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Who Gets Breast Cancer and Who Survives?

Nearly Half of Women Don't Get Enough Chemo continued...

Beyond surgery and chemotherapy, any long-term treatment depends on tumor type. For instance, women with early-stage hormone-sensitive cancers often take an anti-estrogen drug like tamoxifen, which reduces chances of recurrence by about half. Drugs like Herceptin and Tykerb are used to treat HER2-positive breast cancers; both work to block the HER2 protein that triggers cancer cell growth. These and other treatments are more successful than ever, but many sufferers aren't reaping the full benefits: A whopping 70 percent of women who had mastectomies were never told that less dramatic surgery, such as lumpectomy, was an option, according to a study commissioned by the American Society of Clinical Oncology. And up to half of all breast cancer patients may have received chemotherapy doses that were lower than the recommended levels.

"To get the best, most up-to-date treatments, make sure that all of the physicians you are seeing are experienced in treating breast cancer, whether it's your surgeon, your oncologist, or the radiation oncologist," says Winer. An option: one of the 64 NCI-designated comprehensive cancer centers across the country — these facilities are often involved in clinical trials and treat large volumes of breast cancer patients. (Find a center near you at cancercenters.cancer.gov.)

verweight Women Are More Likely to Develop — and Die from — Breast Cancer

Very few of us can boast that we still fit into our high school prom dresses, but if you've gained more than 20 pounds since your 18th birthday, your risk of developing breast cancer is 40 percent higher compared with those who stay within 5 pounds of their teenage weight, research from the ACS shows. Excess pounds also lower your risk of survival: Breast cancer sufferers with a body mass index (BMI, a measure of body fat based on height and weight) of 25 to 29 are 34 percent more likely to die of breast cancer than those at a normal weight, according to a major review from the Hutchinson Center. And obese women (those with a BMI of 30 plus) are 63 percent less likely to survive.

"When you're obese, you have higher insulin levels, which promotes cancerous cell growth," explains review author Anne McTiernan, M.D., director of the Prevention Center at the Hutchinson Center. Another explanation for poor survival rates: Almost 40 percent of severely obese women get a significantly lower dose of chemo than they need, according to research at the University of Rochester. "The heavier you are, the more chemo you need to wipe out cancer — and some physicians are scared to give such massive doses to patients," says Griggs, who authored the study.

However, there is some reassuring news for those who are heavyset: Losing weight at any age can help cut breast cancer risk. Findings in the Journal of the American Medical Association reveal that postmenopausal women who lost 22 pounds were 57 percent less likely to develop the disease compared with those who maintained their weight.

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