Breast Health in Your 40s
Keeping your breasts healthy as you age is not a one-size-fits-all proposition. "The general principles are the same whether you’re in your 40s, 50s, or 60s," says Larry Norton, MD, deputy physician-in-chief for breast cancer programs at Memorial Sloan-Kettering Cancer Center, in New York City. "But how you apply them shifts over time." That’s because the changes and options you face in your 40s are different from those you confront in your 50s or 60s. Here’s a decade-by-decade guide to your breast health, including the best choices to make concerning everything from your diet to your bra size.
Breast Health in Your 40s
As you head toward menopause, your body starts a new phase of change. One result: 95 percent of all new breast cancers and 97 percent of all deaths from the disease occur in women over 40 (though both are more likely to happen at older ages). So if you haven’t paid much attention to breast health before, now is the time to start.
Expect Your Breasts to Feel Different Each Month
In this decade, women often have their first experiences with breast lumpiness, tenderness, and cysts.
"The hormone levels in your body are starting to fluctuate, and your breasts are responding to that," says breast surgeon Shawna Willey, MD, of the Lombardi Comprehensive Cancer Center, at Georgetown University. So from the time you ovulate until you menstruate, you may encounter lumps, bumps, and thickening. Report any new change to your doctor. The presence of cysts or lumps may lead to biopsies, but according to the American Cancer Society, the results of most biopsies (80 percent) are benign. "Seventy percent of women have fibrocystic changes in the breasts over time, and these will become more exaggerated in this decade," Willey says. "But they will diminish after menopause."
Keep Up Self-Exams
Although not many cancers are discovered by this method, of those that are, most are found by the women themselves. Self-exams are still a useful tool, says Jennifer Eng-Wong, MD, a medical oncologist at the Lombardi Comprehensive Cancer Center. Performing exams will keep you familiar with how your breasts feel, she says, which means you’ll be alert to any changes that do occur. Which changes should you investigate? "The ones that come and don’t go away," says Banu K. Arun, MD, associate professor of breast medical oncology at the M.D. Anderson Cancer Center, at the University of Texas. Schedule a visit to the doctor if you notice changes that linger after your period has ended. If your menstrual cycle is erratic and you experience something unusual, play it safe and talk about it with your physician.
Watch the Calendar
Systematic screening is crucial in your 40s: monthly self-checks, annual ob-gyn checkups, and yearly mammograms. On the one hand, your risk for cancer is lower than it will be in the next two decades. (According to the ACS, a 40-year-old woman has only a 1.43 percent chance of developing breast cancer over the next 10 years.) On the other hand, the tumors that do show up tend to be more aggressive, and less responsive to treatment, than those that appear later. That’s why, even though it’s unlikely you will develop a problem, you need to start annual screening once you hit 40, says Debbie Saslow, PhD, director of breast and gynecologic cancer at the ACS. Regularity is key: The more time that passes between screening tests, the longer cells can grow unchecked.
Keep Your Weight Steady
Women who get significantly heavier in midlife are more likely to develop breast cancer after menopause than those whose weight remains roughly the same, according to a study in the Archives of Internal Medicine last fall. "Those who gained 40 to 60 pounds between the ages of 35 and 50 had a 40 percent increase in risk compared with women who maintained their weight," says the study’s lead author, Jiyoung Ahn, PhD, research fellow at the National Cancer Institute. Over time, even a few extra pounds a year ups your odds of developing breast cancer, as well as a host of other chronic, even deadly, diseases. That’s why Ahn calls maintaining a healthy weight the key to cancer prevention.