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+ What to expect after a cancer diagnosis

Survivor-bloggers offer advice, hope Doctor creates cute cancer care package

AN EDITION OF THE CHRONICLE-EXPRESS | 2012

31 DAYS 31 WAYS
TIPS ON RAISING BREAST CANCER AWARENESS ALL MONTH LONG

+ Understanding the latest research and headlines + Know your risk factors, how to stay healthy

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EDITORIAL

treatments

The Chronicle-Express

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Take the Next Steps

Life After a Breast Cancer Diagnosis
By American Prole

Types of Treatment
Surgery: Many women are able

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reast cancer treatment often involves more than one approach. The treatment plan your doctor suggests will be based on several factors, such as: The stage of the cancer. The size of the tumor com pared to the size of your breast. The type of breast cancer. Whether you have reached menopause. Your general health. Dont be afraid to ask your doctor lots of questions. The better you understand your options, the easier it will be for you to make an informed choice about treatment.

Mammograms showing a normal breast (left) and a cancerous breast (right). WIKIMEDIA
PHOTO

to have surgery that removes the cancer but leaves the breast intact. Other women may have their entire breast removed. Plastic surgery to rebuild the breast often can be done at the same time as breast cancer surgery.
Radiation therapy: High-energy

Staging
After breast cancer is found, your doctor will need to learn the extent of the cancer. This is called staging. Many tests may be used to learn this information. A womans treatment options depend greatly on the cancer stage. Often the stage is not known until after a woman has surgery to remove the cancer from her breast.

X-rays or other types of radiation are used to kill cancer cells or keep them from growing.
Chemotherapy: Drugs are used

to kill cancer cells or keep them from dividing.

Hormone therapy: Hormone therapy reduces the bodys ability to make hormones or stops their action to keep cancer from growing. Targeted therapy: Drugs or other substances are used to nd and attack specic cancer cells.

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briefs
BY CATHERINE WINTERS AMERICAN PROFILE

PREVENT, DETECT, TREAT

The atest on breast cancer headlines
The headline: You can lower your risk for breast cancer even if you have a family history. The details: A study found that The take-home message:

20 minutes of moderate exercise at least ve days a week, a body mass index of less than 25 and fewer than seven alcoholic drinks a week lowered breast cancer risk regardless of family history.

Sometimes a family history leads a woman to think This is something I cant change, says study author Dr. Robert E. Gramling of the University of Rochester Medical Center in Rochester, N.Y. But engaging in these three behaviors appears to have the same benets for women with a family history of breast cancer as it does for women without a history.

Exercise five times a week for 20 minutes to lower breast cancer risk. MORGUEFILE PHOTO

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briefs
The headline: Many breast The headline: Most women The headline: Tailored treatThe headline: Vitamin D re-

cancer patients who can benet from radiation arent getting it.
The details: We know that

nd their own breast cancers.

The details: In a study, 57 per-

women with advanced breast cancer who get radiation are more likely to be alive 10 years after their diagnosis than women who dont, says Dr. Benjamin D. Smith of MD Anderson Cancer Center in Houston. But Smiths research found that 45 percent of women over age 66 with advanced breast cancer dont undergo radiation. Whether docs arent suggesting it or women are passing on it is unclear.
The take-home message: Ask

cent of breast cancer survivors reported that their tumors had been found by a detection method other than mammography. Twenty-ve percent had noticed the tumor during a breast self-exam and 18 percent by accident. Forty-three percent said their cancers had been found by a mammogram.
The take-home message: Reg-

ments may offer new hope to women with triple negative breast cancer, a particularly aggressive form of the disease.
The details: TNBC, which is more common in African-American and Hispanic women, doesnt respond to standard treatments like tamoxifen or Herceptin, so the tumors tend to recur; less than 30 percent of women with metastatic TBNC survive ve years. But researchers at Vanderbilt-Ingram Cancer Center at Vanderbilt University in Nashville recently identied six subtypes of triple negative breast cancer that are linked to the activities in several genes and may respondto different therapies. The take-home message:

lieves joint pain in breast cancer patients, typically caused by aromatase inhibitors prescribed to many women to shrink tumors and prevent a cancer recurrence.
The details: A study from

your doctor to spell out the treatments considered standards of care for your stage of cancer. Plus, visit websites for the American Cancer Society or National Cancer Institute to make sure you have all the facts.

ular mammograms are the gold standard for detecting breast cancer. But almost half of breast cancers are still found by women, says study author Dr. Diana L. Miglioretti, of Group Health Research Institute in Seattle. Since a tumor can be missed or start to grow after youve gotten the all-clear from a radiologist, see your doctor if you notice anything suspicious.

