What Every Woman Should Know about Breast Cancer

I am living with a disease that is considered incurable. I am fortunate that my current treatment line has not failed, but the reality is that it probably will. There has been “no evidence of disease” since April of 2023, but NED does not mean "cured." It means that, right now, there is no detectable evidence of disease on my scans. Cancer is still part of my reality, though right now I am experiencing a best-case scenario. I refuse to shy away from the reality of my situation or the fact that the best case may not last forever. For now, even when I feel like shit from my meds' side effects, when the fatigue and brain fog make it hard to remember what it felt like to have a functioning body, I can remind myself that I am still here — Ryan N’s story: breastcancer.org

There are questions people ask out loud, and there are questions they quietly carry with them. “Why did she get breast cancer? She was so young.” “Can it happen to me even if nobody in my family has had it?” “Is there something I should be doing to prevent it?”

Perhaps the most unsettling question of all: What if I do everything right and still get it?

October brings breast cancer awareness into sharper focus, but awareness should be more than pink ribbons, matching outfits, and reminders to get checked. It should leave us with something more valuable: an understanding of our bodies, the courage to seek help, and the knowledge to make informed decisions about our health. So, to get there, let's start with the question I got asked by my audience and I am so sure many of us have wondered about: How is breast cancer gotten and how can it be prevented?

First, what actually happens when breast cancer develops?

Our bodies are made up of cells that grow, divide, and eventually die in a carefully regulated cycle. This process allows tissues to repair themselves and replace old or damaged cells.

Now sometimes, changes occur in the DNA that controls how these cells behave. The instructions become disrupted, and cells may begin growing and dividing when they shouldn't. When these abnormal cells grow uncontrollably and form a malignant tumour in the breast, breast cancer can develop. If the disease progresses, these cells may invade surrounding tissues or spread to other parts of the body.

Breast cancer is not one single disease with one single cause. Different types can behave differently, grow at different rates, and respond to different treatments and no, it isn't exclusively a disease of older women. Although risk increases with age, younger women can develop it too. Surprisingly, men can also develop breast cancer, even though the vast majority of cases occur in women.

I can know that this disease may eventually take something from me, without letting it take everything from me now. I can know that my treatment may someday stop working and still be grateful that it is working today. I can know that I do not have forever and still make plans for next month. I can miss the people who are no longer here and still laugh until my stomach hurts with the people who are. I can be afraid of what is ahead and still be curious about it. Maybe “Not Yet” is not a promise, or even optimism. Maybe it is simply an acknowledgment of the present: Today, I am here. Four years later, I am still here. My story is not finished...Not yet…..Ryan N’s story: breastcancer.org

Why does breast cancer happen?

This is where the conversation becomes complicated.

Researchers have identified several factors associated with breast cancer, but having a risk factor does not mean someone will definitely develop the disease. Equally, a person without obvious risk factors can still be diagnosed.

Some factors are beyond our control.

Age is one of the most important. The risk generally increases as we grow older.

Family history and genetics also matter. Inherited changes in genes such as BRCA1 and BRCA2 can substantially increase risk. However, most people diagnosed with breast cancer do not have a known family history of the disease. So, the absence of breast cancer in your family does not automatically mean you are risk-free. Scary, I know…

Other factors include certain reproductive and hormonal influences, previous radiation exposure to the chest, and having particular breast conditions or dense breast tissue.

Then there are factors we may be able to influence like alcohol consumption, physical activity, and body weight, particularly after menopause.

I would like to point out that risk is not blame. A woman who develops breast cancer has not necessarily eaten the wrong foods, neglected exercise, or failed to take care of herself. Risk factors help researchers and healthcare professionals understand probabilities, they do not in any way provide a moral explanation for someone's diagnosis. 

image from Ehealth

Knowing your breasts matters, too

Imagine noticing a new lump in your breast but dismissing it because it doesn't hurt or noticing a change in your nipple and assuming it must be normal because you've never experienced pain. These are reasons awareness matters.

Possible warning signs of breast cancer include:

• A new lump or thickened area in the breast or underarm.

• A change in the size, shape, or appearance of a breast.

• Dimpling, redness, or other unusual changes in the breast skin.

• A newly inverted nipple or changes around the nipple.

• Unusual nipple discharge, especially bloody discharge.

  
  

Not every breast lump or change is cancer. Many are caused by benign conditions but you cannot reliably determine the cause by appearance, touch, or pain alone. If you notice a new or unusual change, seek medical assessment promptly rather than waiting for it to become painful.

Learning how your breasts normally look and feel can help you recognise changes but note thatyou do not need to live in constant fear of finding something wrong. Awareness should empower you, not make you anxious about every sensation.

Breast cancer conversations often focus on prevention, but there is another part we must not overlook which is what happens when prevention isn't possible.

We owe people living with breast cancer compassion rather than judgement. We owe them access to accurate information, timely assessment, and appropriate treatment and we owe ourselves the willingness to seek medical help without shame.

Early diagnosis and timely treatment can improve outcomes but awareness alone cannot solve every problem. Access to diagnostic services, treatment, and follow-up care matters too. For many people, the hardest step is not learning that a lump can be a warning sign. It is deciding to seek help despite fear, financial concerns, stigma, or the hope that the change will disappear on its own.

That is why conversations like this matter.

So back to the question, can breast cancer be prevented?

My answer is Not completely but we can take evidence-based steps to reduce risk, understand our personal risk factors, recognise unusual changes, and seek appropriate medical assessment.

Regular physical activity, maintaining a healthy weight, and avoiding or limiting alcohol are among the measures supported by evidence. Breastfeeding is also associated with a lower risk of breast cancer.

For people with a strong family history or certain inherited genetic changes, a healthcare professional may recommend additional assessment and, depending on individual risk, discuss preventive medicines or surgery.

These options are not necessary or appropriate for everyone.

They require a proper assessment of personal risk, benefits, and potential harms. 

I really hope this brings some clarity, I would love to hear everyone's thoughts and thank you so much for your question!

With love,

Jojo Talks Med