80 over 50 The figure usually quoted is that 80% of breast cancer occurs in women over age 50. I haven\'t seen the latest official stats but I think these are probably pretty accurate...maybe changed by a few percentage points..anyone know?
I know it appears that there are loads more young women with breast cancer..partly because younger women more likely to use sites like this, and younger women are more likely to get aggressive forms of bc but the biggest risk factor for getting bc is still age. There is loads of hidden ageism about breast cancer, but it doesn\'t get much attention in the press...or on these forums. For example older women in their 60s and 70s are sometimes denied access to chemo regimes which would be given to younger women.
I think there seems to be some confusion on this thread between the concept of a risk factor and the concept of cause. I am childless and have probably drunk too much alcohol in my time and I\'m over 50...all these factors increased my risk of getting breast cancer, and I got it, but equally that doesn\'t mean that other women with similar risk factors will all get breast cancer, or that those without those risk factors won\'t.
Even when a risk factor becomes firmly established as a cause, as in the case of smoking and lung cancer, still one-third of people with lung cancer haven\'t smoked (though passive smoking may be the cause here. )
In the case of breast cancer it is unlikely that there is a single cause.
I used to know quite a lot of Queen Elizabeth 1..but can\'t remember it all now...loads of misogyny around about her.
Interesting thread Just getting into this really interesting thread.
Like Mole, I had heard that breast cancer used to be called Nun\'s disease.
I feel similarly to you Daphne that there may be a link between childlessness and breast cancer but that it might not be quite as strong as is being suggested. Also wasn\'t there something a while ago (maybe even quoted in the infamous GH article) that losing weight might help prevent breast cancer?
As a former anorexic (and despite fat tamoxifen tummy!) still slightly underweight person who has never been on pill, had two children, breast fed them for over a year and almost two years respectively, apart from chocolate I have always eaten healthily, taken exercise etc - something must have gone wrong - I simply didn\'t have the \"classic\" risk factors in my life.
Also whilst on the subject I would dispute the 80% over 60 stat quoted for those who get breast cancer. Is this not surely outdated by now?
Never knew that Queen Elizabeth I might have been a bloke - you learn something every day don\'t you!
Nuns\' Disease Is not a term I\'d heard until I came on this forum. I don\'t deny there\'s a link between childlessness and breast cancer, but I think the link is not as strong as suggested as there are so many other risk factors that seem to be involved. Breakthrough Breast Cancer\'s website talks about the high numbers of nuns who developed the disease in the Middle Ages so who I am to argue?
But it would be interesting to see a breakdown of the 41,000 breast cancer diagnoses per year to see what proportion were childless women rather than just having anecdotal evidence dating back to the middle ages. Also what proportion of present day nuns get it?
The childless Queen Elizabeth I managed not to get it, but then there has been speculation throughout history that she was really a bloke.
study on women who never had children Breast cancer was known as the nun\'s disease in earlier centuries so the connection between childlessness and breast cancer was made a long time ago.
LindaAnn Your unhappy experience is exactly why I think the breastfeeding and reproductive risk factors set forth about breast cancer are overestated. For every woman who has had no or fewer than three children and not breastfed them at all or for very long, and gets breast cancer there will be at least one like you who\'s done the \"right\" thing and also gets breast cancer.
On a separate topic, one thing I\'ve noticed is that I see far fewer women breastfeeding in public than I did 20 years ago and I didn\'t see that many then.
I wonder if anyone\'s done a study on women who have never had children due to their\'s or partners\' infertility (pre-IVF) to see whether they had higher rates of breast cancer than women who had children.
Feel cheated I feel cheated here, as an NCT Breast Feeding Counsellor for a number of years and as someone who breast fed all my 3 children - my youngest (who is now 22) to the ripe old age of 2 and a half at which point she gave me up rather than the other way around - and now I find I have got BC!??
So much for statistics.
