Can anything be done about the high risk of breast cancer?
“Unfortunately, the risk of breast cancer is largely dependent on things that you as a woman have no influence on, so reducing this risk is not so easy,” says breast cancer surgeon Iris van der Ploeg. “Often multiple risk factors play a role, making it usually impossible to say why someone has developed breast cancer.”
The risk of breast cancer, as with other cancers, depends on a number of factors. These factors differ from person to person. Lifestyle is an important point of attention: “Overweight, smoking and regular alcohol consumption are all risk factors. But the female hormones estrogen and progesterone also play an important role in the development of breast cancer. The risk of breast cancer increases the longer your breasts are exposed to these hormones.”
Therefore, the following women have an increased risk of breast cancer:
- Women who are fertile for a long time. Due to early puberty and late menopause, these women are exposed to estrogen and progesterone for a longer period of time.
- Women who have not been pregnant. When women are pregnant, the ovaries temporarily stop producing hormones, so women’s breasts are not exposed to them either.
- Women who do not breastfeed or breastfeed for a short period of time also have an increased risk of breast cancer. When women breastfeed, the ovaries produce fewer hormones.
- Women who have their first child after the age of 35 are also at increased risk. Pregnancies before the age of 35 actually lead to a greater risk reduction. The relative risk per child then decreases by 7 percent.
- Women who use hormone preparations around the menopause. It is important that the hormones are prescribed for the shortest possible time and in the lowest possible dose.
How often should you check your breasts?
According to Van der Ploeg, there is no fixed rule for this, but there are a number of tips that can help detect any irregularities. “I recommend checking your breasts no more than once a month because your breasts feel different almost every day. That is why it is also advisable to check your breasts at a fixed time. The best time for self-examination is one day after the last day of your period. The breasts are then the most supple, making it easier to feel irregularities. Through self-examination you become more aware of your body and you pick up on any changes faster. Unfortunately, you cannot influence the risk of developing breast cancer with it. It has also not been proven that self-discovered abnormalities have a better prognosis.”
But what are possible deviations? “A lump or dent, discoloration of the skin or fluid from the nipple are all possible abnormalities. The most common change is a lump or bulge. Such a lump does not hurt in most cases and feels like a hard spot.”
To what extent is breast cancer hereditary?
“A hereditary predisposition can be demonstrated in five to ten percent of women with breast cancer. For men, this percentage is around ten percent,” says Van der Ploeg. The genetic predisposition to breast cancer almost always comes from one of the parents. The two main genes that contribute to a high breast cancer risk are the BRCA1 and BRCA2 gene mutations. A son or daughter has a fifty percent chance of inheriting this from his or her parent.
“If you’ve inherited one of these two mutations, there’s a 60 to 80 percent chance you’ll get breast cancer. You also have an increased risk of ovarian cancer. In these cases, a preventive breast or ovary removal is often advised, but this is of course not an easy decision. It is important to consider the age of the woman when making this choice. Is the gene only discovered at the age of 60? Then the chance that it will develop into breast cancer is a lot less than if it is discovered at the age of 30.”
What options are there if you opt for breast reconstruction?
A breast reconstruction can very often be performed immediately, in some cases, depending on the breast cancer treatment or the wishes of the patient, this is done later, several months after the first operation.
Breast reconstruction can often be performed immediately after the mastectomy. In some cases this happens a few months after the first surgery, but it depends on the breast cancer treatment or the patient’s wishes. If you opt for breast reconstruction, you have several options: “In most cases we spare the nipple and skin. Although the nipple can also be tattooed on it later. The breast is filled with a silicone prosthesis. We do all that in one operation. When you wake up, you will have a newly formed breast. This is also the least invasive procedure.”
“Some women opt for breast reconstruction using their own material. The most common is the DIEP lap reconstruction. A new breast is then made with skin and fatty tissue from the abdomen. This procedure is a lot more intense than reconstruction with a silicone prosthesis and is also not possible for every woman. A body’s own reconstruction depends on your posture, because there must be sufficient tissue present. A plastic surgeon can give you good advice on this,” says Van der Ploeg.
Is the number of people dying from breast cancer increasing or decreasing?
In recent decades, the number of people dying from breast cancer has decreased by 30 percent. A strong decrease, but what is the cause? “It is a combination of several factors. We are detecting breast cancer earlier, but the most important thing is that we have made a huge improvement in the systematic therapies. Immune, chemotherapy and hormone therapy: we know better and better which combinations work for which type of breast cancer, so that we can really offer a tailor-made treatment.”
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Freelance journalist and author Marith Iedema writes about love, sex and relationships. Life smiles at her until she is told she has breast cancer. For VROUW she reports on what she is experiencing.
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