6 October 2019
The headline was promising: “Breast Cancer Awareness Month: 3 Ways to Prevent and Detect the Disease” – but the word “prevent” always gets my attention. Can we really prevent breast cancer?
Good info on breast cancer RISK REDUCTION (but bad headline – we don’t have prevention) from @CNN. Headlines like these imply if you eat your veggies and exercise you’ll be fine. https://t.co/pGTzcnnUyo #bcsm #BCAM
— Dr. Deanna Attai (@DrAttai) October 3, 2019
As always, the context is important. When we look at populations, large groups of individuals, there is no question that a healthy diet, regular exercise, and limitations in alcohol intake will result in reduced rates of breast cancer (and other disease) development. So for populations, yes, we can prevent disease. Unfortunately it’s not that simple when it comes down to the individual level. Cancer, even breast cancer, is not one disease. People are complex and there are multiple factors influencing the likelihood of disease development in any one individual. For example, breast feeding lowers risk, but a woman who breast-fed her children is not immune from developing breast cancer. On an individual level, the best we have is risk reduction.
To me the issue is that the word “prevent” is so absolute. Implies follow these steps and you won’t get cancer. Ignores the fact that many men and women do everything “right” and still develop breast cancer #bcsm #bcam 1/
— Dr. Deanna Attai (@DrAttai) October 3, 2019
What’s the harm in using the term prevention when discussing risk factors at an individual level? It is not uncommon for a patient newly diagnosed with breast cancer to start second-guessing all of her life choices, and feeling guilty that she caused her disease:
I was 41 when diagnosed, non smoker, non red meat eating, 4/5 times a week gym going social only drinker with a spot on BMI, I spent those first few vulnerable months in treatment thinking of everything I might’ve ever done that meant I got cancer, mentally exhausting
— Sally Bolger Keen (@SalBK76) October 5, 2019
The reality is that one can do everything “right” and still develop breast cancer and one can have a high alcohol intake and junk-food diet and never develop the disease. In the majority of individuals, we cannot determine exactly why breast cancer develops. We are all looking for answers and for control. Adopting a healthier lifestyle with known risk factors in mind will help contribute to a longer and healthier life. But there are no guarantees. Life is for living, and it’s too short to be burdened with guilt if disease does develop.
so encourage the healthy behaviors to lower risk and to improve overall health, but avoid the false hope and then eventual shame when “prevention” doesn’t work for the individual #bcsm #bccww #BCAM 5/5
— Dr. Deanna Attai (@DrAttai) October 4, 2019
