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Nurturing Your Well-being: Breast Awareness, Healthy Habits, and Tracking Your Health
Nurturing Your Well-being: Breast Awareness, Healthy Habits, and Tracking Your Health

Contrary to widespread knowledge, breast cancer affects women of all ages, not just those over 40. According to Dr. Geoffrey Ray and Oncology Nurse Navigator Debra Rundles, who were IAWH guests at the "Breast Health, By Any Means Necessary" webinar, many younger women believe that breast cancer is something they don't need to worry about until later in life. However, breast cancer knows no age, and this blog supports our being body-aware, which means understanding that breast changes occur at any time, regardless of age, health habits to consider, and being vigilant in tracking our health.


Healthy Habits and Basics of Breast Health

Breast health is a vital part of our overall well-being. Understanding your body, maintaining a healthy weight, and adopting positive habits impact your health significantly, as there are known associations between these factors and determining breast cancer risk. According to the Mayo Clinic, “Breast health begins with breast awareness — getting a sense of what's typical for you. Being familiar with how your breasts usually feel makes it easier to detect when there's a change. Over time, you'll discover how your breasts change in sensitivity and texture depending on your menstrual cycle, age, and other factors.

Concerns about breast lumps, breast pain, or nipple discharge are common. When you have questions or concerns, talk to your healthcare provider. Your provider can discuss imaging tests you might need based on a clinical exam.

It's essential to understand the screening tests you may need for early detection of breast cancer. They include:

· Clinical breast exams

· Mammograms

· Breast ultrasounds

· Breast MRI



Weight Management for our Health and Risk Factors to Cancer


Weight management is essential to our overall health. IAWH turns to a recent Cleveland Clinic discussion, "How to Reduce Your Risk of Breast Cancer (with Tiffany Onger, MD," to provide context and best practices about weight management, physical activity, and our health.

One out of eight women will be diagnosed with breast cancer at some point during their life. However, there are things you can do to lower your risk. Dr. Onger mentions that some risks cannot be controlled or reduced (like genetics, family history, or as we age, our risk for breast cancer goes up). However, she says, there are modifiable risk factors or things that we can each do to reduce our risk - some of those modifiable risk factors include being at a higher weight, physical inactivity, and alcohol use.


Another vital point Dr. Onger makes is that "In particular for postmenopausal women, that being at a higher weight category - we call this either overweight or having obesity - can increase your risk for breast cancer. Part of it has to do with the fact that you're carrying more fat within the body, and that can affect the hormones that are circulating throughout your body. But we also know that physical inactivity can contribute to not only a higher weight but can also independently increase your risk for breast cancer. She recommends physical activity recommendations of 30 minutes a day of physical activity, five days a week. She says, "So if you're walking with friends, you should be a little breathless as you're having the conversation. So not so slow that you could sing, but not so fast that you're not able to have a conversation at all." Overall, maintaining a healthy weight is not just about appearance but overall health.


BMI – What Is It?


You may have heard a lot about Body Mass Index (BMI) – generally defined as a numerical value based on your overall height and weight. However, due to significant limitations associated with the widespread use of BMI in clinical settings, in June 2023, the American Medical Association suggested that "[BMI] be used in conjunction with other valid measures of risk. Body shape and composition differences across race/ethnic groups, sexes, genders, and age spans should also be considered when using BMI as a health measure.


Given this, the IAWH snippet of a 2020 video discusses BMI and its importance to cancer risk. It is referenced in the more widely used context before the June 2023 suggestion provided by the AMA. Overall, some physicians find it helpful to measure body fat using BMI as one factor for diagnosing obesity. Still, it can also provide an incomplete health picture - as always, ask questions and get answers.



Six Healthy Habits to Support Your Healthy Lifestyle Goals


Cancer cells are opportunistic invaders, so they thrive in a body out of balance. Weight gain, especially if it leads to obesity, disrupts your body's equilibrium, and is linked to numerous health issues, including diabetes, hypertension, and cancer. According to the American Society of Clinical Oncology's (ACOG) Cancer.net, losing as little as 5% to 10% of your body weight can reduce your cancer risk. It may seem small, but research shows it can improve your health. Healthy habits form the foundation of a strong body and mind. Here are some practical tips to consider if you're trying to adjust your lifestyle:


Eat More Fruits and Vegetables: Aim for at least five servings daily. Fruits and veggies are packed with nutrients and antioxidants that boost your health. The Cleveland Clinic provides excellent advice and finds that following a plant-based diet has significant health benefits if done correctly.

Regular Exercise: Incorporate physical activity into your daily routine. It doesn't have to be intense; even a brisk walk makes a difference.


