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Know Your Risk for Breast Cancer

By Susan Beane, M.D., Vice President and Medical Director, Healthfirst

Even with new advances in cancer screenings and detection, the American Cancer Society estimates that 232,340 women will be diagnosed with breast cancer in 2013, and close to 39,620 will die of the disease this year. Nationwide, African American women have the highest death rate for breast cancer.

 

Cancer is often a curable disease when it is caught early, and as we observe National Breast Cancer Awareness Month in October, I took the opportunity to speak with Gina Villani, M.D., the CEO and medical director of the Ralph Lauren Center for Cancer Care and Prevention, to get her recommendations for cancer prevention. The Ralph Lauren Center is a community-based center for the prevention, diagnosis, and treatment of cancer located in East Harlem at 124th Street and Madison Avenue.

Dr. Susan Beane: What are your recommendations for women when it comes to breast cancer screenings?

 

Dr. Gina Villani: The United States taskforce does their screening recommendations very broadly. All the data for these screening recommendations is from majority populations. So if you look at the new screening recommendations for breast cancer that say to start at age 50, but African American women present with cancer at a much younger age and tend to have a higher stage of disease, is that the right recommendations for African Americans?

 

The problem with all these recommendations is they are not drilled down to specific populations. It creates a lot of confusion, so what patients need to do is really understand their individual situation. People have to take the recommendations with a grain of salt and say, “how do those recommendations apply to me.” Look at what your lifestyle and your family history is and then figure out what are your individual risks and how you can globally reduce your risk of developing cancer.

 

 

Dr. Susan Beane: So, how can youreduce your risk of developing cancer?

 

Dr. Gina Villani: We’re trying to educate people that screenings are great, but there are a whole bunch of other things you need to do to prevent cancer in addition to having a yearly mammogram. We know that obesity is a risk factor for all cancers, and it increases your risk of breast, uterine, and colon cancer.

 

There are more and more data coming out about the anti-cancer effects of exercise—and even in people who have been diagnosed with cancer and how exercise can reduce their risk of reoccurrence. People are saying doctors should be writing prescriptions for exercise, even more than for chemotherapy.
 

Try to eat as cleanly as possible. Stay away from all these processed foods. There are additives in processed foods that help maintain their shelf lives but also have estrogenic activity. So if we know that estrogen is linked to breast cancer in some women, and then you’re eating things that mimic estrogen—think about what that’s doing to you.

 

Try eating organic foods, which are an emerging market. There are a lot of choices with hormone-free eggs, milk, and chicken. They are in neighborhood grocery stores, too. You just have to read labels.

 

 

Dr. Susan Beane: What challenges do you face with treating your patients at the Ralph Lauren Center?

 

Dr. Gina Villani: We have a lot of challenges and one of them is we have a really high no-show rate [for appointments]. We work with people who the medical field has not embraced. If you look at a lot of the hospitals that serve underserved patients, they are dirty and rundown and the first person you see when you walk in the door is an armed uniformed police officer. Who’s going to want to voluntarily go there for screenings? I wouldn’t.
 

The whole point of the Ralph Lauren Center is when you walk in it looks so different; it’s really clean, really homey, it’s decorated by Ralph Lauren, and the people are nice. We never turn anyone away. We want people to know that we really do care about them. That’s the first step.

 

We can control what we do here, but we can’t control the whole world. So it’s really hard to try to get people who have been really disenfranchised by the healthcare system to have any trust. The sooner that the healthcare system recognizes this, stops blaming the patient, and tries to fix that, the better.
 

 

Dr. Beane is Vice President and Medical Director at Healthfirst.  For more tips on leading a healthier lifestyle, visit the Healthfirst website at www.healthfirst.org.