Hi Jane Yes, it was provocative of me to use the term \"human husk\", though personally, if I had no breasts, no ovaries, no oestrogen (and no uterus as they might as well whip that out with the ovaries for good measure), I would feel quite a lot like a human husk. The fact that every cell in my body still had two X chromosomes would not be much consolation for the loss of most of the organs and bodily chemicals that I believe play a big part in defining me as female. I don\'t claim to speak for everyone, or even the majority, but that\'s how I feel about it. I\'m sorry if what I said is offensive, but I think it needs discussion because otherwise the danger is that assumptions may be made that it\'s OK to remove a woman\'s biological female attributes to protect her from cancer or a recurrence and women won\'t mind because their lives will be prolonged and they\'ll be terribly grateful. I think that\'s a pretty big assumption.
I accept the argument about child rearing patterns up to a point, but I think you have to go back to the 19th and early years of the 20th Century for large families and plenty of breast feeding to be the norm. Certainly, if I look at my own family and my husband\'s family, we have to go back to great grandparents to find families of more than 2 children, though there is an exception as one of my grandmothers had three, two of them were twins.
I come back to my favourite statistic which is appalling actually, that in England, breast cancer incidence increased by 80% between the years 1971 and 2003. I simply don\'t believe that reproductive habits dramatically changed in the latter half of the 20th Century to partly account for that increase. Whether it\'s the effect of the contraceptive pill is another matter, but many people who get breast cancer have never taken the pill so is it\'s residue in our drinking water? I don\'t know.
Did you have a nice break in Spain over Christmas?
A few thoughts for Daphne 1. Femininity and gender are not just biological..they are also socially constructed. I think to describe a woman on hormonal treatments without ovaries and breasts as a \'human husk\' is an unfortunate and very inaccurate misnomer. (and dare I say sexist?)
2. While CRUK may say too little on diet and prostate cancer Cancer Bacup displays no sexism (I think) in its description of the causes of breast and prostate cancer. There\'s quite a lot about diet and prostate cancer (including animal fat and dairy).
3. There is evidence that breast feeding and having children does lessen risk of breast cancer (both are \'natural\'..whereas not having children isn\'t!). This is not to blame women at all..but to raise issues about what can be done to lessen risk now that child rearing patterns are so different from the past.
And finally of course risk is not the same as cause. As yet the causes of breast cancer are not known.
More thoughts I agree that prevention and treatment using hormone inhibiting drugs and genetic and cell biology manipulation is better than doing nothing and is helping people with breast cancer to survive longer and I support research into new prevention and treatments to help triple negative women. I agree that Susan Love gives a good and reasoned summary of breast cancer risks, including environmental factors. She says (of pesticides and other environmental hazards)
\"I think the issue is complex and must take into consideration time of exposure and other associated risk factors. There still might be an environmental relationship, but it is probably small. Nonetheless, this lack of definitive answers is no excuse for not cleaning up the environment. There are enough known health problems from environmental pollution to convince us that it needs to be seriously curtailed. This is a fairly new area of scientific study. Who knows what we\'ll find in the next 5 or 10 years\".
I have my doubts that we will know any more in the next 5 or 10 years about whether or not environmental factors have anything to do with breast cancer because mainstream cancer researchers seem to take the view that because there\'s no conclusive evidence that environmental factors don\'t affect breast cancer risk, it means that they have nothing to do with breast cancer (which seems an extremely foolhardy assumption to make) and therefore ignore it and concentrate on research into prevention and treatment that involves doing stuff to women\'s bodies. Other researchers strongly argue that environmental factors do affect cancer risk - for example, Samuel Epstein MD and Theo Colborn, and they argue the evidence is there. Judge for yourselves whether they are extremists. I think they raise important questions that need to be acknowledged and answered.
According to the WWF, there are 80,000 chemicals in the environment now that were not present 50 years ago. For many, little is known about their effect on human (and animal health) and that\'s why the EU is introducing the REACH programme - Regulation, Evaluation and Authorisation of Chemicals, but that will take years to actually do anything and the Chemical Industry has been very successful in watering down the original proposals.
