Chapter List

• Introduction to Age Erasers for Women
• Stop the Clock
• Age Spots
• Allergies
• Anger
• Arrhythmias
• Arthritis
• Back Pain
• Binge Eating
• Bladder Problems
• Burnout
• Bursitis and Tendinitis
• Cellulite
• Depression
• Dieting
• Double Chin
• Drinking Problems
• Drug Dependency
• Eating Disorders
• Endometriosis
• Fatigue
• Fibroids
• Foot Problems
• Hair Loss
• Heart Attack
• Heart Disease
• Hemochromatosis
• High Blood Pressure
• Hysterectomy
• Infertility
• Midlife Crisis
• The Pill
• Respiratory Diseases
• Sex Problems and Stds
• Smoking
• Snoring and Sleep Apnea
• Stress
• Stroke
• Television
• Thyroid Disorders
• Type A Personality
• Unwanted Hair
• Varicose Veins
• Vision Changes
• Worry
• Wrinkles
• Adventure
• Aerobics
• Affirmations
• Alcoholic Beverages
• Altruism
• Antioxidants
• Aspirin
• Breakfast
• Breast Care
• Calcium
• Career Change
• Change and Adaptability
• Confidence and Self-Esteem
• Cosmetic Dentistry
• Cosmetic Surgery
• Creativity
• Fiber
• Fluids
• Forgiveness
• Friendships
• Goals
• Honesty
• Hormone Replacement Therapy
• Humor
• Immunity
• Learning
• Leisure Time
• Low-Fat Foods
• A Litany of Low-Fat Foods
• Makeup
• Marriage
• Massage
• Medical Checkups
• Optimism
• Relaxation
• Religion and Spirituality
• Resistance Training
• Sex
• Skin Care
• Sleep
• Stretching
• Vegetarianism
• Vitamins and Minerals
• Yoga
• Credits
• Gray Hair Rethinking Your True Colors
• Biological Clock
• Body Image
• Caffeine
• Cancer
• Cholesterol
• Dental Problems
• Diabetes
• Digestive Problems
• Hearing Loss
• Injuries and Accidents
• Memory
• Menopausal Changes
• Metabolism Changes
• Migraines
• Osteoporosis
• Overweight
• Premenstrual Syndrome
• Reaction Time
• Skin Cancer
• Ulcers

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Breast Care

Keeping Your Breasts Firm and Healthy

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You turn to the right and look at your breasts sideways in the mirror. You turn back to the front, lift your arms over your head and check again. Then you turn to the left and check one more time.

What are you looking for?

Two things: the sags and stretch marks that suggest you're beginning to age--and which you intend to fight with every trick in the book--and any lumps, bumps, dimples, discharge, droops, wrinkles or differences in size, shape or color that may signal the presence of cancer.

While none of us wants to see the signs of aging, what we fear most is breast cancer. And for good reason--it's the most common type of cancer that women get.

Most breast cancer is found by women themselves, not by the doctor or a mammogram. They notice that something doesn't look or feel right. Yet 80 percent of women say that they don't do breast self-examinations, or BSEs, on a regular basis. Some say they feel uncomfortable touching themselves and others simply can't face the possibility that breast cancer could happen to them.

These feelings reflect the fact that our breasts act as physical markers for our transitions from one stage of life to another: They emerge as we begin to menstruate, bloom as we begin an active sexual life, ripen into fullness as we prepare to give birth and eventually wither or sag.

Yet the very reasons that may make us reluctant to examine our breasts are also the most compelling reasons that we should.

Breast cancer is a major health threat to any woman who has passed her 30th birthday, says Sondra Lynne Carter, M.D., a gynecologist in private practice in New York City who treats patients with breast problems. And the threat escalates with every year.

Where you had a 1 in 21,441 chance of having breast cancer at age 25, by age 30 it's 1 in 2,426. By age 35 it's 1 in 622. By age 45 it's 1 in 96 and by age 80 it's 1 in 10.

Since the majority of breast cancer actually occurs after age 45, many women may tend to think of breast cancer and saggy breasts in the same way: "It's something to worry about when I'm old." That's wrong. Both may be most likely to occur after age 45, experts agree. But preventing both needs to start with good breast care in the decades before.