Washington University School of Medicine in St. Louis has found that prescription megadoses of vitamin D2 can ease the muscle and joint pain that may prompt women on AIs to abandon the treatments. A group of women taking 50,000 IUs of D2, a type of the vitamin that comes from plants, weekly for eight weeks and a second group on the megadoses for 16 weeks reported up to a 40 percent reduction in joint and muscle pain.
The take-home message:

While the ndings are tantalizing, theyre not ready for primetime. More research is needed before theyll inuence treatment, says co-investigator Dr. Brian D. Lehmann, a postdoctoral fellow.

While more research is needed before D2 megadoses become routine, ask your doctor about trying it if you develop side effects from AIs.

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advice

Blogging For a Cure

Breast Cancer Survivors Insight in Their Own Words
BY ASHLEY HAUGEN | AMERICAN PROFILE

n their own words, breast cancer survivors offer insight on challenges they faced, how they overcame them, and what advice they offer for those who are newly diagnosed.
morguefile photo

What I learned: When Katie Hall was diagnosed with breast cancer at age 41, she was overwhelmed by her emotions and had a difcult time processing them all. I was angry, sad, confused and most of all, scared I was stunned into silence, she says. Four or ve weeks after my diagnosis, I grabbed my dusty journal and wrote out all of my worst fears ... my kids growing up without a mother, my husband growing old alone. I cried, but putting it all down on paper created some order in my own personal chaos, tamed my monsters a bit. I only wish I would have picked up my pen and journal earlier. What I recommend: I think

What I learned: I was surprised to learn that a lot of breast cancer patients who have frozen shoulder difculty moving their shoulders get better between year one and two, says Suzanne Harp, who blogs at Breastcancerloop.org. I thought I was going to not have mobility forever. What I recommend: When

What I learned: I was a 37 and

What I learned: A year after

keeping a written chronicle is crucial, via journal or a blog. It has helped me to keep the big and small stuff in perspective; and I have a great record of what my year in treatment was really like. Katie Ford Hall blogs at UneasyPink.com. She lives near Cincinnati with her husband and two children.

you are diagnosed, get yourself to a support group, Harp advises. When I think of my time of diagnosis and treatment, I was in a sheer freefalling panic until I went to a support group. Also I love the book Cancer Vixen! It made me feel less alone it was like my security blanket. Suzanne Harp is a broadcast journalist and breast cancer survivor. She was diagnosed at age 42, just a year before she was married to her husband, Ethan. She blogs at breastcancerloop.org.

pregnant with my fth child when I was diagnosed with breast cancer. One thing I regret, ve years later, is that I have no photos of me during this time period no photos of me and my kids or even my newborn, says Tammy Winstead, who blogs at pinkstinx.blogspot.com. I believe it is important for me to embrace this ght as it is part of what made me who I am today. Cancer doesnt dene me, but it certainly touched me and changed my life.
What I recommend: If youre

my breast cancer treatment in 1996, I developed lymphedema in my left arm, says Jan Hasak, a two-time breast cancer survivor, of the blockage in the lymphatic system that prevents lymph uid from draining, causing pain and swelling. The surgeon convinced me the risk was minimal and provided no precautions. Having received extensive treatment for the lymphedema, Jan now takes extreme caution with her affected arm, wearing a compression sleeve and avoiding skin trauma and heavy lifting.
What I recommend: Jan sug-

facing cancer treatment, I suggest journaling, documenting, starting a blog and taking photos, Winstead says. You may not want to look at them right away, but eventually you will and you will be glad you have them. I promise! This is just another part of your life that will determine what makes you you. Tammy Winstead is a veyear breast cancer survivor. She blogs at Pinkstinx.blogspot.com.

gests that a person newly diagnosed with breast cancer can reduce the risk of lymphedema by educating themselves via the free literature available at the hospital or the National Lymphedema Network, lymphnet.org, as well as at stepup-speakout.org. Jan Hasak has written two books on her medical journey and blogs at Janhasak.com. Continued on Next Page

advice Continued from Previous Page

What I learned: Losing your hair is not as big a deal as I thought

it would be, says Marcy Bruch, who blogs at BattlingBreastCancerWithClass.com. Also, losing both breasts isnt the big deal I thought it would be either. When reconstruction is nally done, everything looks as good or better than it used to.
What I recommend: Marcy recommends looking up before and

cologists ofce, and it helped to read and see pictures of women wearing low-cut dresses after breast reconstruction, gushing about how happy they were with the end results of their reconstruction surgery. Marcy Bruch is a Stage 3 breast cancer survivor who shares tips for ghting breast cancer with grace, humor and style.

