Oct 23, 2018
Breast cancer is one of the most daunting diseases in women’s health, as it affects about one in eight U.S. women at some point during their lives. Dr. Ami Chitalia discusses four lifestyle changes women can make to reduce their risk of developing breast cancer.
Intro: MedStar Washington Hospital Center presents Medical Intel where our healthcare team shares health and wellness insights and gives you the inside story on advances in medicine.
Host: Thanks for joining us today. We’re speaking with Dr. Ami A. Chitalia, a breast medical oncologist at MedStar Washington Hospital Center. Welcome, Dr. Chitalia.
Dr. Ami A. Chitalia: Thank you for having me.
Host: Today we’re discussing general best practices to reduce breast cancer risk. While breast cancer can have a genetic component, there are things that women can do to prevent the disease altogether or improve the chances that, if breast cancer develops, it’ll be detected at an earlier, more treatable stage. Dr. Chitalia, is there a number one thing women can do to reduce their risk for developing breast cancer?
Dr. Chitalia: Well, I think there are a few things that women can do to decrease their risk of breast cancer. There are lifestyle modifications, such as having a healthy diet, exercising and maintaining a normal weight. Also, limiting alcohol intake has been shown to decrease risk of breast cancers. And, of course, screening mammograms will not reduce a woman’s risk of developing a breast cancer, but they may help to find a cancer at an earlier stage, where treatment may be easier to go through. And when there’s a better chance of curing the cancer.
Host: So many cancers have been linked to healthy eating, exercise and weight management. How do these factors affect a woman’s breast cancer risk?
Dr. Chitalia: Yes, these have certainly all been linked to breast cancer risk. I counsel my patients with breast cancer on maintaining a healthy and balanced diet. So, this includes a focus on whole grains, fruits, vegetables and lean meats. However, all foods are okay in moderation. So far there’s no clear link between breast cancer and red meat intake or sugar intake. In terms of exercise, I recommend 30 minutes, at least, of any exercise that will make you sweat or breath faster, so aerobic exercise, 4 to 5 times per week. By maintaining a healthy diet and exercising, a woman can maintain a healthy weight, and this has certainly been shown to decrease their risk of breast cancer.
Host: How are unhealthy habits, such as tobacco use and alcohol consumption, associated with an increased risk of breast cancer?
Dr. Chitalia: So, tobacco use is an interesting question. There has been a study that shows an increased risk of breast cancer with smoking, but in premenopausal women only - so, in younger women. Other studies have not shown this to be true. So, we don’t really have a clear answer for how tobacco use is linked to breast cancer but, either way, tobacco use clearly does increase risk of many other cancers and diseases and can certainly impact healing after breast surgery. Excess alcohol intake - which, for women, is more than four drinks per week - has been associated with an increased risk of certain types of breast cancer as well.
Host: What should women, who are at increased risk because of family history or genetics, do differently to reduce their risk of breast cancer?
Dr. Chitalia: So, women with a family history of breast cancer should seek guidance from their primary care physician on when to begin screening mammograms, as depending on their family history, or the genetics, screening may be recommended at an earlier age than an average woman. Women who carry a genetic mutation with an increased risk of breast cancer should be under the care, ideally, of a breast surgeon or medical oncologist to determine the best screening strategy for them, as well as for monitoring. In addition, these women should be counselled on the risks and benefits of risk-reducing surgeries, such as mastectomies or oophorectomies.
Host: Should all women perform breast self-exams?
Dr. Chitalia: Although self-breast exams have not been shown to have a clear benefit in finding a breast cancer earlier, I think it is important that women maintain a breast awareness so that they’re aware of any changes to their breasts, either in feeling or in appearance.
Host: If women chose to do self-exams, how often should they do them?
Dr. Chitalia: If women chose to perform self-breast exams, I think a monthly basis is a good idea. Typically, at the time when their breasts are the least tender is also a good idea, and when there are less changes such as from a menstrual cycle, if that’s applicable to a woman.
Host: Do you have any stories you could share about patients who successfully found a lump on their own and came in?
Dr. Chitalia: Sure. So, we do have a number of women that come in, usually at first to their primary care doctor or their OB-GYN, saying that they felt a lump. And this, you know, was either while they were showering or while they were performing their monthly self-breast exam. Typically, then, their doctor has referred them to a diagnostic mammogram, an ultrasound, and skipped the screening mammogram in order to expedite their work up. And then they usually get referred to one of us in the practice. So, that has definitely happened a number of times.
Host: If a woman finds a lump, why is MedStar Washington Hospital Center the best place to seek breast care?
Dr. Chitalia: So, I think, for a number of reasons, MedStar Washington Hospital Center is the best place for women to seek breast cancer screening. We offer state-of-the-art equipment and imaging techniques, including MRI-guided biopsies, which are sometimes needed and are only offered at selected imaging centers. In addition, we offer comprehensive care so that in case something is found, such as a breast cancer, we have a large multidisciplinary team, including nurse navigators, radiologists, surgeons, radiation doctors and medical oncologists who focus on breast cancers, such as myself. We also have dedicated breast radiologists who have expertise in reading breast imaging, such as mammograms and ultrasounds. And, above all, I think our nurses, technicians, and staff are kind and caring and really aim to make sure that a patient’s experience is as smooth and comfortable as possible.
Host: Thanks for joining us today, Dr. Chitalia.
Dr. Chitalia: Sure! Thanks again for having me.
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