The Breast Self-Exam

Good breast care begins with learning when and how to do a breast self-exam.

Doctors agree that a self-exam should be done the first week after your period every month. Your goal is twofold: one, to become so familiar with the normal ridges, lumps and bumps in your breasts that anything out of the ordinary will be very apparent and, two, to detect any lump (about a half-inch in size, for example) that suddenly appears, stays in the same place and remains for one or two cycles.

What's the best way to do a self-exam? Any way you feel comfortable, doctors say. Some women prefer to do it standing in the shower when their breasts are slippery with soap. Others prefer to do it standing in front of a mirror. Still others prefer to do it lying on their backs.

Here's how doctors suggest you make a breast exam as accurate as possible.

Stretch first. What's important is that before you start, stretch your arms over your head and look in the mirror to see if there are any obvious changes in your breasts. Look for something major: a dimpling you've never noticed before or a nipple that has suddenly inverted, developed eczema or has a discharge that isn't a result of being squeezed. Put your hands on your hips, push your shoulders back and look for changes again. Then push your shoulders forward, contracting your chest muscles. Any dimpling should be obvious in this position.

Choose a search strategy. There are several different ways to do the breast exam itself: You can use the nipple as a focal point and feel for lumps along imaginary lines radiating out from the nipple all the way up to the collarbone and down to the brassiere line; you can use the nipple as a center and keep circling it with your fingers in ever-larger circles; or you can simply imagine a grid placed over your breast and examine it in up-to-the-collarbone and down-to-the-bra-line strips.

Whichever method you choose, put the hand on the side you want to examine behind your head before you start. This shifts any breast tissue that's under your armpit over to the chest wall where you can check it thoroughly.

The Anti-Cancer Lifestyle

Good breast care also means adopting a lifestyle that reduces your risk of cancer. No one has figured out exactly why, but women who adopt lifestyle strategies that reduce the amount of estrogen circulating throughout their bodies may significantly reduce their risk of developing breast cancer. And that includes women who have a family history of the disease.

Which strategies are best? Here's what doctors suggest.

Lower the fat. A study at Tufts University School of Medicine in Boston compared estrogen levels in a group of women who ate a diet that got 40 percent of its calories from fat with a group of women who got only 21 percent of their calories from fat.

The result? Pre-menopausal women in the higher-fat group had blood levels of estrogen that were 30 to 75 percent higher than their lower-fat eating sisters. In the postmenopausal group, women who ate the higher-fat diet had estrogen levels that were 300 percent higher.

Eat plant fiber. Animal studies indicate that the substances in plants--phytoestrogens--may be able to prevent the estrogens circulating in your body from causing breast cancer. Good sources of phytoestrogens include soy products, alfalfa sprouts, apples, barley, oats and peas.

Nosh on veggies. In a Harvard Nurses' Health Study, which studied nearly 90,000 women in Boston, researchers found that those who reported eating two or three servings of vegetables a day had a 17 percent reduced risk of breast cancer compared with those who ate less than one full serving per day.

No one's willing to bet the ranch on an explanation, but many scientists suspect that it may have something to do with the presence of vitamins A and C, antioxidants believed to block cancer-causing substances produced by the body's normal metabolic process.

Avoid mid-cycle drinking. A study at the National Cancer Institute found that just two mixed drinks a day between days 12 and 15 of a woman's menstrual cycle will elevate estrogen levels anywhere from 21 to 31 percent.

Put your arms over your head and look for any dimpling, nipple discharge or other changes in appearance. Put your hands on your hips, push your shoulders first back, then forward, and look for any changes in your breasts that occurred since your last self-examination. Place your right hand behind your head. With the finger pads of your left hand, examine your entire right breast from collarbone to bra line and into your armpit. Repeat the process on your left breast with your left hand behind your head. See above for a description of the different search strategies.

Beating Breast Sag

Although good breast care primarily means keeping your breasts healthy, for some women it also means keeping your breasts smooth and firm.

There are two ways to sag when we pass our thirties, doctors say: When large breasts sag, the nipples do a swan dive and head toward your waist; when small breasts sag, the nipples gracefully sink back toward your chest.

One way you look like a cow that needs milking. The other way you look like a boy. It may not be what God, nature and Victoria's Secret intended, but sag can be the reality of the post-30 breast.

"Somewhere between the ages of 30 and 40, the elastic tissue in the breast begins to degenerate," explains Albert M. Kligman, M.D., professor of dermatology at the University of Pennsylvania School of Medicine in Philadelphia. The breast fibers, which act like rubber bands and provide that resilient bounce as you walk, will still stretch. But they don't snap back quite as well. The result is saggy breasts with a few stretch marks thrown in for good measure.

Adding to the problem, hormonal changes--both during pregnancy and as you reach menopause--make breasts sag more.

During pregnancy, the hormones estrogen and progesterone, which are secreted by the ovary and the placenta, stimulate development of the 15 to 20 lobes of milk-secreting glands embedded in the breast's fatty tissue. These changes are permanent. And although the glands may be empty after they're no longer needed to produce milk, they will still add bulk and firmness to the breast.

Once menopause arrives, however, the drop in estrogen and progesterone signal the breast that its milk ducts and lobes can retire. As a result, the breast shrinks, adds fat and begins to sag over and above the demands of gravity.

Fortunately there are several ways to prevent, and sometimes reverse, both sag and stretch marks.

Think weights. "There's no way I know of to build up the breast's fatty tissue," says Dr. Carter. "But you can build up the pectoralis muscles underlying the fatty tissues so that you get the same effect."

To prevent or reduce sag, get a couple of two-pound weights--no heavier--and work those muscles five times a week, says Dr. Carter.

With a weight in each hand, extend your arms sideways and do 15 small, backward circles about a foot in diameter. Widen the circles slightly and do another 15; widen them again and repeat. Slowly work your way up to 50 circles for each repetition.

Roll your shoulders. Put your weights aside and with your arms hanging at your sides, roll your shoulders backward, down and forward in a circular motion 15 to 20 times, says Dr. Carter. Do it five days a week.

Hit the deck. "Start off trying to do 10 push-ups and work your way up to 20," says Dr. Carter. It may take up to six months, she adds. But you're more likely to do them regularly if you add one push-up at a time. Just get on your hands and knees, raise your feet six inches off the floor, and lower your upper body down to within an inch of the floor. Do these five days a week as well.

Get some support. Wearing a bra is a good way to prevent sagging, says Dr. Kligman. In fact, he suggests that any female over the age of 15 do so.

Get a style that has great support and allows minimal bounce, says Dr. Kligman. And wear it all day, not just when you work out.

Shrink the stretch marks. If you've just had a baby and the stretch marks on the top and sides of your breasts are red and inflamed, you can treat them with daily applications of tretinoin (Retin-A), says Dr. Kligman. Talk to your doctor about getting a prescription for the drug. Not only does Retin-A tighten the stretched skin but there's some evidence that it also builds a new superstructure under the skin to help firm it.

Talk to your doctor about HRT. Hormone replacement therapy, or HRT, can halt breast sagging that occurs after menopause by helping to keep breast fibers from further degenerating, doctors say. It won't turn back the clock to your twenties, but it will keep your breasts from sagging more.

Getting a Lift You stand up straight and pull your shoulders back, and they sag. You stand up straight, pull your shoulders back and suck in your gut, and they still sag. What's sagging are your breasts. The score is: woman 1, gravity 2. But does that mean you're ready to have a breast lift? Only you can answer that question based on discussions with your doctor. But here is some information on your options. "There are basically two kinds of lifting procedures we do in this country," says Robert L. Cucin, M.D., clinical instructor of plastic surgery at Cornell University Medical College in New York City. "For smaller degrees of sagging, we can do what's called a doughnut mastopexy. You take some skin out from around the nipple's areola, then tuck the skin underneath where it gives you a modest degree of lift and tightening." When sagging is more severe, American surgeons tend to use the inverted T, or anchor, mastopexy, says Dr. Cucin. The surgeon cuts around the nipple, straight down from the nipple to the bra line, then along the bra line in both directions for several inches. Excess skin and fat are removed, the nipple is repositioned and the remaining skin is drawn tight to support the breast. Scars will be about nine inches long, and the amount of sensation left in your nipple depends on how much it's moved during the procedure.