Fill in Your Family Health History
If you haven’t done so already, collect as much information as possible from relatives on both sides. "Go back several generations, if you can," Norton says. "It’s especially important to know if your mother or father carries cancer-predisposing gene mutations, including BRCA-1 or BRCA-2. So if your parents are alive, you might ask them to consider genetic testing." Even if there’s no breast cancer in your immediate family, you may still be at risk if you have first-degree relatives with other hormonally driven cancers, such as prostate and ovarian cancers, which are also linked to the BRCA-1 and -2 genes. "If you have a strong family history of breast or ovarian cancer, or any cancer in a parent or a sibling, it’s worth a trip to a genetic counselor to assess your personal risk," Norton says. Afterward, you may be advised to seek genetic testing. The process is simple (your doctor takes a regular blood sample and sends it to a special lab); the cost ranges from $300 to $3,000, depending on the test ordered, and many insurers will cover it. If privacy concerns have stopped you from considering such tests in the past, be aware that Congress recently passed the Genetic Information Non-Discrimination Act, which forbids employers and insurers to use DNA test results to deny coverage.
Breast Health in Your 50s
This decade marks your prime time for cancer: 77 percent of all breast cancers are detected in women of 50 and older, according to the American Cancer Society. Moreover, a study in the journal Breast Cancer Research in May 2008 found that tumors in women 50 through 59 doubled in size over an average of only 1.4 years, making annual surveillance a must.
Get a Shape Update
"As women age and go through menopause, their breasts can feel softer: The dense tissue is replaced with fatty tissue," Eng-Wong says. "But some women maintain density, even after menopause. Neither is abnormal; the key is knowing how your own breasts feel." In other words, keep up your self-exams. "Even women who are closely followed by a physician tend to discover their own lumps," Norton says, since they come into contact with their own breasts daily, while clinicians see patients only a few times a year at most. If you can alert your doctor to changes in your breasts, she’ll be better able to determine what needs further screening and attention. Be aware that caffeine and some asthma and migraine medications may also cause breast lumps. Toward the close of this decade, once you no longer have your period, the lumpiness, tenderness, and cysts you endured in your 40s and early 50s will start to subside. "In general, the older women are, the less active their breasts become in terms of cystic changes and nipple discharge, because of waning estrogen and progesterone levels," says Mary Jane Minkin, MD, clinical professor of obstetrics and gynecology at Yale University. "There are changes all the time in premenopausal women, and it’s no big worry. But if a postmenopausal woman who is not taking hormone therapy is experiencing changes, it’s more of a concern."
Considering hormone therapy? Before deciding, weigh your family history against the severity of your symptoms (hot flashes, vaginal dryness, night sweats, and so on). "If relatives have had breast cancer, you may incur an increased cancer risk from hormone therapy’s combination of progesterone and estrogen," Willey says. If you do have a family history but symptoms are making you miserable, take the lowest dosage possible, for the shortest time possible, to ease yourself through the worst of your suffering. Talk to your ob-gyn about local therapy (creams or suppositories) that may ease symptoms with minimal whole-body hormonal impact.