Think Pink in the Month of October

Pink-Ribbon_BIMC

October is once again wonderfully awash in pink for worldwide breast cancer awareness and for good reason —breast cancer remains the top cancer in women around the globe with incidence in countries like Indonesia only increasing due to urbanization and the adoption of western lifestyles.

Early detection (see mammogram screening below) remains paramount to improve outcomes united with ongoing prevention… and here are eight vital steps you can take toward greatly reducing chances of developing breast cancer. Remember, some risk factors, such as family history, can’t be changed however, there are lifestyle modifications you can make right now to lower your risk.

1. Keep Your Weight Down
Maintaining a healthy weight is on the top of the list. If you are overweight you can increase the risk of breast and others cancers especially after menopause.

2. Get Active
If you live in the south of Bali, take to the esplanades in Sanur or Nusa Dua daily for a robust power walk-run at least 30 minutes or another form of exercise to lower risk of breast cancer. Regular exercise is also one of the best ways to help keep weight in check.

3. Consumer Fruit & Veg Daily
Simple: A healthy, fresh and leafy diet lowers the risk of breast cancer. Try to eat a lot of fruits and veg and it’s made super easy on this fertile island of Bali.

The only person who can save you is you: That was going to be the thing that informed the rest of my life. Singer – Songwriter Sheryl Crow

4. Cut back on alcohol
Perhaps a drink a day will help your overall health although low levels of intake can also increase the risk of breast cancer. If you drink moderately, there’s likely no reason to stop. But, if you drink more — cut down or quit.

5. Just Don’t Smoke!
Who still smokes anyway? Smoking (even vaping!) will increase your risk of heart disease, stroke, and many types of cancers, including breast cancer. Careful, it’s easy to fall into the smoking habit in Indonesia due to having few restrictions. Turn your back on this dreadful addiction forever.

6. Breastfeeding is just healthy
Breastfeeding for a total of one year or more (combined for all children) lowers the risk of breast cancer and provides proven health benefits for the child. Go to this invaluable site for more info: http://www.breastcancer.org/

7. Avoid Birth Control Pills
Birth control pills have both risks and benefits. The younger a woman is, the lower the risks are. While women are taking birth control pills, they have a slightly increased risk of breast cancer. This risk goes away quickly only after stopping the pill.

8. Avoid Post – Menopausal Hormones
Post-menopausal hormones shouldn’t be taken long term to prevent chronic diseases, like osteoporosis and heart disease. Studies show long period use can increase the risk of breast cancer.

9. Drugs for women at high risk
Not commonly thought of as a “healthy behavior,” taking the prescription drugs tamoxifenand raloxifene significantly lowers the risk of breast cancer in woman at high risk of the disease. Approved by the USFDA for breast cancer prevention, these powerful drugs can have side effects, so they aren’t right for everyone. If you think you’re at high risk, talk to your BIMC doctor to see if tamoxifen or raloxifene may be right for you.

Breast cancer prevention and control

(Republished from the http://www.who.int/cancer/detection/breastcancer)

Breast Cancer Control & Prevention
Control of specific modifiable breast cancer risk factors as well as effective integrated prevention of non-communicable diseases which promotes healthy diet, physical activity and control of alcohol intake, overweight and obesity, could eventually have an impact in reducing the incidence of breast cancer in the long term.

Early detection
Although some risk reduction might be achieved with prevention; these strategies cannot eliminate the majority of breast cancers that develop in low – and middle -income countries. Therefore, early detection in order to improve breast cancer outcome and survival remains the cornerstone of breast cancer control (Anderson et al., 2008).

There are two early detection methods:
Early diagnosis or awareness of early signs and symptoms in symptomatic populations in order to facilitate diagnosis and early treatment, and
screening that is the systematic application of a screening test in a presumably asymptomatic population. It aims to identify individuals with an abnormality suggestive of cancer.

A screening programme is a far more complex undertaking that an early diagnosis programme. (WHO, 2007)
Irrespective of the early detection method used, central to the success of population based early detection are careful planning and a well – organized and sustainable programme that targets the right population group and ensures coordination, continuity and quality of actions across the whole continuum of care.

Targeting the wrong age group, such as, younger women with low risk of breast cancer, could cause a lower number of breast cancers found per woman screened and therefore reduce its cost-effectiveness. In addition, targeting younger women would lead to more evaluation of benign tumours, which causes unnecessary overload of health care facilities due to the use of addition diagnostic resources (Yip et al., 2008).

Early diagnosis
Early diagnosis remains an important early detection strategy, particularly in low- and middle-income countries where the diseases is diagnosed in late stages and resources are very limited. There is some evidence that this strategy can produce “down staging” (increasing in proportion of breast cancers detected at an early stage) of the disease to stages that are more amenable to curative treatment (Yip et al., 2008).

Mammography screening
Mammography screening is the only screening method that has proven to be effective. Although there is evidence that organized population – based mammography screening programmes can reduce breast cancer mortality by around 20% in the screened group versus the unscreened group across all age groups, in general there appears to be a narrow balance of benefits compared with harms, particularly in younger and older women. There is uncertainty about the magnitude of the harms – particularly overdiagnosis and overtreatment. Mammography screening is very complex and resource intensive and no research of its effectiveness have been conducted in low resource settings.

Breast self examination (BSE)
There is no evidence on the effect of screening through breast self-examination (BSE). However, the practice of BSE has been seen to empower women, taking responsibility for their own health. Therefore, BSE is recommend for raising awareness among women at risk rather than as a screening method.

Clinical Breast Examination (CBE)
Research is underway to evaluate CBE as a low-cost approach to breast cancer screening that can work in less affluent countries. Promising preliminary results show that the age-standardized incidence rate for advanced-stage breast cancer is lower in the screened group compared to the unscreened group (Sankaranarayanan, 2011).

Health-e reporting along with sources: Cancer.org; WHO; Daily Mail; Independent; News.com.au; Mayo Clinic

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