Clothes For A Cause

Every three minutes, another woman is diagnosed with breast cancer According to the American Cancer Society, in 2004, an estimated 217,440 new cases of female breast cancer will be diagnosed in the United States, and an estimated 40,110 women will die from breast cancer.

Breast cancer is the most frequently diagnosed non-skin cancer in the United States; only lung cancer causes more female cancer deaths than breast cancer.

The Good News - mammograms can help.
The survival rate for localized breast cancer has increased from 72% in the 1940s to 97% today - most likely due to earlier detection and improved treatment. Mammograms can play in critical role in this because they canidentify breast cancer at a stage when it can be most effectively treated. In fact, mammograms reduce the chance of dying from breast cancer by 17% for women in their forties, and by 30% for women fifty years and older.

Clothes for a Cause helps fund mammograms for un- and underinsured women.
The American Cancer Society recommends annual mammograms to women forty and older. Approximately 30 million women will receive mammograms this year. Unfortunately, low income and poorly educated women are less likely to receive mammograms. Partial proceeds from all Pink Ribbon Collection Fashions are donated to help make mammograms available for those who cannot afford them - or do not have easy access to them.

Breast Cancer Risk Factors: (Courtesy of the American Cancer Society)
Family history of breast cancer: Breast cancer risk is higher among women whose close blood relatives have this disease. Your risk of developing breast cancer is increased if:

You have 2 or more relatives with breast or ovarian cancer.
Breast cancer occurs before age 50 in a relative (mother, sister, grandmother or aunt) on either side of the family. The risk is higher if your mother or sister has a history of breast cancer.
You have relatives with both breast and ovarian cancer.
You have 1 or more relatives with two cancers (breast and ovarian, or two different breast cancers).
You have a male relative (or relatives) with breast cancer.
You have a family history of breast or ovarian cancer and Ashkenazi Jewish heritage.
Your family history includes a history of diseases associated with hereditary breast cancer such as Li-Fraumeni or Cowdens Syndromes.

Personal history of breast cancer: A woman with cancer in one breast has a 3- to 4-fold increased risk of developing a new cancer in the other breast or in another part of the same breast. This is different from a recurrence (return) of the first cancer.

Race: White women are slightly more likely to develop breast cancer than are African-American women. But African-American women are more likely to die of this cancer because their cancers are often diagnosed later and at an advanced stage when they are harder to treat and cure. There is also some evidence that African-American women have more aggressive tumors. Asian, Hispanic, and Native American women have a lower risk of developing breast cancer.

Previous abnormal breast biopsy: Women whose earlier breast biopsies detected any of these changes have a slightly higher risk of breast cancer (1.5 to 2 times greater than other women):

fibroadenoma with complex features
hyperplasia without atypia
sclerosing adenosis
solitary papilloma

Previous breast radiation: Women who as children or young adults have had radiation therapy to the chest area as treatment for another cancer (such as Hodgkin disease or non-Hodgkin lymphoma) have a significantly increased risk for breast cancer. Some reports found the risk to be 12 times normal. This varies with the age of the patient at the time of the radiation. Younger patients have a higher risk. If chemotherapy was also given, the risk may be lowered if the chemotherapy stops ovarian hormone production.

Menstrual periods: Women who started menstruating at an early age (before age 12) or who went through menopause at a late age (after age 55) have a slightly higher risk of breast cancer.

Diethylstilbestrol (DES): In the 1940's through the 1960's some pregnant women were given diethylstilbestrol because it was thought to lower their chances of losing the baby. Recent studies have shown that these women have a slightly increased risk of developing breast cancer.

Not having children: Women who have had no children or who had their first child after age 30 have a slightly higher breast cancer risk. Having multiple pregnancies and becoming pregnant at an early age reduces breast cancer risk.

Oral contraceptive use: It is still not certain what part oral contraceptives (birth control pills) might play in breast cancer risk. Studies have suggested that women using oral contraceptives have a slightly greater risk of breast cancer than women who have never used them. Women who stopped using oral contraceptives more than 10 years ago do not appear to have any increased breast cancer risk. When considering using oral contraceptives, women should discuss their other risk factors for breast cancer with their health care team.

Hormone replacement therapy: It has become clear that long-term use (several years or more) of hormone replacement therapy (HRT) after menopause, particularly estrogens and progesterone combined increase your risk of breast cancer. They may also increase your chances of dying of breast cancer.

If you still have your uterus (womb), doctors generally prescribe estrogen and progesterone (known as combined HRT). Estrogen relieves menopausal symptoms and prevents osteoporosis (thinning of the bones that can lead to fractures). But estrogen can increase the risk of developing cancer of the uterus. Progesterone is added to help prevent this.

If you no longer have your uterus, estrogen alone can be prescribed. This is commonly known as estrogen replacement therapy (ERT). This probably does not increase the risk of breast cancer very much, if at all.

Several large studies, including the Women's Health Initiative (WHI), have found that there is an increased risk of breast cancer related to the use of combined HRT. The most recent results from the WHI found that not only did combined HRT increase breast cancer risk, but it also increased the likelihood that the cancer would be found at a more advanced stage. This is because it appeared to reduce the effectiveness of mammography, as more abnormal findings on mammograms were noted. A large study from the United Kingdom has now found that women who took the combined therapy were also more likely to die of breast cancer than women who didn't.

The risk of HRT appears to apply only to current and recent users, and a woman's breast cancer risk seems to return to that of the general population within 5 years of stopping HRT.

The decision to use hormone replacement therapy after menopause should be made by the woman and her doctor after weighing the possible risks (including increased risk of heart disease, breast cancer, strokes, and blood clots) and benefits (relief of menopausal symptoms, reduced risk of osteoporosis), and considering each woman's other risk factors for heart disease, breast cancer, osteoporosis, and the severity of her menopausal symptoms.

Breast-feeding and pregnancy: Some studies suggest that breast- feeding may slightly lower breast cancer risk, especially if breast-feeding is continued for 1.5 to 2 years. Other studies found no impact on breast cancer risk.

The explanation of this may be that both pregnancy and breast-feeding reduce a woman's total number of lifetime menstrual cycles. This may be similar to the reduction of risk due to late menarche (start of menstrual periods) or early menopause, which also decrease the total number of menstrual cycles. One study concluded that having more children and breast-feeding longer could reduce the risk of breast cancer by half.

Alcohol: Use of alcohol is clearly linked to a slightly increased risk of developing breast cancer. Compared with nondrinkers, women who consume 1 alcoholic drink a day have a very small increase in risk, and those who have 2 to 5 drinks daily have about 1½ times the risk of women who drink no alcohol. Alcohol is also known to increase the risk of developing cancers of the mouth, throat, and esophagus. The ACS recommends limiting your consumption of alcohol.

Obesity and high-fat diets: Obesity (being overweight) has been found to be a breast cancer risk in all studies, especially for women after menopause. Although your ovaries produce most of your estrogen, fat tissue produces a small amount of estrogen. Having more fat tissue can increase your estrogen levels and increase your likelihood of developing breast cancer.

The connection between weight and breast cancer risk is complex, however. For example, risk appears to be increased for women who gained weight as an adult but is not increased among those who have been overweight since childhood. Also, excess fat in the waist area may affect risk more than the same amount of fat in the hips and thighs. Researchers believe that fat cells in various parts of the body have subtle differences in their metabolism that may explain this observation.

Studies of fat in the diet have not clearly shown that this is a breast cancer risk factor. Most studies found that breast cancer is less common in countries where the typical diet is low in total fat, low in polyunsaturated fat, and low in saturated fat.

On the other hand, many studies of women in the United States have not found breast cancer risk to be related to dietary fat intake. Researchers are still not sure how to explain this apparent disagreement. Many scientists note that studies comparing diet and breast cancer risk in different countries are complicated by other differences (such as activity level, intake of other nutrients, genetic factors) that might also alter breast cancer risk.

