Breast self-exam guidelinesIn addition to scheduling clinical screenings and

mammograms, women should routinely examine and massage their breasts to detect any abnormali-ties. These breast self-exams can be an important part of early breast cancer detection.

Although many women are aware that they should become familiar with their bodies, many are un-sure about just how frequently they should conduct breast examinations. Experts at Johns Hopkins Medical center advise adult women of all ages to perform self-examinations at least once a month. That’s because 40 percent of diagnosed breast can-cers are first detected by women who feel a lump. Establishing a regular breast self-exam schedule is very important.

Begin by looking at the breasts in a mirror. Note the size and appearance of the breasts, and pay attention to any changes that are normal parts of hormonal changes associated with menstruation. Breasts should be evenly shaped without distortion or swelling.

Changes that should cause concern include dim-

pling, puckering or bulging of the skin. Inverted nipples or nipples that have changed position, as well as any rash or redness, should be noted. In addition, the same exami-nation should be done with arms raised over the head.

The breasts should be felt while both lying down and standing up. Use the right hand to manipulate the left breast and vice versa. Use a firm touch with the first few fingers of the hand. Cover the en-tire breast in circular motions. The pattern taken doesn’t matter so long as it covers the entire breast. All tissue, from the front to the back of the breast, should be felt.

The same pattern and procedure should be con-ducted while standing up. Many women find this easiest to do while in the shower.

It is important not to panic if something is de-tected. Not every lump is breast cancer. And bumps may actually be normal parts of the breast, as cer-

tain areas can feel different than others. But bring any concerns to the attention of your doctor.

Breast self-exams are a healthy habit to adopt. When used in conjunction with regular medical care and mammography, self-exams can be yet an-other tool in helping to detect breast abnormalities. Doctors and nurses will use similar breast examina-tion techniques during routine examinations.

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The pink ribbon has been syn-

onymous with breast

cancer for years. Nowadays, people rarely think twice when they see pink ribbons, having grown accustomed to the pink ribbon and what it symbolizes. Breast Cancer Awareness Month has been celebrated each year since 1985, and many other breast cancer aware-ness initiatives have been devised since then. While the pink ribbon may seem like it’s been in use for just as long, it was actually established only about 20 years ago.Ribbons have long symbolized some-thing important. For decades, yel-low ribbons have been used to alert others to soldiers at war or hostages

that hadn’t yet come home. People often tie yellow ribbons around trees at home until their service men and women came home safely. During the height of HIV/AIDS activism and awareness, red ribbons were worn to symbolize support for those with the disease.Although the pink ribbon evolved be-cause pink expresses femininity, calm, health, and youth, the first breast can-cer ribbon was actually peach. Char-lotte Haley is credited with devising the first breast cancer ribbon in 1992. She was a breast cancer survivor and came from a family of women who also fought the disease. She created peach-colored loops at home and then distributed the ribbons at her local grocery stores. Haley encour-aged people to wear the ribbons and contact legislators to demand more

funding for breast cancer research. An attached note was distributed with the ribbons stating, “The National Cancer Institute annual budget is $1.8 billion, only 5 percent goes for can-cer prevention. Help us wake up our legislators and America by wearing this ribbon.”The same year Evelyn Lauder, senior corporate vice president for the Estee Lauder company, and Self magazine editor Alexandra Penney teamed up to produce a pink ribbon. It was distrib-uted at makeup counters all across the country. The company collected more than 200,000 pink ribbon peti-tions asking the U.S. government for increased funding for breast cancer research.Although Lauder and Haley reached people on different levels, their goals were the same: To educate the public

on the lack of funds allotted to breast cancer research.Pink ribbons are now seen all over and have become the uniting force for millions of women who are facing breast cancer or supporting someone with the disease. In 1996, Nancy Nick created a blue-and-pink ribbon to symbolize male breast cancer ribbons in honor of her late father. The rib-bons remind others that breast cancer can affect men as well as women.Although you can see waves of pink every October for Breast Cancer Awareness Month, many people don their ribbons year-round. Great strides have been made with respect to breast cancer, but with about 225,000 new cases popping up each year in the United States alone, there is still work to be done.

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2 — The Bradford (Pa.) Era, October 20, 2015, Breast Cancer Awareness

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Mammography remains one of the most popular and well-known diag-nostic tools for breast cancer. It is es-timated that 48 million mammograms are performed each year in the United States and many others are conducted all around the world under the rec-ommended guidance of doctors and cancer experts.Mammography can be traced back more than 100 years to 1913, when German surgeon Albert Salomon attempted to visualize cancer of the breast through radiography. By the 1930s, the concept of mammography was gaining traction in the United States. Stafford L. Warren, an Ameri-can physician and radiologist, began his own work on mammography, developing techniques of produc-ing stereoscopic images of the breast with X-rays. He also championed the importance of comparing both breast images side-by-side.Raul Leborgne, a radiologist from Uruguay, conducted his own work on mammography and, in 1949, intro-duced the compression technique, which remains in use today. By com-pressing the breast, it is possible to get better imaging through the breast and use a lower dose of radiation.

Also, compression helps spread the structures of the breast apart to make it easier to see the individual internal components. Compression helps to pull the breast away from the chest wall and also to immobilize the breast for imaging.Advancements in mammogram tech-nology continued to improve through the 1950s and 1960s. Texas radiologist Robert Egan introduced a new tech-nique with a fine-grain intensifying screen and improved film to produce clearer images. In 1969, the first mod-ern-day film mammogram was invent-ed and put into widespread use. The mammogram process was fine-tuned in 1972 when a high-definition intensi-fying screen produced sharper images and new film offered rapid processing and shorter exposure to radiation. By 1976, the American Cancer Society began recommending mammography as a screening tool. Through the years, mammography became a great help to women looking to arm themselves against breast can-cer. Thanks to improvements in early detection and treatment, breast cancer deaths are down from their peak and survival rates continue to climb.

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The moment a person receives a breast cancer diagnosis, his or her life changes immeasurably. The roller coaster of emotions begins, and suddenly this person is thrust into a schedule of doctor’s appointments, treatments and visits from friends and family.

The World Cancer Research Fund International says breast cancer is the second most common cancer in women and men and is the most frequently diagnosed cancer among women in 140 of 184 countries worldwide. Despite that prevalence, the five-year relative survival rate for women diagnosed with localized breast cancer (cancer that has not spread to the lymph nodes or outside the breast) is 98.5 percent, says the American Cancer Society. Survival odds increase as more is learned about breast cancer and more people take preventative measures, includ-ing routine screenings. Today, there are nearly three million breast cancer survivors living in the United States.

Breast cancer treatments may last anywhere from six months to a year.

Adjusting after treatment may not come so easily at first. But adjust-ments are easier with time, and many cancer survivors continue to live life to the fullest in much the same way they did prior to their diagnosis.

When treatment ends, patients often still have fears about the cancer, won-dering if all of the cancerous cells have been destroyed and worrying about recurrence. But focusing on the present and all of the things you now can do with health on your side is a

great way to put your fears behind you.

Many cancer survivors must still visit their doctors after treatments end. Doctors still want to monitor patients closely, so be sure to go to all

follow-up appointments and discuss any symptoms or feelings you may be having. Side effects may continue long after radiation or chemotherapy has ended. Your doctor may have suggestions for coping with certain side effects or will be able to pre-

scribe medications to offset these ef-fects. Follow-up appointments should gradually decrease the longer you have been cancer-free.

It’s not uncommon to feel differ-ently after cancer treatment, as your body has been through quite a lot. Many women still experience fatigue, and sleep or normal rest doesn’t seem to make it abate. Realize this is nor-mal, and how long it will last differs from person to person. It can take months or years for you to experi-ence your “new normal.” Things do not happen overnight. While your hair may grow back quickly, it may take some time for you to feel like yourself again. Exercise routines or other lifestyle changes may help you overcome fatigue or make it more manageable.