Limit Alcohol Intake: One drink per day is a reasonable limit.


Quit Smoking: If you smoke, make every effort to quit. It may take several attempts, but persistence pays off.

Set goals to help build strength and make you more healthful in years to come.

Get good sleep: Disruptions in the body's "biological clock," which controls sleep and thousands of other functions, may raise the odds of breast, colon, ovaries, and prostate cancers. Exposure to light while working overnight shifts for several years may reduce melatonin levels, encouraging cancer to grow. (Johns Hopkins Medicine)


Body Awareness and Self-Care: "Tracking" Your Health


Oncology Nurse Navigator Debra Rundles recommends keeping a notebook (or journaling) to track our well-being, including our menstrual cycle, medications, and any health-related questions – she emphasizes starting the young women in our life with this form of journaling as early as possible. Hence, they become accustomed to being aware of their health and body changes. Keep notes of crucial preventive appointments, including mammograms, which are necessary for early detection, and be mindful of your hormonal cycle, as breast tenderness affects mammogram discomfort – we know - you get it and that electronic calendars can also support our tracking efforts, but jotting it down in one place is often helpful for quick and easy reference.


Encourage your loved ones to be your accountability partners. They can help monitor your health, just as you would for them. Contrary to some advice, self-breast exams are helpful. Don't hesitate to speak up if you notice any changes in your breasts.


Journaling, or writing down your thoughts and feelings at any age helps to bring clarity to daily situations, and you gain control of your emotions and improve your mental health – a method for releasing anxiety, pouring into yourself with personal affirmations, and can help you gain control of your feelings and improve your mental health.


Nurturing your well-being involves body awareness, maintaining a healthy weight, and adopting positive lifestyle habits. Breast health isn't just about mammograms; it's about understanding your body and taking proactive steps toward a healthier, happier life. Start today, and your future self will thank you.



Resources










Cancer is a complex disease affecting various body parts, and understanding its different forms is crucial for effective treatment. In this blog, we delve into metastatic and triple-negative breast cancer concepts. This blog and short videos pulled from the IAWH-hosted webinar, “Breast Health, By Any Means Necessary,” with Dr. Geoffrey Ray, Radiation Oncology Specialist and Oncology Nurse Navigator Debra Rundles, are also included. View the entire webinar here.

What Does it Mean for Cancer to be Metastatic?

Cancer often begins in a specific organ or tissue, referred to as its "origin." For example, breast cancer typically starts in the breast tissue. However, when cancer cells break away from their primary site and travel to other body parts, it becomes metastatic cancer.

Metastatic cancer is especially concerning because it means the disease has spread to distant locations, making treatment more complex. Common sites where cancer cells metastasize include the bones and the brain, although metastasis can occur in different organs.

The process of metastasis involves cancer cells infiltrating the bloodstream or lymphatic system, allowing them to reach different areas of the body. Once cancer has metastasized, it requires a more aggressive treatment approach, often involving systemic therapies like chemotherapy.


The Unique Challenge of Triple Negative Breast Cancer

Breast cancer is a heterogeneous disease with various subtypes with distinct characteristics. One such subtype is triple-negative breast cancer (TNBC). To understand TNBC, we must first understand the role of hormone receptors. According to the American Cancer Society, triple-negative breast cancer (TNBC) accounts for 10-15% of all breast cancers. The term triple-negative breast cancer refers to the fact that the cancer cells don't have estrogen or progesterone receptors (ER or PR) and don't make any or too much of the protein called HER2. (The cells test "negative" on all three tests.) These cancers are more common in Black women younger than 40 (pre-menopausal) or those with a BRCA1 mutation. TNBC differs from other types of invasive breast cancer in that it tends to grow and spread faster, has fewer treatment options, and has a worse prognosis (outlook).

"BRCA" is an abbreviation for "BReast CAncer gene." BRCA1 and BRCA2 are two genes that impact a person's chances of developing breast cancer. Tests like BRCA1 and BRCA2 genetic testing identify mutations in genes associated with a higher risk of breast and ovarian cancers. However, understanding genetic testing and ensuring the accuracy of these tests is crucial.

Even small TNBC tumors are considered high risk due to their aggressive nature, emphasizing the importance of early detection and prompt treatment. Dr. Geoff and Nurse Debra advise that early precautions and testing should be prioritized, especially in families with a TNBC or metastatic cancer history.