after pictures on the Internet or at your plastic surgeons ofce. I would read these Dealing With Cancer magazines in my on-

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how to help

ACT-TOBER
31 BREAST CANCER ACTION IDEAS
BY KARINA TIMMEL | AMERICAN PROFILE

THURSDAY 11

hether you are doing good for the cause or doing good for you and your loved ones, there are tons of ways to raise breast cancer awareness this month. Here are 31 ideas, one for each day of October:

WEDNESDAY 3
Book a doctors appointment. If

MONDAY 8
Pop some vitamin D. Research released in the September 2011 issue of Anticancer Research found that those whose vitamin D was in the highest quartile were 39 percent less likely to be diagnosed with breast cancer, compared to those whose vitamin D was in the lowest quartile, says Dr. John J. Cannell, executive director of the Vitamin D Council, who recommends getting it through sunlight exposure and vitamin D3 supplements. www.vitamindcouncil.org.

youre 40 or older and havent had a mammogram this year, you should get one.

THURSDAY 4
When it comes to breast cancer, sometimes its hard to nd the right words. Greeting Card Universe, www.greetingcarduniverse.com, offers several customizable cards ($3 each) to create awareness, announce recovery progress, show support, celebrate being a survivor or humor cards to make the patient laugh.

Eat your fruits and veggies more than ve cups a day, say the experts at Breastcancer.org. v The U.S. National Cancer Insti- w tute estimates that one-third of b all cancer deaths may be related to diet, but the good news is that many fruits, veggies, herbs and legumes found at your local grocery store or farmers market contain cancer-ghting properties and antioxidants that battle the damage caused by free radicals. The top foods for breast cancer protection: cruciferous vegetables like broccoli, cauliower and cabbage; dark leafy greens like kale and spinach; fruits like citrus, berries and cherries.

MONDAY 1
Put your blue jeans on. Lee National Denim Day, on Oct. 1, is one of the largest singleday breast cancer fundraisers in the nation, beneting the Entertainment Industry Foundations womens cancer programs (www.eifoundation.org). How it works: Lee Jeans invites companies to go casual for a cause, inviting employees to wear their jeans to work on Denim Day in exchange for a $5 contribution to the ght against breast cancer. www.DenimDay.com.

FRIDAY 12

TUESDAY 9
Walk the walk! Participate in a major three-day awareness walk/fundraising event like the Susan G. Komen 3-Day: www.the3day.org. Or, a two-day Avon Walk for Breast Cancer: www.avonwalk.org. Or, nd another timeframe that works for you: www.komen.org/ndarace.aspx.

FRIDAY 5
Auction off a cast of your and your friends breasts! Organize a Cast Exhibition through the Keep a Breast Foundation, www.keep-a-breast.org/home.

Sip a glass of red vino. Seattles Dr. Richard Baxter, author of Age Gets Better with Wine: New Science for a Healthier, Better and Longer Life, says, Theres powerful scientic evidence that resveratrol, a molecule found in red wine, may hold the key to preventing breast cancer. But remember: thats one glass. Drinking largew amounts of alcohol increases the risk of breast cancer.

SATURDAY 13

TUESDAY 2
Go pink with NASCAR. Through Toyota Racings Racing for Awareness, fans can vote for their favorite Tshirt design at www.toyotaracing.com/RacingForAwareness through Oct. 4, with the winning design unveiled at Charlotte Motor Speedway the weekend of Oct. 13. Toyota will donate $500 in the name of each participant to the Charlotte-based charity Carolina Breast Friends, in recognition of Breast Cancer Awareness Month.

SATURDAY 6
Support your sisters and wear pink!

WEDNESDAY 10
Hit the pavement. It has been shown that regular cardiovascular exercise decreases risk of breast cancer and improves survival for those who have it, says Dr. Diane Radford of the Mercy St. Louis Cancer & Breast Institute. Exercising four or more hours a week may decrease hormone levels and help lower breast cancer risk, says the National Cancer Institute.

