A federal panel recently advised women get a mammogram every other year starting at age 40, rather than 50.

And the American Cancer Society estimates that in 2023, nearly 300,000 women in the United States will learn they have breast cancer. About 43,700 women will lose their life due to the disease.

The headlines are reminders to know your breast cancer risks. While many risks are out of your control, there’s just as much you can control, says Heather Thompson, a breast health navigator at OSF HealthCare.

Major risks you can control

• Active lifestyle and healthy eating: Thompson puts it plainly. If you eat junk, you’ll feel like junk. And any exercise will give you more energy and burn fat. Fat produces estrogen, which feeds cancer cells.

“You want to make sure you’re well-maintained with your weight, even after menopause,” Thompson says.

• Taking hormones: This impacts your ovaries, reducing or adding estrogen. Whether you’re at a routine appointment or you have been diagnosed with breast cancer, talk to your provider about what hormones you’re taking.

“We don’t encourage people who are having menopause symptoms [like hot flashes] to take hormones,” Thompson lists as an example. “We encourage other things to help treat those. It eliminates those estrogen cells increasing.”

• Alcohol and smoking: They are a risk for any type of cancer. But Thompson says one drink per day can increase a woman’s breast cancer risk by 12%. Alcohol is sugary, and that’s a fuel for estrogen.
   
• Night shift work: Thompson says our body expects to sleep when the sun goes down. Night work throws that off.

                “You’re getting artificial light all night. That changes the melatonin that the body naturally makes,” Thompson explains. “When your melatonin is off, it increases estrogen.”

                If you don’t work the traditional day job, see if you can work different shifts so you are not up all night all the time.

Risks you can’t control

• Age: Thompson says women generally develop breast cancer at age 50 and above. 
   
• Family history and genetic mutations: A family history of breast cancer puts you at a higher risk. Thompson says the higher risk is often seen on the person’s mother’s side of the family. For example, your mother and her sister (your aunt) may have breast cancer, and so you’d need to talk to your provider about your risk.

              Some women diagnosed with breast cancer and who have a family history may undergo a genetic test.

“Those tests can tell us if this is something being passed down from generation to generation,” Thompson says.

• Reproductive history: Young women who develop menstruation before age 12 and women who go through menopause after age 55 have an increased risk.

“That gives them a longer time with their ovaries working. They’re producing estrogen,” Thompson says.

• Dense breast: More tissue and less fat mean a dense breast and an increased cancer risk, Thompson says. Usually, the younger you are, the denser your breast is. The density of your breast is something that will be noted on every mammogram result. Thompson says mammogram technology is getting better at finding cancer in dense tissue. An early diagnosis may mean a better outcome.

Takeaways

Make sure your health care provider knows about your circumstances so they can decide on the best preventive care, like a different schedule for mammograms. Some of the information to have handy: a family history of cancer and any physical change you noticed during your monthly breast self-check.

Learn more about breast health and breast cancer care on the OSF HealthCare website.

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Say yes ma'am to the mammogram
FDA dense breast rule promotes earlier cancer detection
A woman's battle with breast cancer
Prevention of breast cancer starts with awareness

The Peoria, Illinois-based hospital system has brought surgical oncologist Tamara Floyd, MD, to the care team at OSF HealthCare Saint Francis Medical Center in Peoria. Dr. Floyd performs cytoreductive and HIPEC (hyperthermic intraperitoneal chemotherapy) surgeries in Peoria, while also seeing patients in Bloomington and Galesburg.

HIPEC procedures are mostly for patients who have tumors or cancer spread in the abdominal cavity. 

Cancerous tumors are removed through cytoreductive surgery where the surgeon initially attempts to remove as much of the cancer as possible. Surgery is then followed by HIPEC, which is when a heated chemotherapy – at just over 106 degrees Fahrenheit – is administered into the abdomen. The heated chemo is then circulated around the area inside the abdomen to treat any remaining microscopic tumor cells.

HIPEC can be beneficial for several types of cancer patients. The one it benefits the most is LAMN, or low-grade appendiceal mucinous neoplasm. HIPEC is considered a standard of care for patients who have seen their cancer spread into the space in the abdomen that contains the abdominal organs.

These can be appendix, colorectal, and now more data indicates stomach cancer patients may benefit from HIPEC, Dr. Floyd says.

"Additionally with more data, pancreatic cancer is being looked at as well. Even patients with breast cancer. Another cancer that benefits from HIPEC is peritoneal mesothelioma." 

HIPEC can be a viable treatment option at any stage, Dr. Floyd says. But as some people are diagnosed with later stage disease, it can feel like no options are possible. HIPEC changes that.

"It's beneficial to have the option of doing HIPEC, or cytoreductive surgeries, for patients who have peritoneal spread of disease, which for most cancers means it is a stage 4 disease," Dr. Floyd says. "In a lot of instances, if you're talking about stage 4 disease, there aren't a lot of other options."

While HIPEC is a viable option for low-grade cancers, it's also a helpful option for later stage, more aggressive cancers. Patients with signet ring or goblet cell features, which are more aggressive subtypes, can also be treated with HIPEC. 

"Signet ring is one of the subtypes of appendiceal, colon or rectal that can be treated. There are even some subtypes of gastric or stomach cancer that are considered a signet ring or have signet ring features," Dr. Floyd says. "Cytoreductive and HIPEC can be considered for those patients."

Throughout a cancer journey, combining traditional chemotherapy that is administered through IV with HIPEC provides a "synergistic effect" Dr. Floyd says. HIPEC allows the chemotherapy to be administered directly to the cancer cells and kill them that way. 

Dr. Floyd has done one HIPEC at OSF Saint Francis so far and has another planned soon. It's anticipated that within the next year, Dr. Floyd and her team will start to do three to four HIPEC surgeries a month as OSF HealthCare Cancer Institute continues to grow as a destination center.

Patient recovery times can be one to two weeks in the hospital after HIPEC surgery, which is why having this option for Central Illinois patients is so important. It allows the patient and their families to stay close to home, instead of having to travel hours away. Dr. Floyd says the longer travel times can turn patients and their families away from pursuing care. 

Heated chemotherapy can also be used in thoracic cavities. This would then be called HITEC or HITOC, Heated IntraThoracic Chemotherapy. This is for patients who have disease spreading in the pulmonary area. 

Types of cancers that can be treated by HIPEC: 

-          LAMN (Low-grade appendiceal mucinous neoplasm)

-          Appendiceal

-          Colon

-          Rectal

-          Gastric

-          Stomach

-          Pancreatic

-          Breast

-          Mesothelioma

-          Ovarian

For more information on cancer treatment options at OSF, visit the OSF HealthCare Cancer Institute website.

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