Of course, the role of a woman\'s own hormones should be investigated in breast cancer risk and incidence, but equally, so should the possible role of all these chemicals that have never been properly tested and whose effect on human health is unknown. Are those scientists who say that there is no conclusive evidence that environmental pollutants cause cancer saying that, contrary to the WWF, there is evidence that all these 80,000 chemicals have been properly tested? If so, where is the proof that they have no link to cancer?
Until fairly recently, many scientists denied the links between environmental pollution and global warming. They were wrong and now it seems everyone (apart from the Bush Administration) accepts that global warming is man-made and actually far more advanced than many scientists thought. Maybe it\'s the same with environmental pollution and cancer (and other diseases). I hope not, but I\'ve no reason to suppose the link isn\'t there while mainstream scientists seem to be in denial like they were for global warming. I would also like to understand what relationships exist between cancer research funding and industry in case this sheds some light on why environmental factors get swept under the carpet. Breakthrough\'s longest standing corporate partner is Avon Cosmetics and they have raised over Ã‚Â£9m for the charity, which is great, but I suggest that this relationship may not be conducive to Breakthrough\'s scientists carrying out any independent research into the chemicals that are used in cosmetics to investigate whether they have any effect on breast cells and breast tumours.
If the best 21st Century science can do to prevent breast cancer in future is to offer high risk women drugs to shut down their hormone production, tinker with their genes and cell biology and have them consider prophylatic mastectomies and oopherectomies, that\'s just not good enough. And what about the majority of us who got breast cancer despite not being high risk. Will breast cancer incidence reduce from 41000 per year or will it increase and, if it increases, will the future for people like us be the offer of precautionary de-feminising treatments when we have had children or are sure we don\'t want any so we have no female hormones, no breasts and ovaries - a human husk?
From where I\'m sitting -With an aggressive triple negative cancer I would love to have some drugs I could take which might prolong the period of remission I can expect before recurrence. Bring on the arimidex..if only..if only. Research which has led to improved aromatose inhibitors etc means that many women are living longer with breast cancer but not those of us who are triple negative.
People who are er- and pr- have a higher risk of recurrence in the first five years after diagnosis than people who are er+ and pr+ with similar tumours. There are no targetted treatments for triple negative cancers.
Moreover if there had been a drug I could take prior to getting breast cancer that might have reduced my risk I\'d have willingly taken it, and had mastectomies at 40 to up my chances.
There is no significant evidence that environmental pollutants increase breast cancer risk. (I believe the senisible summary of research in Susan Love\'s book.) It sounds plausible to contrast \'natural\' oestrogen with \'artificial\' chemicals, but the story of oestrogen and breast cancer is a bit more complex than this simplistic dichotomy.
I do agree with you Daphne though that there is a load of sexism around women and breast cancer, and that sexism often takes the form of infantalising women and blaming them for getting breast cancer. I just don\'t think the answer to that sexism is to start glorifying the \'natural.\'
Seasons greetings to all.
Quality of Life Holeybones,
I\'m glad you\'ve brought up the question of quality of life on Aromatase inhibitors because I\'ve been involved in some regular email correspondence about breast cancer prevention with my MP since the Westminster Fly-in organised by Breakthrough Breast Cancer.
I\'ve said that I don\'t like the way that research into prevention (for high risk women or those who\'ve already had BC) all seems to be directed at giving drugs to manipulate women\'s hormones or messing about with their genes and cell biology. I\'ve said that I think there are huge ethical questions here, especially about giving drugs to healthy women to prevent cancer when these are powerful drugs with side effects that can adversely affect quality of life. I would like to see greater public awareness and debate about what\'s going on with prevention and I want to know why all the focus is on fiddling with people\'s cells and hormones and ignoring (my perception) what\'s causing DNA mutations and reducing the population\'s exposure to the factors that cause these mutations.
