Dr. Melinda Wu is a family physician at Women’s College Hospital and a general practitioner–oncologist at Princess Margaret cancer centre in Toronto. Here, she answers your most pressing breast cancer questions.
Q: What preventive lifestyle changes can I make to reduce my risk of breast cancer?
"There are many things beyond our individual control that affect breast cancer risk, such as family history, genetics, reproductive factors and breast density. That said, there are also many modifiable risk factors for breast cancer, such as physical inactivity, obesity, alcohol consumption and use of hormone replacement therapy. We know that maintaining a healthy weight and an active lifestyle—150 minutes of exercise per week is recommended—decreases your risk. And limiting alcohol intake to less than one drink per day, on average, or abstaining altogether, reduces it further. Breast cancer risk is five percent higher in women who consume one drink per day as compared to those who don't consume alcohol."
Q: I've been called back after a routine mammogram. Should I be worried?
"A callback is common, particularly if you're embarking on imaging for the first time. Mammography has a fairly good detection rate when looking at one image, but accuracy is improved when comparisons between mammograms can be made. When you're in your 40s and 50s and moving from premenopause to menopause, your breasts go through several changes; this fluctuation in breast tissue can affect the images. So, although callbacks are frequent, only a small set of women require further testing, such as a biopsy, of which 80 percent are likely to return with benign or noncancerous diagnoses."
Q: I have a friend who was diagnosed with Stage 1 breast cancer. What does that mean?
"Breast cancer staging refers to the size of a tumour and whether the cancerous cells have spread to the lymph nodes. Generally speaking, the severity of breast cancer increases through the stages. Stage 0 cancer is confined to the ducts, lobules or nipple with no invasive component.
Stage 1 applies to an invasive tumour that has started invading surrounding tissue. The first step of treatment is surgery to remove all of the tumour.
Stages 2 and 3 relate to the size of the tumour (typically between two and five centimetres) and whether or not cancer cells have spread to the lymph nodes in the armpit.
Stage 4 distinguishes breast cancers that have spread to other parts of the body, such as the liver, lungs, bones or brain.