Speaking with others who have survived breast cancer can help. Join a support group or reach out to others through social media. Getting a first-hand account of what can be expected the first year after treatment can assuage anxiety.

The Bradford (Pa.) Era, October 20, 2015, Breast Cancer Awareness — 3

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Breast cancer is the second most common cancer among women, second only to lung cancer. One in eight women is expected to develop breast cancer in her lifetime, and a recent survey by the Society for Women’s Health Research found that 22 percent of women named breast cancer as the dis-ease they fear most. The specter of breast cancer makes it no surprise that women are eager to seek various ways to reduce their risks of developing this potentially deadly disease.

Though cancer treatments continue to evolve, there remains no cure for breast can-cer or any other types of cancer. However, there are steps men and women can take to reduce their risks of developing breast cancer. In fact, the National Cancer Institute says avoiding breast cancer risk factors is the best path to prevention.

• Avoid exposure to radiation. Repeated exposure to radiation therapy used to treat illness-es like Hodgkin’s disease can increase a person’s risk of breast

cancer, particularly if treatments begin at an early age.

• Keep a healthy weight. Obesity increases the risk of breast cancer, particularly in postmenopausal women. Healthy eating and exercise can help women control their weight while reducing their risks of developing breast can-cer and a number of other dis-eases. Scientists at The Mayo Clinic believe there is a link between estrogen production in fatty breast tissue and breast cancer.

• Get your exercise. Exercising four or more hours a week can lower breast cancer risk. Exercise need not be heavy lift-ing at the gym. Any moderate physical activity, from cycling to walking, can be effective. Exercise decreases hormone levels in the body that can impact breast cancer risk. Some studies indicate simply walking briskly for one to three hours per week can reduce a woman’s breast cancer risk by 18 percent.

• Eat a low-fat diet. The Women’s Intervention Nutrition

Study from the National C a n c e r Institute found that the high-est rate of breast cancer reduction was among a group of women who

ate a low-fat diet.• Reduce alco-

hol consumption. Various studies have indicated that women who drink alcoholic beverages may develop can-cer at a higher rate. Women who con-sume two to five drinks daily have a greater risk of devel-oping breast can-cer than those who abstain from alcohol.

• Weigh the risks of hormone replace-ment therapy. There are mixed reviews on hormone replacement therapy, or HRT, for postmeno-pausal women. There may be a link between long-term HRT and breast cancer, particularly when estrogen and progesterone are used in combination. Some doctors advise estrogen-only hormone therapy for women who have had a hysterectomy.

• Use of SERMs and aroma-tase inhibitors. Selective estro-

gen receptor modulators, or

SERMs, are drugs that act like estrogen on some bodily tissues but block the effect of estro-gen on other tissues. Aromatase inhibitors decrease the amount of estrogen made by the body. Women with a high risk of breast cancer may benefit from taking a SERM or aromatase inhibitor.

• Increase fruit and vegetable

consumption. Carotenoids are cancer-protective pigments found in a vast number of fruits and vegetables. Researchers at New York University found women who had higher blood carotenoid levels had a sig-nificantly smaller risk of breast cancer than women with lower levels.

• Go sparingly on antibi-otics. Only take antibiotics when they are truly need-ed. New evidence sug-gests that the more often a woman takes antibiotics, the higher her breast can-cer risk. A study of more than 10,000 women found that women who took anti-biotics for the equivalent of about 25 prescriptions over an average of 17 years where twice as likely to develop breast cancer than women who never took the

drugs.• Breastfeed your children.

Lactation can suppress ovula-tion and the body’s production of estrogen, which has been linked to higher levels of breast cancer. Breastfeeding may drop a woman’s breast cancer risk by 4 percent.

Although there is no cure for cancer, there are a number of different ways women can reduce their risks for breast cancer.

Easy steps to help lower your risk of

breast cancer

Regular exercise can help women lower their risk of developing breast cancer.