You mention about aromatase inhibitors and effect on bones & joints. As part of the IBIS-II study (looking at Arimidex as possibility for prevention by giving it to high risk, healthy women), there is study monitoring cognitive function of people taking it during the 5 year trial. Oestrogen is thought to maintain cognitive function. After natural menopause, women still produce some oestrogen, but Arimidex shuts down oestrogen production completely and the researchers want to find out whether long term use of Arimidex affects memory and reasoning. If it doesn\'t - fine, if it does, they\'ll have to decide whether the benefits of recommending it for prevention outweigh possible quality of life issues for healthy, high risk women. Nice choices for everyone affected. Of course it doesn\'t matter for those of us that have already had cancer because we just take the drugs and hope they keep us alive and put up with any quality of life side effects. That\'s always ignored when triumphal statements are made by media, charities and medics about improved breast cancer survival.
Since chemo my hair is growing back snow white and so are the whiskers on my chin. I\'ll look like Father Christmas soon - only not so pretty.
Oestrogen Before breast cancer, I always expected to be on HRT in later years and therefore looking and feeling better than my chronological age.
I was told it was good to be ER+ because it meant I could benefit from Tamoxifen. Really couldn\'t stand Tamoxifen (weight gain, out of condition hair, dry skin, weepy etc) so gave up. Looked and felt my old self very quickly.
Don\'t know if I might have avoided secondaries if I had stuck it out. with the Tamoxifen.
When I was diagnosed with secondaries, I was put on aromatase inhibitors and told I was lucky to have that option. While I know I have no choice any more, I get depressed when I see black whiskers appear on my chin thanks to the oestrogen suppression - tweezers never far away. Lack of oestrogen makes bones brittle and joints ache (great when you already have bone mets to contend with).
I\'d much rather that anti-cancer viruses suitable for ER+ and ER- were the big push, because nobody is factoring in the damage to health and QOL caused by aromatase inhibitors.
I\'m sure the logic is that if men don\'t get breast cancer very often, the answer, once we\'ve had children and are becoming old and past it, is to make us more like men? We aren\'t allowed to be vain any more. Surprised they don\'t suggest double mastectomies and a complete hysterectomy for all over 50 because we don\'t need any of that any more.
Me too. I had an oestrogen negative cancer too. I seem to have had only two risk factors not breastfeeding and becoming overweight for a time.
No oestrogen I don\'t understand this blaming oestrogen for precipitating cancer. My cancer is oestogen lacking but it is still very much breast cancer unfortunately. I was very low risk for getting breast cancer except for becoming overweight.!!
Food for thought Thanks for this posting Daphne, which I found interesting. I have certainly found it depressing that the life-giving female hormone should also have the capacity to precipitate cancer. As I have learned, I fall into 3 high-risk categories for developing BC, only 2 of which I could have any control over, viz. very early onset of menstruation, very late menopause - and being heavily overweight. Now, as I understand it, these are precipitating factors, i.e. prolonged exposure to oestrogen gives rise to increased risk of BC.
It seems to me that the more that cells are caused to proliferate, viz. breast cells continuing to regenerate through continual exposure to oestrogen washes, the more likely it is that mutation will occur, simpy because there is more activity producing more new cells available to mutate. Add into this mix additional risk factor(s) through exposure to potential food toxins, i.e. not poisoned food but food which may poison, then the statistical balance begins to tilt ever more steeply.
In this construct, the oestrogen matrix stimulates production of cell building blocks but some of them turn out to be misshapen and, just as plants can produce mutant \"sports, the human metabolism produces mutant cells as a predictable chance of nature. I don\'t decry the possiblity of environmental risk factors - in fact it seems sensible to suppose they must exist - but I don\'t think that is anywhere near the major element in the story.
