Fitness Club

October is National Breast Cancer Awareness Month, but what some people want people to become more aware of is how little progress has been made in defeating this disease over the last quarter century. Since 1990, when National Breast Cancer Awareness Month was first launched, the rate of decline of breast cancer deaths has been a disappointing 2 percent per year. On average, 117 people -- mostly women -- died each day from breast cancer in 1991. Today that figure stands at 110.

In an article published in the Los Angeles Times, Dr. H. Gilbert Welch of the Dartmouth Institute for Health Policy and Clinical Practice in Lebanon, NH, notes that breast cancer is many different diseases. Some tumors -- called "indolent" -- are basically harmless, while others grow slowly and may eventually cause trouble. However, the most dangerous forms of breast cancer are those characterized by aggressive tumors that grow fast and metastasize before they're detected.

The Detection Conundrum

Women have been encouraged for years to examine their own breasts and, after they reach a certain age -- the recommendations on age have become controversial -- to have annual mammogram screenings. The problem, according to Welch, is that these measures are best at finding the least-threatening tumors.

Treatments tend to be the same for all breast cancers, so what's happening is that many women whose tumors might never cause them any problem are being subjected to unnecessary surgeries, radiation and chemotherapy.

For every life a mammogram has saved, five to 15 lives may have been irreparably altered by mammogram findings that led to unwarranted treatments, suggested Welch in an editorial published in the New England Journal of Medicine accompanying a study on the role of mammograms in reducing the breast cancer death rate.

What Welch and others are proposing is that more attention be paid to preventing breast cancers, rather than putting all the eggs, so to speak, in the detection-and-treatment basket. That approach is complicated by the fact that a high-profile campaign such as National Breast Cancer Awareness Month is sponsored by AstraZeneca, which markets the breast cancer drugs Arimidex, Faslodex, Nolvadex and Zoladex. Welch has called the pharma's sponsorship a "huge conflict of interest."

10 Steps for Prevention

Following are some ways to reduce the risk factors for breast cancer, based on current research:

1. Consume a healthy diet that emphasizes vegetables, fruits, lean protein (chicken, fish), whole grains and vegetable oils. Avoid sugar, refined carbohydrates and foods high in animal fat.

2. Exercise at least 30 minutes a day.

3. Strive to maintain a normal weight (body mass index under 25). Obesity is linked to breast cancer.

4. Limit alcohol consumption to one drink per day or less.

5. Don't smoke.

6. Breastfeed your babies for as long as possible. Women who breastfeed for one or more years have significantly lower risk.

7. Avoid menopausal hormone replacement therapy. If you have severe symptoms, ask about other options.

8. Limit use of antibiotics.

1.9. Avoid exposure potentially carcinogenic chemicals in pesticides, cleaning supplies and other household products. 2.

3.10. Choose cosmetics and beauty supplies with natural ingredients. Choose products that are fragrance-free or are scented with essential oils over those containing synthetic "fragrance."