Breast cancer is both the most common and deadliest cancer among women. However, follow-up screenings and self-examinations are still not routine for some patients. Many misconceptions also persist. We clarify things with Dr. Michel Mouly, gynecologist, surgeon, and oncologist in Paris, and author of several books on the subject.
Every year, the beginning of October marks the launch of the “Pink October” campaign, aimed at raising awareness of breast cancer screening among women. Indeed, breast cancer is the most frequently diagnosed cancer in women worldwide. In Morocco, 40,000 new cancer cases are diagnosed each year, 36% of which are breast cancer cases in women. One in eight women will be affected by this disease during her lifetime.
Given that breast cancer remains the leading cause of cancer-related death in women, it is crucial to detect the early signs. To help sort fact from fiction, Dr. Mouly agreed to answer our questions. As a gynecologist, surgeon, and oncologist, he has been raising awareness on this subject for years, as well as on the risks associated with untreated menopause. He released his second book, Menopause: No More Suffering in Silence, in February 2024.
Breast cancer only affects women: False
While it predominantly affects women, breast cancer can also occur in men. Although only around 500 men are diagnosed with breast cancer each year in France (1% of the total number of breast cancer cases), it is important to know of its existence, potential risk factors, and early symptoms. Since men are not part of an organized screening program like women, their diagnosis is often late and, therefore, more serious.
Some women are more predisposed than others: True
There are several factors that can increase the risk of developing breast cancer, starting with age. “80% of cases are diagnosed in women aged 50 and over. While the average age is 61, 25% of breast cancers occur after age 70. This is why it’s important to continue mammograms beyond 75,” explains Dr. Mouly. Family history and genetic factors also play a role. Having a family member (mother, sister, daughter) diagnosed with breast cancer increases the risk. Certain hereditary genetic mutations, notably those in the BRCA1 and BRCA2 genes (which control cell division), significantly raise the chances of developing breast or ovarian cancer.
Other risk factors include alcohol and tobacco consumption, sedentary lifestyle and lack of exercise, being overweight or obese, as well as pollution. Hormonal causes are also worth mentioning. “For a long time, prolonged exposure to estrogen (female sex hormones), such as in cases of early menstruation (before age 12), late menopause (after age 55), or lack of pregnancy, was thought to increase the risk of breast cancer. However, it has been shown that estrogen alone reduces breast cancer occurrence by 26% (WHI American study, 2002, and Abenhaim study, Obstetric Gynecol, 2022),” notes the gynecologist.
He adds, “However, certain oral contraceptives may increase the risk of developing breast cancer, particularly those using synthetic progestins, especially if taken alone between ages 40 and 50. Lastly, women who haven’t had children or had their first child late are at higher risk. However, it is important to note that having one or more of these factors does not guarantee the development of breast cancer but simply increases the probability.”
Breast cancer only affects women over 50: False
As previously mentioned, women over 50 are at higher risk of developing breast cancer, but 20% of patients are under fifty. Most of these cases are genetic (BRCA1-2). It is estimated that about 2 in 1,000 women carry a BRCA1 or BRCA2 mutation. According to the website e-cancer.fr, “These two genes help repair the damage that DNA regularly undergoes. The presence of mutations in one of these genes disrupts this function, significantly increasing the risk of breast and ovarian cancer.”
Pregnancy can reveal breast cancer: True
Whether it’s content creator Emilie Brunette (real name Emilie Daudin) or reality TV contestant Eloise Appelle, it seems that more and more young women are speaking out on social media about their battle against this disease. The first was 33 years old when she learned she had triple-negative breast cancer, and the second had just turned 26. Both are young mothers, prompting the question of whether there is a causal link between the hormonal upheaval caused by pregnancy and breast cancer. Indeed, in France, out of 800,000 annual pregnancies, between 200 and 300 women are diagnosed with breast cancer during or in the months following their pregnancy. According to Dr. Mouly, this is a complex issue.
“Some studies suggest that women may be at increased risk of developing breast cancer in the years following pregnancy. During these nine months, the body undergoes significant hormonal changes, including elevated levels of estrogen and progesterone. These may influence the growth of breast cells. However, although these changes can be concerning, many women will not be affected. Other factors, such as age and medical history, are also important,” he emphasizes.
Indeed, a late pregnancy (after age 30) may be associated with a slightly higher risk of breast cancer, mainly due to prolonged exposure to hormones. “Pregnancy behaves like French-style hormone replacement therapy (HRT), which replicates ovarian function using natural hormones, unlike American HRT, which uses synthetic hormones. It doesn’t cause breast cancer but reveals it earlier. During pregnancy, women benefit from regular medical checkups, which can lead to early detection of health problems that might otherwise have gone unnoticed,” adds the specialist.
Early detection allows for better treatment: True
In general, the earlier breast cancer is detected, the greater the chances of recovery. Early detection allows 99 out of 100 women to be alive five years after diagnosis. Moreover, cancers detected early often require less aggressive treatment, thus reducing side effects. This is why screening is so important. Starting at age 25, it is recommended to perform a monthly self-examination of the breasts, 7 to 10 days after the menstrual period, to detect any changes (size, shape, lump, nipple discharge, abnormal skin color, etc.). Then, from age 50, it is important to have a mammogram every two years.
Read also : DAILY ANTI-POLLUTION HABITS: 4 STEPS TO PROTECT YOUR SKIN AND HAIR
Physical activity improves cancer treatment: True
As you know, staying active is essential for good health, and this is even more true when dealing with cancer. During treatment, regular physical activity improves quality of life. It reduces fatigue, depression, improves sleep and self-esteem, and may even help improve tolerance to treatments by reducing side effects. In the long term, exercising after a breast cancer diagnosis reduces the risk of recurrence by 24% and the risk of cancer death by 28%.
In Casablanca, the Bodypilates center, opened in May 2024, offers a weekly Pilates Reformer session to women suffering from or recovering from breast cancer. This initiative was started by Achraf Baba Hammou, founder of the center and Pilates instructor trained at Martine Curtis’s school in Paris. “I recently lost my best friend to breast cancer, and it was very difficult. In her memory, I wanted to offer a completely free class to women suffering from this disease. It’s a way for me to give them an opportunity to clear their minds and, most importantly, to feel good both physically and mentally,” she tells us.
Hormone replacement therapy (HRT) causes breast cancer: False
In 2002, the American “Women’s Health Initiative Study” accused hormone replacement therapy (HRT) of causing breast cancer. This claim is now refuted (more details in our dedicated article on perimenopause). According to Dr. Mouly, it is important to differentiate between French-style HRT, which uses natural hormones, and American-style HRT, which contains synthetic progestins. “French-style HRT does not increase the risk of breast cancer. On the contrary, it will allow earlier detection. The cancer will be smaller, with fewer lymph node involvements, fewer metastases, and a 50% reduction in mortality compared to women who do not take it,” he says.
For women who have undergone a hysterectomy (removal of the uterus), the gynecologist explains that using HRT made of estrogen alone could reduce breast cancer occurrence by 25%. Finally, studies show that French-style HRT has no time limit. The longer it is taken, the lower the recurrence and mortality rates compared to shorter durations.
“Personal factors such as heredity, age, weight, inactivity, alcohol, tobacco, and medical history can influence the risk of developing breast cancer, with or without HRT. There is no simple answer to this question. The risk may vary depending on the type of hormone therapy, its duration, and each woman’s individual characteristics. It is important to weigh the benefits of the treatment against potential risks,” concludes Dr. Mouly.
Picture (c) : Vogue
