make it harder to diagnose breast cancer while at the same time making it more likely to develop breast cancer.

What is Breast Density?

Breast density describes the relative amount of different types of breast tissue — glandular, connective and fat — that is seen in a mammogram. If there is a high amount of glandular or fibrous connective tissue and low amounts of fatty tissue, the breast is considered dense.

According to the National Cancer Institute, doctors use the Breast Imaging Reporting and Data System to define breast density. The American College of Radiology developed this system to help radiologists interpret and report mammogram findings.

There are four categories classifying breast density:

1. Almost entirely fatty breast tissue, found in about 10% of women.
2. Scattered areas of dense glandular tissue and fibrous connective tissue, found in about 40% of women.
3. Heterogeneously dense breast tissue with many areas of glandular tissue and fibrous connective tissue, found in about 40% of women.
4. Extremely dense breast tissue, found in about 10% of women.

Dense breasts are defined as being either C or D in the list.

What Causes Dense Breasts?

Researchers are still studying what causes dense breasts and the relationship between them and cancer. It is suspected to be genetic, though there are some factors that might influence breast density.

Lower breast density is often associated with increasing age, having children and using tamoxifen, an estrogen modulator. The risk for dense breasts increases for those who use postmenopausal hormone replacement therapy and have a low body mass index.

Risks of Dense Breasts

There are two important factors associated with dense breasts.

First, dense breasts indicate a higher risk for breast cancer. Researchers are still trying to figure out why, but some suggest that it might be because there are more cells in a dense breast, thus increasing the number of places where cancer can develop.

Second, it makes cancer harder to diagnose. Both dense tissue and breast masses/cancer show up as white on a mammogram, so it decreases the contrast and the ability to detect them. A person with dense breasts is more likely to be called back for additional tests.

All of that said, a person with dense breasts has no greater or lesser risk of dying from cancer.

What Should a Person with Dense Breasts Do?

Some states, according to the American Cancer Society, require radiologists to tell patients that they have dense breasts. Many states require insurance companies to cover supplemental imaging tests for people with dense breasts.

As of 2022, there are still ongoing clinical trials evaluating whether people with dense breasts should get 3-D mammograms, ultrasounds and MRIs.

Some research, according to the National Cancer Institute, suggests that people with dense breasts should adopt a screening strategy that includes other risk and protective factors. People with dense breasts should discuss their risk factors with their doctor.