SUNDAY 7
Cancer, schmancer, is what Fran Drescher (a uterine cancer survivor) says. check out her site Cancer Schmancer, www.cancerschmancer.org, which has info on early detection and prevention, as well as ways to Trash Cancer in your home.

Find a local group donating to y breast cancer research. It could be an athletic team donning pink jerseys for a game, or a special night at a nearby y restaurant where part of the proceeds go to ght cancer, or y a hospital holding a womens health fair. Check your local paper for ideas.

SUNDAY 14
Buy the Pink Ribbon apron from www.susanandveronica.com/sho p/pink-ribbon-aprons.html, benetting Young Survival Coalition, www.youngsurvival.org.

how to help
MONDAY 15
Be informed on healthy living. Think Pink, Live Green provides practical tips for women who have or who have had breast cancer, such as choosing the safest sunscreens and cosmetics, buying organic at the grocery store and what cleaning and household products are safe to use to decrease the risk of cancer. www.breastcancer.org.

SATURDAY 27
Since 2010, Otis Spunkmeyer has donated more than $200,000 to Susan G. Komen for the Cure through sales of its Pink Cookies. The group will donate to Komen $1.50 per cookie sold, with a minimum guaranteed donation of $100,000. Find the cookies through October at grocers and convenience stores.

YOUNGSURVIVAL.ORG PHOTO

SUNDAY 28 TUESDAY 16
Read up on alternative therapies for prevention and treatment. It worked for Hollie Quinn, who wrote a book about it with her husband in 2010: www.youdidwhatbook.com.

FRIDAY 19
Write or email your local government urging them to keep state Medicaid programs that help cancer patients. Many states are cutting their Medicaid programs, leaving many people without health insurance and unable to pay for care.

TUESDAY 23
Help out. GiveForward provides personalized fundraising webpages for people facing a medical crisis, like breast cancer, so they can cover their out-of-pocket medical expenses. Friends and family can leave nancial and emotional support for their loved ones. www.giveforward.com.

Give a hug. Hug Wraps are hospital gown alternatives for cancer patients to wear during various treatments. Using all recycled material from pillows and blankets, these robes are meant to comfort. www.hugwraps.org.

MONDAY 29
Clean green. Most of our cancers are environmental and until the cleaning industry has to tell us what is in their products, I suggest making your own, says Leslie Reichert, The Cleaning Coach and author of The Joy of Green Cleaning. She has recipes on her site: www.greencleaningcoach.com.

WEDNESDAY 17
Eat breakfast. LUNA Bars

SATURDAY 20
Write or email federal legislators urging them to remove the six-month waiting period for Pre-existing Condition Insurance, urges Melissa Veselovsky, director of patient Advocacy at the Ironwood Cancer & Research Centers in Arizona, www.ironwoodcrc.com.

WEDNESDAY 24
Do a breast self-exam and report any changes (including lumps, swelling, nipple pain or discharge) to your doctor.

THURSDAY 18
Find out if your breasts are dense. About one-third of women older than 50 have dense breasts, which makes mammograms more challenging, says Dr. Stacey Vitiello, a breast imaging specialist at Montclair Breast Center in New Jersey. If they are dense and you are over 40, you need to have a screening test (breast ultrasound or MRI, depending on your other risk factors) in addition to your mammogram each year. Several states, including Connecticut, Texas and California, have passed bills requiring that women be informed about their breast density. www.AreYouDense.org.

THURSDAY 25
Consider switching your method of birth control from the pill if you have a family history and are at high risk for breast cancer. There are conicting studies out there, but some show that oral contraceptives may increase your risk, especially if you are older than 45.

TUESDAY 30
Just because the month is ending, the ways to ght cancer and the need for research are not. Check out other organizations, such as Stand Up To Cancer, standup2cancer.org, and keep your family, friends or co-

SUNDAY 21
Stop smoking! If you didnt already have enough reasons, studies show that there is a link between breast cancer and smoking and secondhand smoke.

MONDAY 22
Colonial Candles rst Pretty in Pink breast cancer awareness candle will be sold this year, with 10 percent of the proceeds going to the Avon Breast Cancer Crusade. Find the $25 three-wick candles at www.ColonialCandle.com.

FRIDAY 26
Donate to an organization that directly pays for cancer care. Find a list at www.ironwoodcrc.com.

WEDNESDAY 31
Have you ever contacted your local chapter of the American Cancer Society? Chances are they have information and volunteer opportunities for you. Find yours, and other resources, at cancer.org/treatment/supportprogramsservice s/app/resource-search.

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research

Breakthroughs
BY KATIE D. NEAL | SPRY MAGAZINE

New treatments in breast cancer

n 1980, at 34 years old, Janelle Hail was facing breast cancer a disease most women only whispered about. So when she beat it, she wanted to help change the status quo. In 1991, she founded the National Breast Cancer Foundation, which counts as its main mission providing free mammograms and other screening exams for women who cant afford them. While breast cancer research is vital, at that time nobody was doing anything with prevention, Hail says. We felt we had to meet those needs for women, right there where they live. Hail chatted with Spryliving.com about the past, present and future of the cause that shes made her lifes work.

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research
Spryliving.com: Whats

changed most in the 21 years youve been involved in breast cancer activism?

Spryliving.com: What recent developments in breast cancer detection and treatment are you most excited about? JH: There are a few tremendous things. One is digital mammography, which can give a much clearer picture, and help with the reading of the mammogram. Thats exciting, because youre going to get more information. The other is personalized medicine. That means the treatment is tailored to the patient and the type of breast cancer they have. We think of breast cancer as one lumpedin thing, but not every drug is going to help every cancer. So instead of a scatter-shot method, this targets the cancer according to the patients specic needs.

Spryliving.com: Clearly, these innovations are positive, but do you nd that women sometimes feel overwhelmed by all the options? JH: Yes, and we try to be a resource. On our website, NBCF.org, we have a section called Beyond the Shock, which helps women whove just been diagnosed to understand the disease, through videos and animation and other tools. Were trying to change the fear that people have when they get breast cancer. Fear lurks around in the darkness, when you dont know whats going on. But education can put a big, bright spotlight on it. I just want women to understand theres life beyond breast cancer.

Spryliving.com: Why did you

decide to focus your efforts primarily on prevention and screenings when you founded the NBCF?
JH: I think because Ive always

Janelle Hail: I think there are better attitudes about breast cancer because were talking about it. My doctor told me, You can have chemotherapy, radiation or a mastectomy, and I didnt know what any of it was about. People didnt talk about breast cancer back then. They were fearful they could lose their jobs if they mentioned it. Now people realize this is a disease, just like any other disease. Women are getting more aggressive about their health care, too. Im happy to see those changes.

believed early detection was important in everything. In my life, Im always thinking ahead I dont want to just wait until it happens to me. So when I got breast cancer, I think it was that attitude that spared my life. We have an early detection plan on our website, where women can sign up to be reminded to schedule a mammogram however she wants (by email, text message or via a calendar program). Its simple to do, and thats the only communication they get from us. Continued on Next Page

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research Continued from Previous Page

Spryliving.com: Theres been some backlash lately about the rash

of pink products in October, and whether theyre truly helping the cause. How do you think consumers should approach these products and campaigns?

JH: Im very proud of all the pink that is presented in October. Sometimes we need to have it in our faces in order to think

about it, and what we need to do. I think probably most of those products are legitimate, but it is important to check the packaging and see who the funds are going to. If I go into a store and see a product with a pink ribbon on it, but it has very little information about that, Ill ask the clerk or the stores owner.

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Breast Cancer Awareness 2012

patient care

Its in the bag

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Dr. Elizabeth Chabner Thomas
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By Anna Dickens

American Prole

s a radiation oncologist at Northern Westchester Hospital in Mt Kisco, N.Y., Dr. Elizabeth Chabner Thompson sees cancer patients day in and day out. But Thompsons knowledge of breast cancer is not limited to the hospital room the physicians own life has been touched by the disease in many ways. When her mother was diagnosed with breast cancer in 1993, Thompson witnessed rsthand how debilitating chemotherapy can be. I used to hate the way people would stare at my mom, Thompson says, recalling an incident at a gas station in which a man made a disparaging remark about her mothers bald head. I thought to myself, Where do you get off doing that? Shes been through hell and back. The experience inspired Thompson, then an aspiring doctor, to enter radiation oncology as a way to help others struggling with cancer. But even while she provided care for cancer patients, Thompson knew that she was not immune from the disease. I had done a lot of genetic testing, and I was certain that breast cancer was coming towards me, Thompson says. Not wanting to take any chances, Thompson underwent a double prophylactic mastectomy in 2006 to reduce her risk of developing breast cancer. Being on the other side of the stethoscope was eye-opening, Thompson says. Coming out of surgery, youre nauseous, your eyes are dry, your mouth is sticky. You feel lousy. Of course I had seen so many

