1) A lot of people talk about preventing breast cancer, but the correct term is risk reduction.
"We don't really know how to prevent breast cancer. We know how to reduce people's risks," said Judith Swasey, a nurse practitioner at the University of North Carolina-Chapel Hill's cancer hospital. The basics: Don't smoke, exercise a lot, watch your diet, annual screenings.
2) There has been lots of controversy in recent years over the usefulness of annual mammograms for some women. Some researchers suggest they aren't needed until women reach 50 and that it's OK for women not at high risk to have scans every other year.
But the American Cancer Society and many breast cancer centers continue to recommend annual mammograms starting at 40. The cancer society also recommends clinical breast exams by physicians annually, beginning at the same age as mammograms.
For those at high risk for breast cancer because of family history, annual screening should begin before age 40. For example, if you have a sister who developed breast cancer at 45, the recommendation is to start mammograms at 35.
Monthly self-exams also have been the subject of debate, but the cancer society recommends them for women starting in their 20s.
Mammograms are controversial partly because they produce both benefit and harm. Awareness and screening have led to more early detection. But critics say that some patients have been harmed by unneeded surgery, radiation and chemotherapy for small cancers that wouldn't have been found without mammography and wouldn't have caused problems.
3) Post-menopause weight gain is particularly dangerous when it comes to breast cancer risk. With extra body fat comes more estrogen, which can stimulate breast cancer growth. A normal body mass index is less than 30.
To calculate BMI, multiply your height in inches by that same number; divide that total into your weight in pounds; then multiply the total by 703. A person who is 5-feet-5 (65 inches) and weighs 150 pounds has a body mass index of 25. (Or Google "BMI calculator" for an online tool.)
4) Many studies have looked for a link between diet and breast cancer risk, but results are conflicting.
Experts say it's good advice to eat a diet high in fruits, vegetables and whole grains, and low in fat and red meat. "That's what I tell my patients," Swasey said. "Whatever diet is heart-healthy is probably the best one to follow."
5) Evidence is growing that regular exercise lowers the risk of breast cancer. "It doesn't have to be high-intensity exercise," said Rachel Burns, dietitian with Levine Cancer Institute at Carolinas Medical Center. "It can be as easy as just walking, being physically active 30 minutes a day."
6) Avoid soy supplements, Burns said. Soy contains isoflavones, which can act like estrogen and stimulate the growth of certain types of breast cancer. Supplements usually contain more concentrated doses of isoflavones than whole forms of soy, such as soy milk, tofu or edamame, Burns said. "Three servings a day of those (whole) forms are OK."
7) Smoking hasn't been linked specifically to breast cancer risk, but a recent study of women at high risk for breast cancer found that, for those who smoked, the more they smoked and the longer they smoked, the more their risk increased, Swasey said.
8) MRI scans are not recommended as regular screening tools for the general population. But they are used, in addition to mammography, for screening high-risk patients and for diagnosis after mammograms that detect suspicious masses.
9) Women with dense breasts are at higher risk for breast cancer, and mammograms aren't as effective in detecting cancer in very dense breasts. Ask your doctor whether you have dense breasts and, if so, you might benefit from regular MRI scans or ultrasounds along with mammography.
10) Breast cancer risk goes up with age. The often-repeated statistic that "1 in 8" women will get breast cancer is calculated over a lifetime to age 95. The National Cancer Institute has created a Breast Cancer Risk Assessment Tool. Take the test at: www.cancer.gov/bcrisktool.
Karen Garloch, McClatchy Newspapers
Breast cancer gets a lot of attention, but heart disease is the No. 1 killer of women. One in three U.S. women die of heart disease compared with 1 in 30 who die of breast cancer, according to the American Heart Association.
Other gynecological cancers are harder to detect and treat. For example, 70 percent of women with ovarian cancer are diagnosed in the late stage of the disease, when it's difficult to treat.
"There are 80,000 women who contract a gynecological cancer other than breast cancer annually," said Dr. James Hall, a gynecological oncologist with the Levine Cancer Institute in Charlotte.
"I celebrate the fact that (breast cancer survivors) have done a wonderful job of educating the population and getting increased awareness. I just hope we can replicate that success."
Recently, we asked readers to share with us stories about how breast cancer has touched their
lives. Here is what two women from the Lowcountry had to say:
Read all the stories at Breast Cancer Stories
Anita Ward, 24, Charlotte
Ward found a lump in her breast in November 2010. Because she was under the age recommended for annual mammograms, her insurance would not pay for one. Her physician referred her for an ultrasound. That was followed by a biopsy, which showed she had breast cancer. She had a double mastectomy, partly to prevent future cancer, and reconstructive surgery, followed by chemotherapy.
Her advice: "Listen to your body. If you feel a lump, do everything you can to make sure that you know it's not cancer."
If you can't afford a mammogram, she suggested finding a free one.
Mary Paulette Williams, 45, Charlotte
Williams began having mammograms when she was 40. Her 2009 scan was negative, but she developed pain in her right breast months later. A scan detected no problems. In September 2010, she found a lump. A biopsy confirmed cancer. She had a lumpectomy and is undergoing chemotherapy, to be followed by radiation. Her advice: "Self-examination. ... Just get in the habit of checking every month."
Ann Decker, 64, Hickory, N.C.
She was diagnosed with cancer in March 2010 after she noticed bleeding from her left breast. After a lumpectomy, Decker had an MRI scan that detected cancer in her right breast. Instead of having a second lumpectomy, she chose to have a double mastectomy with breast reconstruction.
Her advice: Don't assume results of a biopsy will be benign. Take someone to hear the news with you. Ask for a breast health navigator. "Don't try to get in there and do it by yourself. You have to have people telling you what you need to do."
Tammie Lesesne, 65, Charlotte
Lesesne avoided breast cancer by choosing to have a double mastectomy in 1998, followed by reconstruction, to prevent the disease. Tests showed her breast tissue already had precancerous cells.
She had a family history: Her sister, mother, grandmother and a cousin had breast cancer. Her advice: "Trust your own instincts and do your research. ... (After reading a Mayo Clinic study), my question shifted from, 'Should I have the surgery?' to, 'Why would I not have the surgery?'
"Take the process one step at a time. Look at pictures of reconstruction and see how natural they can look."