Women’s Cancer Q&A: Advances in Care
WebMD’s women's cancer expert, Harold J. Burstein, talks to WebMD's chief medical editor about treatment advances, research breakthroughs, and the prognosis for the future.
Women hear a lot about the benefits of a low-fat diet and exercise, and popular rumors advocate avoiding chemicals such as those in antiperspirants. What’s your take on breast cancer prevention strategies?
With some cancers, we do know what the major risk contributors are. For
instance, we know smoking is directly associated with lung cancer, bladder
cancer, head and neck cancer, cervical cancer, and pancreatic cancer.
But with breast cancer, we don’t have such clear risk factors; in fact, most
are fairly weak -- such as whether you had children or at what age you first
became pregnant, how much you weigh, and how much alcohol you drink. They
increase the risk of getting diagnosed with breast cancer only by a little bit.
For most women, we don’t really know why they develop breast cancer.
However, the one risk factor that’s different is heredity. It’s clear that
women who have a strong family history of breast or ovarian cancer have a
greater risk of developing breast cancer themselves.
And we know now that there are at least two specific genes associated with
both cancers: BRCA1 and BRCA2.
Common sense suggests that habits such as getting more cardiovascular
exercise and eating more fruits and vegetables are good for everyone’s overall
health. But it’s not clear that avoiding red meat, going on an all-vegetarian
diet, drinking red wine, eating soy or avoiding soy, or similar actions will
lower the chances of being diagnosed with breast cancer.
You mentioned genes earlier, and certainly BRCA1 and BRCA2 are in the news. Also, I see the occasional study looking at other genes that may or may not predispose women to breast cancer, or that may point to their getting a more aggressive type. Given this, should women seek out genetic testing or be more proactive in learning about their own genetic profile?
Not really, because breast cancer’s hereditary risk factors probably account
for only 5% to 10% of cases. However, genetic counseling may be useful for
women who do have several relatives who have had breast or ovarian cancer; or
women from families where breast cancer strikes at a very early age, typically
younger than 40; or women who have had breast and ovarian cancers -- these all
could signal a possible hereditary risk.