When we have children, many of us slip in the self-care department. We may not eat as well, not exercise like we did “pre-baby,” and don’t have time to go and see our own doctors. Simply put, our own care doesn’t come first. Parenthood immediately demotes our status…

All fine in some ways. It’s astonishingly wonderful to care so deeply about our children. That devotion still catches me off guard.

But we have to keep on top of our preventative screening. No reason not to when it may allow us a longer time to parent our children! So that’s where I come to breast cancer screening. As women, breast cancer will affect about 1 in 8 of us during our lifetime, the most common cancer in women after non-melanoma skin cancer. It can be highly curable if detected and treated early. Most women diagnosed with breast cancer are over age 50, but many are younger and some are new moms. There are some risks we need to know and scientific evidence that can help us do a better job caring for ourselves.

Share this widely, please.

Yesterday I teamed up with Dr Julie Gralow, the head of breast cancer oncology at the Seattle Cancer Care Alliance (SCCA) and the UW on Twitter for a 1 hour conversation about moms and breast cancer— lifestyle choices, genetic risks, screening, & coping with breast cancer. I learned a ton preparing for the chat and have already tried to think about changes I’ll make in my own life. When I finished the fast-paced hour conversation I sent a note to a friend on Twitter  that I now had to head out for a run, pour out the wine in the house, call my friends to schedule mammography, and ask about a breast MRI. You’ll see why:

Lifestyle Choices May Decrease Breast Cancer Risk

  • Alcohol consumption is associated with breast cancer. And it’s dose dependent meaning that for every increase in alcohol consumption on a daily basis, the more the increased risk of breast cancer. This is simply a reminder to moderate. One glass of wine really may be better than 3.
  • Weight matters. Obesity increases your risk of breast cancer. If you’re overweight, chat with your doctor now about strategies and ideas to make change. No reason to wait–the longer you wait, the longer the risk maintains itself.
  • Exercise matters, too. The reason? When you exercise, it causes your hormone levels to go down, thus helping to decrease risk for breast cancer. Data shows that exercise may be most protective in young, pre-menopausal women who are lean and/or or normal weight. Exercise isn’t just for weight control. I’m using this as a motivator to schedule the >4 hours of exercise a week I need going forward. Wish me luck.

The Pill, Babies, & Reproductive Risk For Breast Cancer

  • It’s true, if you’re able to have your babies very early in life, it may be protective against breast cancer. Moms who have babies before 20 have a decreased risk. But pregnancy at any time has the benefit of lowering risk in the estrogen during pregnancy is lower and therefore lowers risk. It is also known that having babies later in life may increase our risk (>35 years of age). Little we can do to control this—but just know the risks & talk with your doc.
  • Oral contraceptive pills (birth control) pills do not cause breast cancer.
  • The less menstrual cycles you have in life, the less hormones around and the lower the risk of breast cancer Those girls who start periods later (>age 14) and those who enter into menopause early have lower risks.
  • Breastfeeding: when you’re breast-feeding your estrogen levels are lower and so it decreases your breast cancer risk. AMAZING. Breastfeeding is good for mom, great for baby and decreases risk of breast cancer.

Genetics And Breast Cancer Risk

  • There are genes that are passed between families that increase risk for breast cancer. Errors or changes in the BRCA1 & BRCA2 genes we know increases likelihood of cancer. You can test for changes in there genes with blood tests. If you have relatives, especially siblings or mothers and grandmothers with breast cancer, talk with your doctor about screening for genetic risks. It’s always great to see a genetic counselor, too.
  • If you have a family history of breast cancer, it may make sense to have the family member with breast cancer tested for genetic studies first, then be tested if they are positive. Read more about genetic risks here.

Screening For Breast Cancer–Mammography, Ultrasound, And MRI

  • Most women need annual mammography starting at age 40. If you have a family history of breast cancer, if you are BRCA1 or BRCA2 positive, or have other types of cancer, talk with your doctor about screening for you.
  • Younger women have more dense, fibrous breasts. Our breasts get fattier as we age (oh the glory!!). This density, especially in younger women, makes mammography less sensitive and less able to pick up cancers. Believe it or not, some studies show that mammographies miss 20% of cancer at the time of the screen, especially in young women. If you have a family history of breast cancer, if you’re young and have risk factors, ask about getting a breast MRI. Breast MRI may be better at detecting cancer in young women with fibrous breasts.
  • Ultrasound of the breast is not a screening test. However, if an abnormality is found on a mammogram, sometimes an ultrasound is used to help further determine if more testing is needed.
  • Monthly self-breast exams are ways to track changes in your breasts, too.

Young Moms With Breast Cancer

  • Young women with cancer are juggling incredibly precious balls in the air. Young Survival is a great resource for moms.
  • Be open and honest with children about cancer. But remember, you don’t have to share every detail about a diagnosis, all at once. Let time help you understand what information your children need to understand about a cancer diagnosis. And know that children will form their own understandings, too. Be open to their perspective. As Dr Gralow says, “Children may learn fear of cancer from us. Be open and provide them information. Take them to the chemo room if they want to go. This will help normalize it for them.”

Turning 40?

And one last thing as I near age 40. What about this? Have a big party and then team up with your friends for annual mammography?