Johns Hopkins Medicine states in their discussion about triple-negative breast cancer that “Surgery for triple-negative breast cancer does not always have to be a mastectomy. Effective chemotherapy done first opens up the possibility of less-invasive surgical options that are less of an ordeal for the patient. If the tumor is small enough after chemo, outpatient procedures or a lumpectomy may be possible.” The American Cancer Society provides treatment information for each triple-negative breast cancer stage that includes mastectomy as one of several interventions, which Dr. Geoff and Nurse Debra discusses in the video below.




Visit these links to help define symptoms and treatments of Metastatic and triple-negative breast cancer – each highlights the complexity of cancer, which is why understanding their intricacies is crucial for effective diagnosis and treatment. Research continues to advance in these areas, offering hope for improved therapies and outcomes for those facing these challenging diagnoses.

Resources



Breast cancer treatment often involves a combination of therapies tailored to specific circumstances. Two critical aspects of breast cancer care are radiation therapy indications and genetic testing accuracy. This blog and short videos pulled from the IAWH-hosted webinar, “Breast Health, By Any Means Necessary,” with Dr. Geoffrey Ray, Radiation Oncology Specialist and Oncology Nurse Navigator Debra Rundles, are also included. View the entire webinar here.

Radiation Therapy Indication in Breast Cancer

Radiation therapy plays a vital role in the treatment of breast cancer, and the decision to recommend radiation therapy depends on various factors:

● Type and stage of breast cancer,

● Tumor size,

● Lymph node involvement, and

● Other individual patient characteristics.

Breast-conserving Surgery (Lumpectomy)

A radiation oncologist may recommend radiation therapy if a woman undergoes breast-conserving surgery to remove the tumor (lumpectomy), which is an effort to ensure any remaining cancer cells in the breast are destroyed, reducing the risk of local recurrence. This surgical procedure preserves as much of the breast tissue as possible.

Mastectomy

In some cases, radiation therapy is still indicated after a mastectomy if there is a high risk of cancer returning. This decision depends on factors such as tumor size, lymph node involvement, and adverse features in the pathology report. Your doctor may suggest you have radiation therapy because you have cancer cells in the armpit (axilla) lymph nodes, cancer cells are seen close to the removed breast tissue, or the cancer is large (Cancer Research UK).

Lumpectomy and Mastectomy follow different procedures and yield different results. While every breast cancer patient can undergo a mastectomy, not every patient is eligible for a lumpectomy. During lumpectomies, an axillary lymph node dissection or a sentinel lymph node biopsy may be carried out to check if the cancer has spread to nearby lymph nodes. If the cancer has spread to nearby lymph nodes, radiation therapy targets the breast and the lymph node areas to eradicate residual cancer cells.



Reconstruction

According to the National Breast Cancer Foundation (NBCF), "If you think you will opt for a breast reconstruction, you should speak with your medical team before you have the lumpectomy or mastectomy, even if you plan to wait until later to have your breast reconstruction. More in-depth and well-researched information on this subject is found here. "Whether you undergo breast reconstruction, wear a prosthetic breast, or choose to embrace the changes you have experienced by allowing the breast removal to remain obvious, you should feel free to make whatever decision is right for you. The goal is to prevent the discomfort of unwanted change while enabling you to accept what has occurred and continue with your life." (NBCF, 2023)

Genetic Testing Accuracy in Breast Cancer

Genetic testing has revolutionized breast cancer care by providing valuable insights into an individual's risk of developing the disease. Tests like BRCA1 and BRCA2 genetic testing identify mutations in genes associated with a higher risk of breast and ovarian cancers. However, understanding genetic testing and ensuring the accuracy of these tests is crucial. "BRCA" is an abbreviation for "BReast CAncer gene." BRCA1 and BRCA2 are two different genes that have been found to impact a person's chances of developing breast cancer.

Genetic testing for breast cancer susceptibility has become highly reliable with advanced laboratory techniques and stringent quality control measures. According to cancer care Dr. Geoff Ray, Radiation Oncology Specialist, and Oncology Nurse Navigator Debra Rundles, the key is to choose a reputable testing laboratory and work with a qualified genetic counselor who will interpret your results accurately.

Accurate genetic testing influences treatment decisions. For example, a positive BRCA mutation prompts women to consider preventive measures like risk-reducing surgeries or more frequent breast cancer screenings.



Familial Implications

Genetic testing results also have implications for family members, and sometimes, genetic experts may suggest relatives undergo testing to assess their cancer risk, i.e., if a mutation is identified, which may raise the chance of being susceptible in the future. Radiation therapy indication and genetic testing accuracy are pivotal components of breast cancer management. An individualized treatment plan that considers the unique characteristics of the cancer and the patient's genetic profile guarantees effective treatment and improved outcomes.

Resources


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