This monthly column features findings from the Chicago Health and Life Experiences of Women ( CHLEW ) study, an on-going study of lesbian health. Women in the study were recruited and interviewed first in 2000-'01. The second round of interviews is currently in process.
According to a proclamation by the President for last month's National Breast Cancer Awareness Month, an estimated 200,000 women will be diagnosed with breast cancer this year. So, who gets breast cancer and what are the risk factors?
Although researchers cannot say definitively what causes breast cancer, the biggest risk factor is—plain and simply—being female. In other words, all women are at risk of getting breast cancer. However, a number of other risk factors can also play a role; some of these are under our control and some are not. Getting older increases the risk of breast cancer, and the highest risk is for women over the age of 70. Other important risk factors are: inheriting a mutated breast cancer gene; drinking more than one drink of alcohol per day; being overweight in adulthood ( especially after menopause ) ; having a sister, daughter, or mother with breast cancer; never having had children—or having children later ( after age of 30 ) ; being younger than age 12 at first menstrual period; later onset of menopause ( 55 or older ) ; and using hormone replacement therapy ( estrogen and progesterone ) .
Are lesbians at greater risk than heterosexual women for breast cancer? Some health researchers think so. Possible reasons are that lesbians as a group are less likely to use birth control and have fewer pregnancies than heterosexual women, which is important because longer exposure to estrogen increases breast cancer risk. Lesbians are also thought to consume more alcohol and to be overweight or obese. Lesbians may delay or avoid health screening and other medical care more than heterosexual women, possibly out of fear of misunderstanding and censure by health practitioners.
We asked about many of these risk factors in the CHLEW study. First, and contrary to popular perceptions, many women who identify as lesbian have been pregnant or given birth. This was true for 171 ( 38% ) of the 447 women in our study. Also, contrary to what many believe, women in the study did not tend to be heavy drinkers. Only about a fourth ( 28% ) drank an average of more than one alcoholic drink per day. Finally, although more than one-half of women in the study are overweight, they are no more likely to be overweight than women in the general population. ( According to the Centers for Disease Control 60% of general population women are overweight ) . We included questions about mammograms and breast exams in the second phase of our study ( these interviews are currently underway ) and will have more information about these and other health screening behaviors in the spring of next year. The really good news is that very few women in the study have been diagnosed with breast cancer. Of the 10 ( 2% ) women who have had breast cancer, most are over 50 years old.
It is important to keep in mind that the majority of women diagnosed with breast cancer have no risk factors—other than being female. So while breast cancer may not be preventable, it is treatable. The key is early detection and early treatment. The American Cancer Society recommends the following guidelines.
— Starting at age 40, have a mammogram and a clinical breast exam by a health professional every year.
— In your 20s and 30s, have a clinical breast exam by a health professional every three years.
— Perform breast self-exams starting in your 20s. Don't depend on a partner to do it for you!
— Report any breast changes to a health professional right away.
— If you are at increased risk—family history, genetic tendency, talk to your doctor about having more frequent or earlier exams.
The continued success of the CHLEW depends largely on our ability to locate and re-interview women who participated in our first round of interviews in 2000-2001. We have lost contact with about 35 of the women who were interviewed in the first phase of the study. If you or anyone you know participated in the first phase of the study please call our toll-free number 1-866-933-3459 or contact us via e-mail firstname.lastname@example.org ) . No one can replace the original participants ( we cannot add lesbians to the study who did not participate in 2000-'01 ) , so it is critically important that we locate each of the missing participants. We very much appreciate your help and look forward to bringing you more interesting and useful information about important health issues in our community.