Breast Cancer, Pt. 2

Angela Lanfranchi, M.D.

We know for sure that there is hope for prevention of breast cancer.


Look at what happened in 2002 after the Women’s Health Initiative Study became known to the public when it made the 6 o’clock news. Women found out that hormone replacement therapy, Pempro, increased breast cancer risk by 26%.  That summer 15 million or half of the 30 million women that were on HRT abruptly stopped.  As one of my patients said, “I’d rather have hot flashes than cancer.” 

Just a few years later in 2007, it was reported that there was an 11% decline in breast cancer rates in women over 50 with estrogen receptor positive cancers. After much scientific debate, those in the medical field conceded that the decline in rates was attributable to the reduction in the use of HRT. 

Information that these hormones could cause breast cancer was in the medical literature for over 20 years.  But when that knowledge was put in the hands of women who needed and considered it, many acted upon it and breast cancer rates fell. 

What do you think will happen when women learn that these same hormones are in oral contraceptives but in much higher doses?  Will half of the 75% of premenopausal women in theUnited Stateswho take hormonal contraceptives stop these hormones like their mothers did after menopause? 

Since 1975, according to the National Cancer Institute SEER data, non invasive breast cancers have increased in women less than 50 by 400%.  What if they learn that in 2005 the UN’s World Health Organization listed oral contraceptives as Group 1 carcinogens, the same group that contains asbestos and cigarettes?  I bet that they will learn about the safer methods of fertility control, especially if they have a family history of breast cancer. 

Breast cancer rates would fall for premenopausal women too. 

What if women knew that having children and breastfeeding decreased breast cancer risk substantially?  Would we wait so long to have our children if we knew that a woman who waits to have her first child at 30 has a 90% higher risk of breast cancer than the woman who has her first child at 20?  I wouldn’t have waited until I was 41 to have my first and only child if I had known. Unplanned pregnancies could bring unplanned joy and adoption could be a better option. 

It is often said by cancer organizations that 70% of women with breast cancer have no identifiable risk factors and that we should give them money to find a cure.  It is simply untrue that 70% of all breast cancer patients have no identifiable risk factors.   If 75% of women of reproductive age have taken oral contraceptives they are at increased risk.  If 20% of the women in this country remain childless, they are at increased risk.  If 50% of post menopausal women have taken hormone replacement therapy, they are at increased risk. 

Let’s be more than “aware” regarding breast cancer.  You’d have to be deaf, dumb and blind not to be aware that breast cancer exists and is a threat to many women.  It’s on the TV news and cable channels, radio, the internet, magazines, newspapers, and even the shopping channel as a patient once told me.  You can’t even go to the grocery store during “awareness” month without being faced with pink ribbons on food containers to benefit one organization or another. 

Let’s be proactive and not just aware. Let’s be proactive make women aware that breast cancer is curable in many cases if not in at least half those diagnosed with screening mammograms. 

We already know lots about what causes breast cancer and what can increase a woman’s risk.  Breast cancer is not the fickle finger of fate randomly pointed at women.  There are many other avoidable risks. We can hope and expect to reduce breast cancer rates with prevention. 

And what of the hope in survivorship? 

There are 2.5 million survivors of breast cancer in our country right now.  Wouldn’t it be a shame if they worried everyday that their cancer might come back, waiting for the other shoe to drop or with the sword of Damocles over their head?  Not able to enjoy life to the fullest?   Or didn’t do the things that would reduce the risk of it coming back?

They need to know that there is a wonderful survivorship programs around the country. The name of one program is Transitions.  It is a national Wellness Community program that helps women to overcome the challenges of survivorship.  There is also a Kids Connect program that helps children to overcome the challenges of having a parent with a cancer diagnosis. 

In a nutshell, hope comes through knowledge and the gift of faith. Both are free for the asking. Visit

(This two part post was adapted from a speech given by Dr. Angela Lanfranchi, MD FACS during the 7th Annual Shades of Pink Celebration Proclaiming Breast Cancer Awareness Month.)


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