I have a confession to make: I do not do regular breast self-exams. I know, I know, you’re supposed to, and it can save your life, and that’s the way so-and-so found hers, etc., etc., etc. But I just don’t understand the idea of looking for something you don’t want to find. When I search for my keys, I am hoping they will materialize. When I scan a room for a friend, I am hoping I will see her. Even when I am not supposed to be looking for trouble, I am still secretly hoping to find it. But looking for something bad? It is like opening up the refrigerator and digging around for something gross to eat. I do not want to find a moldy turnip, I do not want to find a moldy turnip… oh crap! I just found the moldy turnip.
Do not get me wrong, I think early detection of breast cancer, or any cancer for that matter, is extremely important. Life-saving even. But I guess I am at the age (thirty) where I am still swimming upstream, trying to prevent the oh-no-that’s-a-pea-sized-lump-under-my-left-areola from ever happening in the first place. In graduate school, I studied epidemiology, and learned that distribution of disease and health in a population is not random; risk factors can increase a person’s chance of getting an illness. Minimizing my risk factors always seemed easier than going downstream.
However, risk factors are based on statistics, and statistics have outliers. That means those with very little risk may still get cancer and those with very high risk may not. We still do not know exactly what causes breast cancer or who will get it. We do know that breast cancer is the second most common cancer in women (after skin cancer) and the second leading cause of cancer death (after lung cancer). How can we try to avoid it?
Risk Factors You Cannot Change
Hormones. Damn them. Not only do they turn us into crazed carbo-loading fatsos once a month, they go hand in hand with our biggest breast cancer risk factor: being a woman (men get breast cancer too, though it is very rare). The prevailing theory is that breast cancer risk is determined in large part by a woman’s cumulative exposure to estrogen and progesterone during her ovulatory menstrual cycles. This means the longer the intervals of regular menstrual cycling, the higher the risk. So, women that have had early menstruation (before age eleven) and/or late menopause (after age fifty-five), have a higher risk of breast cancer.
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