Did you know women above age 50 are more likely to receive a breast cancer diagnosis? We asked medical oncologist and breast cancer specialist Wade Smith, M.D., and Linda Buck, N.P., a nurse practitioner specializing in medical oncology, why this is so, and what preventive measures can older women take. Smith and Buck both practice at City of Hope’s Newport Beach Fashion Island location.
Why are older women more at risk for breast cancer?
Smith: In part, it is because our cells are more likely to change in abnormal ways over time.
In some cases, it can simply be because unhealthy lifestyle habits have had more time to catch up with us. Smoking, consuming alcohol in excess, and being sedentary or overweight, particularly after menopause, all influence breast cancer risk.
Entering menopause after age 55 also increases breast cancer risk because the woman has had more menstrual cycles, increasing her lifetime exposure to estrogen and progesterone.
Are there lifestyle changes or preventive steps that older women can take to reduce their breast cancer risk?
Buck: As with many diseases, the risk of developing breast cancer depends on a combination of factors, but lifestyle factors are always important because they are factors that you can control. You can’t change your genes or your family history, but you can choose to eat a more nutritious diet, be physically active, quit smoking, and drink less alcohol, for example.
Your breast cancer prevention strategy should also take your reproductive health history into account. Using hormone replacement therapy during menopause may raise your risk of breast cancer when taken for more than five years. Studies have found breast cancer risk may be lower in women who avoid certain oral contraceptives, first become pregnant before age 30, breastfeed their baby, or have had a full-term pregnancy.
Does breast density affect breast cancer risk?
Smith: Breast density is a known risk factor for breast cancer, which is why women with dense breast tissue are screened more frequently. Conversely, because breast tissue becomes less dense over time, screenings are often discontinued once a woman reaches age 75.
However, a recent study found that more older women that expected have dense breasts well into their 60s and 70s. This suggests that breast cancer screening could make sense for more women even beyond age 75.
Research like this is good news for all women, because it makes the case for the development of individualized screening recommendations.
Early detection and treatment options for breast cancer should be as personalized as possible. At City of Hope Orange County, we are meeting that need with a variety of next-generation genomic profiling and precision medicine techniques that help our highly specialized breast cancer physicians get to the best treatment for the patient.
Do breast cancer screening recommendations change based on age?
Smith: For women of average risk, breast cancer screening with annual mammography may start at age 40. Some women with a higher-than-average breast cancer risk may start screenings earlier, as determined by their physician. The guidelines vary as to when older women can stop. There are several other tests to help you stay on top of your breast health. They include:
- Self-check. A monthly self-exam of your breasts can help you identify concerning changes.
- Clinical exam. For most women starting at age 20, your physician will perform a physical exam of your breasts once a year during your well woman visit.
- Ultrasound. Breast ultrasound uses sound waves to produce images of the structure of the breast. It can be used as an alternative to or in conjunction with a mammogram.
- MRI. An MRI creates images of the breast using a magnetic field, and like an ultrasound it can be used instead of or in addition to a mammogram to screen for breast cancer.
- Genetic testing. If you have a family history of breast cancer, your doctor may recommend genetic testing. This will help determine if you have a genetic mutation that elevates the risk of breast cancer.
The first step to understanding and preventing breast cancer is to actively communicate with your physician so you can make informed choices based on expert advice. If you have been diagnosed with breast cancer, speak with a specialist trained in your specific type of cancer who offers advanced treatment and access to promising research that can directly benefit you.
Hope is growing at City of Hope Orange County. Our new locations in Huntington Beach, Newport Beach Lido and Irvine Sand Canyon join City of Hope Newport Beach Fashion Island to form a four-location network of highly specialized cancer care. To make an appointment at any of our four Orange County locations, click here or call: