Helping women make the right choices: Europa Donna launches Breast Health Day

A variety of factors are now known to contribute to raising women’s risk of developing breast cancer. Ensuring key messages on breast health become as familiar as themessage ‘ Smoking is bad for your health’may help prevent needless suffering and death.

» Janet Fricker

In the last few years a plethora of studies have been published revealing the specific lifestyle changes women can be making throughout their lives to help them avoid a diagnosis of breast cancer. Research has shown that around one third of breast cancer cases can be directly attributed to increased weight and lack of physical activity. Alcohol consumption, hormone replacement therapy and the contraceptive pill have also been shown to increase a woman’s risk of developing breast cancer. Additional evidence suggests that reproductive factors, such as having children at a younger age, having several pregnancies and breast feeding, all have a role to play in protecting against breast cancer, along with starting menstruation late and experiencing menopause at an early age. 

While such research is well known to the oncology community, concerns are growing that it is not reaching the wider audience of women in Europe, and is therefore having little effect on the incidence of breast cancer. Europa Donna, the European Breast Cancer Coalition, has now taken up the challenge of getting the information out to women of all ages in Europe. “Given that there is now concrete research about very specific changes women can make to their lives to avoid breast cancer, we feel that it is our obligation as advocates to get this information across to the general public,” said Susan Knox, Europa Donna’s executive director.

“Some risk factors, such as the time of starting menstruation, menopause and number of births, women can’t do much to change. But we want them to realise that there are decisions they can make about leading a healthy lifestyle that have an influence and help them to avoid a diagnosis of breast cancer.”With132,000 European women dying from breast cancer and 430,000 being diagnosed with the disease each year, says Knox, it is vital to get the message across.

The initiative is not a question of changing priorities for Europa Donna, Knox stresses, but of adding a third focus to their range of interests. The campaign, will not in any way detract from Europa Donna’s long-term initiatives on early detection and optimal treatment of breast cancer through population-based mammography screening and specialist breast units, as stipulated in the European guidelines for quality assurance in breast cancer screening and diagnosis. 

To ensure attention gets focused on breast health, Europa Donna have dedicated a special day – October 15 – to raising awareness. Last October 15, Europa Donna got the ball rolling by hosting a media event in Milan, Italy. The aim was two-fold: to train Europa Donna representatives on the published research and get journalists up to speed, and encourage them to start writing about the issues.
 
Thirty-two national representatives and delegates from Europa Donna’s 41 member countries were in attendance, in addition to journalists from Italy, Cyprus, Lithuania, Malta, Romania, Slovenia, Sweden and the UK. “We particularly wanted to target writers on popular health and women’s magazines, to help us reach out to a younger and wider audience,” said Knox. “In the past, women didn’t feel that they needed to worry about their breast health until they were in their 40s, but new research shows they should start following prevention guidelines from an early age.” Invited speakers included Philippe Brunet, head of cabinet to the EU Commissioner for Health, Carlo La Vecchia, advisor to the International Agency for Research on Cancer (IARC), Alberto Costa, director of the European School of Oncology and Umberto Veronesi, scientific director of the European School of Oncology and a Senator in the upper house of the Italian Parliament. 

“Breast Health Day serves to keep this issue in the public eye but, maybe more importantly, at a higher level of priority in decision makers’ minds,” Brunet told the meeting, adding that in 2009 the Commission plans to set up a new EU Platform for Action on Cancer to provide the framework for identifying, sharing and spreading information about cancer prevention and screening. He called for improved communication strategies between citizens, to encourage and educate them about healthy lifestyle choices. “Because in cancer, as in many other important diseases, every person can play a pivotal role in shaping his or her own health through the daily choices made,” he said.

THE EVIDENCE
Presenting a primer on prevention research, La Vecchia, told the audience that there is now enough evidence to show that avoiding weight gain in adult life can reduce the risk of postmenopausal breast cancer. For postmenopausal women who already have breast cancer, losing weight could reduce the risk of recurrence. Regular physical activity also reduces the risk of breast cancer by around 20%, he said, and this effect seems to be independent of body weight. The evidence also shows that alcohol consumption increases the risk of breast cancer, he added. 

Citing the findings of a French study conducted in 2000, which calculated the percentage of breast cancer cases that can be attributed to identified risk factors, La Vecchia said almost 11% of breast cancers could be attributed to the combined use of hormone replacement therapy and oral contraceptives, and about 10% to physical inactivity. Almost 10% are due to alcohol consumption, over 5% to reproductive factors, and almost 5 % to being overweight or obese. 

In an upbeat presentation, Umberto Veronesi said, “zero mortality” due to breast cancer is a goal that should one day become a reality. Prevention through lifestyle is important, he said, but the potential of detection techniques, including mammography, ultrasound and MRI, should not be forgotten. “If we could reach the objective and identify small tumours that are not palpable, we could reach the vision of very close to zero mortality,” he said, adding that survival has been observed to be directly proportional to the size of the tumour at diagnosis. For every millimetre increase in tumour diameter, there is a 1% reduced chance of survival at 10 years.

Europa Donna has published key information on lifestyle factors, prevention, screening and advocacy in a new booklet, EUROPA DONNA guide to breast health, which was launched at the event. Information is also available online at www.breasthealthday.org.

“We felt the media day was a great success and showed there was real agreement across Europe on how much we need to work together on breast health issues,” said Knox, who points out that the ultimate success of the event can only really be judged by the media coverage generated. Seeing articles in print may take time, since breast cancer articles in the popular press are often held back for Breast Cancer Awareness month in October. “Since women’s magazines have a tendency to plan their coverage well ahead, we felt it important to get journalists up to speed on the issues ahead, in the hope that they’ll bear us in mind next year,” said Knox, adding that, in future, Breast Health Day may focus on a particular aspect of the campaign, whether it be physical activity, obesity, bodymass index, diet or alcohol, and each individual Europa Donna group would be asked to develop a media plan around it for their own country.