More research is needed to better understand the effect of the types of fat eaten and body weight on breast cancer risk. But it is clear that calories do count and fat is a major source of these. A diet high in fat has also been shown to influence the risk of developing several other types of cancer, and intake of certain types of fat is clearly related to heart disease risk. We recommend you maintain a healthy weight and limit your intake of red meats, especially those high in fat or processed.

Physical activity: Evidence is growing that physical activity in the form of exercise reduces breast cancer risk. The only question is how much exercise is needed. In one study from the Women's Health Initiative as little as 1.25 to 2.5 hours per week of brisk walking reduced a woman's risk by 18%. Walking 10 hours a week reduced the risk a little more.

Environmental pollution: A great deal of research has been reported and more is being done to understand environmental influences on breast cancer risk. The goal is to determine their possible relationships to breast cancer.

Smoking: Although no studies have yet conclusively linked cigarette smoking to breast cancer, some studies suggest it might increase breast cancer risk, particularly for women who start smoking in early adolescence. Also, of course, smoking affects overall health and increases the risk for many other cancers, as well as heart disease.

Currently, research does not show a clear link between breast cancer risk and exposure to environmental pollutants, such as the pesticide DDE (chemically related to DDT), and PCBs (polychlorinated biphenyls).

Finding a breast cancer as early as possible improves the likelihood that treatment will be successful. Most doctors feel that early detection tests for breast cancer save many thousands of lives each year, and that many more lives could be saved if even more women and their health care providers took advantage of these tests. Following the American Cancer Society's guidelines for the early detection of breast cancer improves the chances that breast cancer can be diagnosed at an early stage and treated successfully.

Women age 40 and older should have a screening mammogram every year and should continue to do so for as long as they are in good health. Women should be told about the benefits, limitations, and potential harms linked with regular screening. Mammograms can miss some cancers. However, mammograms, despite their limitations, remain a very effective and valuable tool for decreasing suffering and death from breast cancer.

Mammograms for older women should be based on the individual, her health, and other serious illnesses. Age alone should not be the reason to stop having regular mammograms. As long as a woman is in good health and would be a candidate for treatment, she should continue to be screened with mammography.

Women in their 20s and 30s should have a clinical breast examination (CBE) as part of a periodic (regular) health exam by a health professional preferably every 3 years. After age 40, women should have a breast exam by a health professional every year. There may be some benefit in having the CBE shortly before the mammogram. The exam should include instruction for the purpose of getting more familiar with your own breasts. Women should also be given information about the benefits and limitations of CBE and breast self-examination (BSE). Breast cancer risk is very low for women in their 20s and gradually increases with age. Women should be told to promptly report any new breast symptoms to a health professional.

Breast Self Examination (BSE) is an option for women starting in their 20s. Women should be told about the benefits and limitations of BSE. Women should report any breast changes to their health professional right away. Women who choose to do BSE should have their BSE technique reviewed during their physical exam by a health professional. It is okay for women to choose not to do BSE or not to do it on a regular schedule. However, by doing the exam regularly, you get to know how your breasts normally feel and you can more readily detect any signs or symptoms If a change occurs, such as development of a lump or swelling, skin irritation or dimpling, nipple pain or retraction (turning inward), redness or scaliness of the nipple or breast skin, or a discharge other than breast milk, you should see your health care provider as soon as possible for evaluation. Remember that most of the time, however, these breast changes are not cancer.

Women at increased risk should talk with their doctor about the benefits and limitations of starting mammograms when they are younger, having additional tests, or having more frequent exams. Women should discuss with their doctor what approaches are best for them. Although the evidence currently available does not justify recommending ultrasound or MRI for screening, women at increased risk might benefit from the results. The American Cancer Society believes the use of mammography, clinical breast examination, and breast self-examination, according to the recommendations outlined above, offers women the best opportunity for reducing the breast cancer death rate through early detection. This combined approach is clearly better than any one examination. Without question, breast physical examination without mammography would miss the opportunity to detect many breast cancers that are too small for a woman or her doctor to feel but can be seen on mammograms. Although mammography is the most sensitive screening method, a small percentage of breast cancers do not show up on mammograms but can be felt by a woman or her doctors.