Is it possible to protect yourself from breast cancer

Who is at risk and what to do if the diagnosis is made

Irina Reznik, MedNovosti

Breast cancer is the most common cancer among women. More than a million new cases are diagnosed annually in the world, 65 thousand of them in Russia. Today, this disease is moving from the category of fatal diseases to chronic and, subject to early detection, is cured in 95% of cases. The trouble is that, like many other malignant tumors, breast cancer in the initial stage is very difficult to detect. Is it possible to protect yourself from this disease, who is at risk, and what to do if you could not avoid the disease, on the eve of World Breast Cancer Day, experts of the charity program "Women's Health" told.

The main risk factors

There are two of them – female gender and age. With age, the risk of getting sick increases significantly, and the peak incidence occurs at 55-65 years. However, the insidiousness of the disease is that it can develop at almost any age. Men are no exception, they also have breast cancer, however, 100 times less often than women. Therefore, you should be vigilant and consult a doctor (gynecologist or oncologist-mammologist) for any changes in the mammary glands compared to their norm. Most likely, it will turn out that you are worried about some benign changes, and you don't need to do anything specifically about it. But it's better to be safe.

How to assess your personal risk?

From a young age, it is important to understand whether you belong to a high or medium risk group for breast cancer. The tactics of preventive examinations depend on this – those that are carried out to people who have no complaints and are apparently healthy in order to find asymptomatic cancer at the earliest stages. Find out if there have been cases of "female cancers" repeated from generation to generation in your family. The fact that oncological diseases manifested themselves at a young age, up to 50 years, should be especially alarming. People belonging to the high-risk group should find an oncologist whom they can trust and begin preventive examinations according to an individual program determined by them.

Can breast cancer be prevented?

Since the causes of breast cancer are not precisely established, there is not a single way that would absolutely help prevent it. However, adhering to a healthy lifestyle (regular physical activity, abstinence from alcohol and smoking, timely childbirth and breastfeeding) can reduce the risk of developing the disease. For women in the high-risk group, there are preventive medical and surgical methods, they are determined by a doctor.

How not to miss the disease?

Despite the recommendations often made, breast self-examination is not a method of early detection of breast cancer and does not affect the reduction of mortality. Nevertheless, it is useful to know how your mammary glands normally look in order to notice the changes in time.

With an average level of personal risk, when nothing bothers, and there are no changes in the mammary glands, there is no need for special examinations until the age of 40. It is enough just to be observed by a gynecologist. At the age of 40, you should ask your doctor about the need to undergo preventive mammography. The fact is that there can be both benefits and harm from any medical research – there is an error in the method, false positive and false negative results. Indisputable, according to modern recommendations based on epidemiological studies, is the recommendation of preventive (screening) mammography for women over 50 years old.

Ultrasound of the mammary glands is not used for screening studies on breast cancer. It is used only as an additional diagnostic method. Abuse of this method at a young age for women of the middle risk group leads to overdiagnosis and increases the risk of unjustified surgical interventions.

How is the diagnosis made?

Preventive examinations catch, first of all, "slow cancers" of the breast. And if cancer is detected immediately at an advanced stage, you don't always have to blame yourself or the doctors. It happens that the tumor develops rapidly. But this does not mean that it is not treatable. Today, breast cancer is well diagnosed, and almost all of its types (with some exceptions) can be treated quite successfully. The main thing is to clearly understand what you are dealing with. Treatment tactics and prognosis depend on the exact diagnosis. The fact is that breast cancer is not one, but a whole group of diseases, so it is very important to correctly type the tumor. This is done using histological, immunohistochemical and genetic analyses.

What should I do if I am diagnosed with breast cancer?

· don't panic

· find your doctor

· start traditional treatment without being distracted by non-traditional methods in the hope that they can save

· collect up-to-date information about the diagnosis, for example, on the website of the charity program "Women's Health" (www.женскоездоровье.рф ). There are a number of useful English-language sites, for example, nccn.org/patients .

· do not hesitate to ask questions to the doctor about what you have to do at each stage of treatment, how to prepare better, what alternatives are there. Prepare for a meeting with a doctor, formulate your questions in advance. Come to a doctor's appointment with someone close to you, because the patient is not always able to ask the right questions or hear the right important information from the doctor.

· do not hesitate to ask for a second opinion. This can be done at any stage of treatment, starting with diagnosis. Normal practice, it concerns your health.

· seek help and support from loved ones, do not try to go down this path alone. The forces will be needed to fight the disease and treatment, so support and real help will be very useful.

· sometimes you may need the help of a psychologist, psychotherapist or psychiatrist. There is nothing shameful or scary about it. Try to use everything that will help you save resources, including psychological ones.

· it can be useful to support people who have experience of living with breast cancer. The Women's Health program develops communities working on the principle of "equal to equal", which you can join, including online. In communities, you can get psychological and informational support from people with similar experiences.

· Keep in mind,  that there are methods of breast reconstruction after mastectomy (some of them are included in state guarantees), as well as various exoforms that restore the appearance and give a feeling of comfort.  Discuss with the surgeon the possibility of plastic surgery.

· breast cancer is treated well enough in Russia, so there is no point in being treated abroad. But if you still decide to go for treatment, then you need to carefully figure out where and why. The level of medical institutions and training of specialists in our country is very uneven, therefore it is better to be treated in large cities, in clinics providing specialized oncological care. And if there is an opportunity to get a quota for treatment at the federal cancer center, we need to take advantage of it.

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