women go through it before me, but your perspective denitely changes when youre on the other side of the table. Thompsons time in recovery conrmed what she knew from her professional practice as a radiation oncologist: that something needed to be done to improve breast cancer patients experiences. Theres a lot of confusion. Many cancer patients undergoing surgery arent sure what to bring to the hospital with them, and after surgery, theyre often pushed out of the hospital without receiving adequate instructions for post-operative care, she says. This doesnt just cause cancer patients undue stress it can lead to complications and hospital readmissions, Thompson says. Inspired to make a difference, Thompson set out to help others with breast cancer get back on their feet after treatment. Armed with scissors, needle and thread, she began sewing together bras that provide gentle support after sur-

gery and during radiation therapy in her living room, and just like that, Bf Co. was born. Launched in 2011, Bf Co. which stands for Best Friends for Life includes a line of radiation bras, bags and surgical accessories designed to ensure a comfortable recovery for patients. The name came from just the idea of reaching out from woman to woman or friend to friend and saying, Im with you through your struggle here are some things that will help you recover, Thompson explains. The Bf Bag is a colorful nylon dufe bag containing a variety of products, toiletries and surgical accessories designed to ease the recovery process for a patient undergoing cancer surgery. For instance, the Breast Bf Bag, created specically for breast cancer patients, contains a drain care kit to help women track their output after a mastectomy or reconstructive surgery, in addition to a toiletry pack, a special support pillow and other helpful items. Because of the success of the original Breast Bf Bag, the companys product line has since expanded to address a variety of different conditions, including traumatic brain injury, stroke, brain tumors and ovarian cancer. Thompson says a C-section bag will soon be added to the lineup.

Wayne S. Strouse, MD, FAAFP

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prevention

Know your risks

By American Prole

Preventing and eliminating them can be the best medicine

Whats my risk of breast cancer? is a question many women ask their doctors. Doctors have tools to help estimate a womans personal risk, but women who get breast cancer sometimes have no known risk factors besides age. Many women with one or more risk factors never get breast cancer. So its impossible to know who will actually get the disease. Factors that affect a womans risk of breast cancer include: Age. The strongest risk factor is age. Risk goes up as a woman gets older. Most women who get breast cancer are older than 50.
Personal history of breast cancer. Women who have had cancer

has a harmful gene mutation, you may want to talk to a genetic counselor to learn more about your risk. You may also want to seek genetic counseling if your family history of cancer suggests a gene mutation. - A woman known to carry a harmful gene mutation should talk to her doctor about ways to try to lower her breast cancer risk or nd breast cancer early. Women who have certain types of abnormal breast changes, such as atypical hyperplasia, ductal carcinoma in situ and lobular carcinoma in situ have a higher risk. These changes are found during a breast biopsy. Breast tissue that is dense on mammogram. Women whose breasts have more dense tissue relative to fatty tissue have a higher risk than women of about the same age who have little or no dense breast tissue.
Menstrual and reproductive history.

in one breast are more likely to get it in the other breast. Family history. Having a mother, sister or daughter who has had breast cancer increases a womans risk. The risk is higher if her family member got breast cancer before age 40. A womans risk also is increased if more than one family member on either her mothers or fathers side of the family has had breast cancer.
Inheriting certain harmful gene mutations. Here are

Getting your rst menstrual period before age 12 increases breast cancer risk. Reaching menopause after age 55 increases breast cancer risk. Never having children or having children after age 30 also increases risk. Women who have a rst baby before age 20 have a lower risk.
Taking the hormones estrogen and progestin. Using menopausal hormone

STOCK.XCHNG PHOTO

some key points about genes and breast cancer: - Inheriting changes to certain genes, such as BRCA1 and BRCA2, greatly increases the risk of breast cancer. - Inherited genetic changes account for about 10 percent of all breast cancers. - If you have a relative who

therapy containing both for more than ve years increases breast cancer risk. Its not clear whether estrogen-only therapy affects risk. Using birth control pills may slightly increase the risk of breast cancer in current users, but this risk returns to normal over time. Radiation therapy to the chest for the treatment of cancer increases breast cancer risk. Risk depends on the dose of radiation and age of treatment. The risk is highest for radiation treatment used during puberty. Women who are not physically active throughout life may have an increased risk of breast cancer. Strenuous exercise for more than four hours a week may help lower breast cancer risk. Also, being active can help women prevent overweight and obesity, which are known risk factors for breast cancer in women who have reached menopause.

2003 Curves International

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