People around the world were shocked to learn that actress and activist Angelina Jolie opted to have a double mastectomy in 2013 to reduce her risk of breast cancer. Jolie, who was 37 years old at the time of the procedure,

reportedly learned that she carries a mutation of the BRCA1 gene, which sharply increases her risk of developing breast cancer and ovar-ian cancer. In addition, the actress has a fam-ily history of cancer. Her mother, Marcheline Bertrand, died of ovarian cancer in 2007 at the age of 56.

By having a preventive mastectomy, Jolie reduced her breast cancer risk from 87 per-cent to 5 percent, according to an op-ed piece she authored in The New York Times. Jolie is not the only well-known actress to opt for a preventive mastectomy, as fellow thespian Christina Applegate had a similar procedure in 2008 after learning she had a mutation of the BRCA1 gene. These highly publicized cases have left many women wondering if a pre-ventive mastectomy is something they should consider.

BRCA stands for “breast cancer susceptibil-ity genes,” a class of genes known as tumor suppressors, says the National Cancer Institute. Mutations in these genes have been linked to

hereditary breast and ovarian cancer. A per-son’s risk of developing breast and/or ovarian cancer is greatly increased if he or she inherits a harmful mutation in BRCA1 or BRCA2. Mutations in these genes could also put a per-son at increased risk for other cancers.

Genetic tests can check for mutations in BRCAgenes. During such a test, a blood sam-ple is taken, and if a mutation is found, a person may get genetic counseling and work with a doctor to develop a plan of action. It is impor-tant to note that not all people with a genetic mutation will get breast cancer or ovarian cancer. The National Cancer Institute’s “SEER Cancer Statistic Review” states a woman who has inherited a harmful mutation in BRCA1 or BRCA2 is about five times more likely to develop breast cancer than a woman who does not have such a mutation.

Although there is no surefire way to deter-mine if a person with a mutated gene will develop breast cancer, many women who are considered high risk opt for a preventive mas-

tectomy to reduce their risk. Women who have a family history of breast cancer, have received positive results from gene testing, have already had cancer in one breast, or have dense breasts that make testing difficult may want to get a preventive mastectomy.

The decision to get a preventive mastec-tomy is not one to take lightly. Many breast centers are staffed with breast-health special-ists, genetic counselors, breast surgeons, and reconstructive surgeons who can help patients make the best decision. Second opinions are strongly recommended for women considering a preventive mastectomy.

Women should understand the options avail-able to them if they have an extremely elevated risk of breast cancer or ovarian cancer.

Preventive Mastectomy to Avoid Breast Cancer

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4 — The Bradford (Pa.) Era, October 20, 2015, Breast Cancer Awareness

Many abnormalities found on a mammogram are not necessar-ily cancer, but rather are benign conditions like calcium de-posits or dense areas in the breast. If the radiologist or a doctor notes areas of concern on a mammo-gram, The Mayo Clinic says further testing may be needed. This can in-clude additional mammo-grams known as compression

or magnification views, as well as ultrasound imaging. If further imaging is not effective, a biopsy,

wherein a sample of breast tis-sue is taken, will be sent to

a laboratory for testing. In some instances an MRI may be taken when mam-mography or ultrasound results are negative and it

is still not clear what’s caus-ing a breast change or abnor-

mality.

Did you know?Did you know?

At the age of 12 to 15, many young women are experiencing the body and life changes that accom-pany adolescence. It can be difficult to imagine that breasts that are just begin-ning to develop may contain cancer. But such is the reality for some girls.

The majority of women who receive a breast cancer diagnosis are over the age of 40. Experts at Monroe Carell Jr. Hospital at Vanderbilt University note that only 5 percent of breast cancer cases are found in women under the age of 40. However, the hospital recently treated a 14-year-old girl who found a lump and learned she had a rare form of breast cancer called a phyllodes tumor. In 2009, a 13-year-old from Little Rock, Ark. found a quarter-sized lump in her right breast, while a 19-year-old student at the College of New Jersey was diagnosed with cancerous cells and underwent a bilateral mastectomy.