Did you ever read One of Dr Lees books on the subject of progesterone ? He was an amazing chap in the field of research into women\'s hormones. It\'s all recorded on the net but it\'s so long since I read it that I can\'t remember the site address. He came to London and did several seminars which I saw one of on a video copy. It would seem that our levels of progesterone will \"balance\" the oestrogen if they are high enough. But as we know the amount of artificial oestrogens we aquire from environment etc , lodge within us and cannot be broken down. We have become experts in destroying the planet and ourselves - which inevitably leaves the \"survival of the fittest\".
Sadly the western world is too ready to make profit out of \"finding a cure\" rather than finding a cause, and seldom is the patient\'s whole body / lifestyle considered when dis-ease arises.
Along my journey with the big C , I have often wondered why my blood pressure is never checked and urine samples aren\'t taken.
Subliminal Misogyny? I was trawling through the Cancer Research UK website recently to compare risk factors for Breast Cancer and Prostate Cancer (I know how to live!) and I couldn\'t help wondering why the risk factors for Prostate Cancer listed in the section about the 27 most common cancers are all things which are outside men\'s control - age, family history, race and exposure to radioactive substances. Risk factors for Breast Cancer are listed as age, menstruation and menopause, family history, dense breasts, previous breast cancer, benign breast disease, long term exposure to radiation which are things outside women\'s control, but then we get the usual lifestyle factors trotted out which we can control - reproductive habits number of births, breast feeding, HRT, Contraceptive pill, also alcohol and obesity.
I recently heard a Prostate Cancer specialist speak on the subject and he stated that high consumption of red meat is believed to increase risk of Prostate Cancer. So how come CRUK ignore lifestyle factors like diet that can affect prostate cancer risk? Well actually, they don\'t because if you go into further detail about prostate cancer on their website, they do discuss diet, but come to no firm conclusions - and there is no mention of red meat.
It may be that it is simply a fact that breast cancer risk is far more affected by lifestyle than prostate cancer risk, but I doubt it somehow since CRUK states that research shows that around half of all cancers in the UK could be prevented by changes to lifestyle ( a statement I don\'t accept in view of my opinions about environmental factors), but if you do accept what they say, why doesn\'t CRUK expand on how men can change their lifestyle and reduce prostate cancer risk?
I think it\'s easier for researchers to get women to accept that the life they lead and the choices they have made have somehow contributed to their breast cancer, whereas men wouldn\'t accept that so readily about prostate cancer. I think women too often accept the concept that when they get a nasty disease, they must somehow be to blame.
CRUK recently told me this in an email:
\" It is now widely known that there is a link between high oestrogen levels and breast cancer.Ã‚Â In general, the higher a woman’s lifetime exposure to oestrogen, the higher her breast cancer risk.Ã‚Â This exposure is determined by several natural factors.Ã‚Â It tends to be higher, for example, in women who started their periods at a relatively young age, have children later in life (or do not have any children), do not breast feed their children or have a late menopause.Ã‚Â All these factors are known to slightly increase a woman’s breast cancer risk\"
I\'ve replied with this:
\"My main observation about the focus on lifetime exposure to oestrogen beingÃ‚Â a risk factor for breast cancer is that oestrogen (as far as I\'m aware) doesn\'t cause the DNA mutations which cause a breast cell to become cancerous. Oestrogen causes breast cancer cells and normal breast cells to proliferate, but it doesn\'t cause the cancer in the first place.
So on that basis, I get rather exasperated that researchers don\'t seem to pay much attention to what exactly is causing those DNA mutations. By pointing the finger at oestrogen, we have the situation where women who have had breast cancer or are at high risk of it are almost made to fear exposure to their own hormones.Ã‚Â The future for prevention seems to focus on manipulating womens\' exposure to their own oestrogen, using drugs (such as aromatase inhibitors) which may cause a reduced quality of life (for example increased risk of osteoporosis,) instead of finding out what substances cause the DNA mutations that cause cancer and reducing the population\'s exposure to them.\"