Preventing Breast Cancer

November 17, 2006 10:44am CST
CANCER affects us all: we probably know of an aunt, a cousin, or a colleague who has fought breast cancer. But what are the factors that can put a Malaysian woman at risk of breast cancer? In the West, breast cancer affects one in seven women. In Malaysia, breast cancer is the most common cancer among Malaysian women. The National Cancer Registry in its latest report in 2003 stated that one in 28 Malay, one in 16 Chinese and one in 16 Indian women may develop breast cancer. In most women, breast cancers happen by chance. But for some families, there may be a faulty gene that increases the risk. So far, researchers have identified two genes, BRCA1 and BRCA2, which may contribute to breast cancer if mutated. Some 15 years’ worth of research on Caucasian populations in the West have allowed health experts to develop a set of guidelines to determine families who are most at risk of breast cancer due to alterations or mutation to their BRCA1 or BRCA2 gene. These guidelines are important in determining which individuals should obtain more frequent breast cancer checks, and what preventive measures can be taken to reduce their risks. While such research has been recognised as key in preventing breast cancer, much of the work is centred on Caucasian populations. In Malaysia, this process started four years ago. The Cancer Research Initiatives Foundation (CARIF) and Universiti Malaya, together with researchers at other local research universities, are currently screening these genes in Asian populations, in a bid to develop guidelines to identify Asian women with higher risk of getting breast cancer, especially if there’s been an alteration in her genes. Based on Western studies, a Caucasian woman may have inherited increased risk if blood relatives from either her mother’s or father’s side has one of these: Mother or sister diagnosed with breast cancer before the age of 40, or with breast cancer in both breasts. Two or more close relatives diagnosed with breast or ovarian cancer, especially before the age of 40. Father or brother diagnosed with breast cancer. The bid to develop Asian, or specifically Malaysian, risk guidelines is important to determine if, with genetic “alteration’” in BRCA1 or BRCA2, a woman’s risk of getting breast cancer at 50 years old is 50%, or higher, for example. And at age 70, will her risks increase to 70%? Another key reason in having Malaysian research is that not all breast cancer cases are a result of faulty BRCA1 or BRCA2 genes. Western studies have suggested that only 5% to 30% of cases are a result of BRCA1 or BRCA2 alteration. For a majority of the remaining cases, no single gene has yet been identified. We are trying to identify other genes which increase risk to breast cancer, especially in the Asian context. It is important to note that a single faulty gene is not a necessary precursor to breast cancer; it just means that her risks are higher than any other woman. Studies are ongoing to assess the extent that family history plays a role, as well as taking into account the variations in the Malaysian context such as population, family structures, and diet. The impact of lifestyle changes experienced by Malaysian women in the post-war period, as a result of globalisation, is also an area that needs study. Sedentary lifestyles and growing obesity have been shown to greatly increase breast cancer risks. Other factors can also play a role. Women have increased risk if their periods start before 11, have late menopause (after 55), have their first child after 30, or have fewer children. Also, breast cancer becomes more common as we age. How can I reduce my risk? How can I reduce my daughter’s or mother’s risk? Get regular checks and go for therapy based on scientific and clinical evidence. Although we can’t do much about many risk factors, we can make sure that we examine our breasts and report any changes to a doctor, and have mammograms (annually after 50). If a lump is detected, it is very important that you seek further medical tests to determine whether the lump is cancerous. Breast cancer detected at an early stage can be cured. Unfortunately, the majority of breast cancers in Malaysia are detected at a late stage, when the chances of survival are significantly lower. Be active! Research has shown that being active can help to reduce the risk of breast cancer, up to 30% – 40%. We don’t yet know the biological mechanism by which being active reduces risk, but some studies suggest three hours per week of activity is required. Breastfeed your children. Research has shown that breastfeeding reduces our risk of breast cancer. The longer the better! Eat healthily. While research on cancer-fighting foods is still at its infancy, there’s evidence to show that nutrition can help prevent breast cancer. Diet is important. Eat less red meat, fatty, sugary and processed foods, and eat more chicken, fish, fruits and vegetables. If you follow these guidelines, you will be well on your way to a healthier diet and maintain normal weight. This will help protect against breast cancer and a variety of other chronic diseases.
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