Breast Cancer Awareness Month is here — 31 days that do great things for fundraising and education on behalf of the disease. What it's not so great for? Peace of mind.
Your "I got this" confidence may not survive the spin cycle of reminders, warnings, and true patient stories. What women often don't hear is that the number of lives claimed by this disease has dropped since 1989. (Heart disease, on the other hand, remains women's number one threat.) Yet breast cancer wins the worry war — it's women's most feared health problem, and fear often leads to paralysis instead of self-care.
Now's the time for some perspective: We take on your biggest concerns one by one so you can take October, and every month, in stride and just focus on being your healthiest self.
Could We Worry a Lot Less About One Type of Cancer?
As science gets better at understanding how different cancers behave, some researchers think that certain troublesome cells in the breast may never turn into invasive cancer. The abnormal cells that make up stage 0 ductal carcinoma in situ (DCIS) may idle in the milk ducts of some women and never become anything harmful, they say.
The current standard of care for this type of cancer is a biopsy followed by a lumpectomy or a mastectomy. That could be too drastic for something that may not be symptomatic or life-threatening, say Shelley Hwang, MD, chief of breast surgery at Duke University School of Medicine, and Laura Esserman, MD, director of the University of California, San Francisco, Carol Franc Buck Breast Care Center. Both docs suggest that DCIS could one day be treated the way a growing number of prostate cancers are being handled: with a program of active surveillance, or "watchful waiting," in which you don't have surgery unless changes occur. Esserman has also written medical journal articles suggesting that unless the highest-risk cells are present, "DCIS should not be called cancer."
A sea change in treatment for DCIS is eight to 10 years off. Unless you want to enroll in a trial (the newest is called the COMET trial), experts say you should stick with the current standard of care for now. But it's promising that in the future, some patients may have options beyond serious surgery.
Who Needs More Screening?
It's women with dense breasts, simply because their scans are harder to read: Dense tissue looks white on an X-ray, and so does cancer.
What's the Deal With Alcohol?
Keep it to one drink a day; more than that raises risk. What experts mean by "one": 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of spirits.