Though such cases are rare, it behooves teenage and adolescent girls to familiarize themselves with the disease and be mindful of their breast health.

Some organizations have increased breast cancer messages for young girls, and it is not uncommon

to find young women participating in runs and fundraisers for breast cancer research. Some orga-nizations even conduct breast cancer workshops to educate young women about

breast health. Dorothy Paterson of Texas, a former Girl Scout leader who was diagnosed with breast

cancer herself, began conducting work-shops for Girl Scouts in 2007. The idea isn’t to scare girls into believing they have the disease, but rather to increase their awareness of changes in their bod-ies that may or may not be normal.

Some parents worry that educating children about breast cancer may cause them to worry unnecessarily, especially considering a young girl’s risk of de-veloping breast cancer is so minimal. However, others see the importance in schooling girls early on about a disease that is so common. Advocates of teach-ing young girls about breast cancer often note that any effort to help save lives and promote health is worthwhile.

Just as with older women, adolescents and teens should realize that eating

healthy foods, exercising, avoiding alcohol and to-bacco, and maintaining annual physical exams with a doctor are key ways to reduce the risk for cancer.

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The Bradford (Pa.) Era, October 20, 2015, Breast Cancer Awareness — 5

Fighting Cancer With FoodFew, if any, families can say they have never had an experience with cancer. Cancer is

a potentially deadly disease with no cure. While cancer can be treated effectively, there is no way for men and women to eliminate their risk of developing cancer.

Though cancer may strike even the healthiest of persons, there are ways men, women and even children can reduce their risk. One such way is to consume certain foods that researchers feel can reduce cancer risk. Though precisely how these foods fight cancer remains a mystery, cancer researchers feel they can effectively lower an individual’s cancer risk when combined to form a healthy diet.

* Beans: Beans boast numer-ous healthy attributes, and their poten-tial to reduce cancer risk is one such attribute. Beans contain many phyto-chemicals that researchers feel protect the cells from the type of damage that can ultimately make a person suscep-tible to cancer. Beans also have been shown to decelerate tumor growth and prevent tumors from releasing poten-tially harmful substances that can dam-age nearby cells.

* Colorful fruits and vegetables: It may seem

odd that a food’s color can have an impact on cancer risk, but colorful fruits and vegetables contain more cancer-fighting nutrients than fruits and vegetables that aren’t as flashy.Consuming such fruits and vegetables also helps men and women maintain a healthy body weight, an important benefit when considering overweight and obesity increases a person’s risk for multiple cancers.

* Grapes: Studies have shown that resveratrol, a key ingredi-ent in grapes, may prevent the type of damage that triggers the production of cancerous cells. Though scientists are not yet comfortable saying grapes, or beverages like grape juice and wine, can reduce cancer risk, they believe that the antioxidant and anti-inflammatory prop-erties of grapes make them a healthy option. * Tomatoes: Tomatoes are

widely beloved, and perhaps that love affair stems from the tomato’s role in fighting can-cer. Though the reasons are unknown, toma-toes have been linked to lowering men’s risk for prostate cancer. One such study, a 1995 study from researchers at the Harvard Medical School, found that men who ate 10 or more servings of tomatoes per week reduced their risk of developing aggressive prostate tumors by nearly 50 percent. Later research from the author of the 1995 study found that processed tomatoes, such as those found in tomato paste and tomato sauce, were even more effective at reducing cancer risk than fresh tomatoes. Tomatoes have also been linked to lowering a person’s risk for lung and stomach cancers.

* Foods with folate: Folate is a B vitamin that can reduce a person’s risk of developing several cancers, including those of the colon, rectum and breast. Those who are fond of a healthy breakfast to begin their day may already be getting healthy doses of folate, which can be found in eggs, forti-fied breakfast cereals, orange juice, and strawberries, among other foods. If toast is your breakfast of choice, opt for whole wheat toast, as whole wheat products are a good source of folate.

6 — The Bradford (Pa.) Era, October 20, 2015, Breast Cancer Awareness