Attie writes:
>Just one more comment before resting tonight. I am awfully afraid to say
>that breastfeeding decreases the risk of breastcancer. My very good friend
>has been diagnosed again with breast cancer in her second breast. Her first
>episode was confirmed 8 years ago, one month after her second child was
>born. Her first baby was breastfed for quite some time , not sure how long.
>She had radiation, than became pregnant again and nursed onesided for over
>one year and is very angry that this is all happening to her again. Please
>give me some confidance to say that it still decreases the risks? Her family
>history of Ca. is phenominal. Her aunt and sister have both died of breast
>cancer. Another sister also had breast ca.5 years ago with as yet not a
>re-occurance. Might her two daughters be at less risk since she nursed them?
>Or are the genes too strong?

Attie, no matter how low the risk of something, if it occurs at all, it
occurs 100% to those to whom it happens.  Nothing can guarantee "you will
not get X" or "Y will not happen to you if only you do Z".  About 5% of all
cases of breast cancer are thought to be related to the BraC1 and BraC2
genes.  It sounds likely that this is what is happening to your friend and
her relatives -- if they carry this gene, they have a much higher risk for
breast cancer, regardless of how they live their lives (diet, exercise,
breastfeeding, beta-carotene, Vitamin E, etc. etc.).  The other 95% of
breast cancer occurs in people with no family history.  It may very well
turn out that breastfeeding's protective effects work only in those people
without the breast cancer prone genes.  And even those people who do
everything "wrong" don't necessarily get sick -- we all know people who
smoke and drank and were couch potatoes and lived to be 100.

Another example, when I had my son with Down Syndrome, my statistical
chances were 1 in 800.  I was that 1 (and view myself as blessed and lucky
now, though I didn't at the time).  In any big city where thousands of
babies are born each year, there will be a handful of children with Down
Syndrome.  As you get older (I was 29 at conception), the risk goes up, so
that by the time you are 45 years old, the risk is 1 in 12 children.  That
doesn't mean that every 45 year old mother's child is going to have Down
Syndrome -- 11 out of 12 don't.  But the risk is sure a lot higher.

It is difficult to remember to think epidemiologically when we were
"counting" on something within our own control (breastfeeding) to protect us
from one of life's many cruel whims, and we still got whacked.  I've had
people suggest that I could have prevented the birth of a child with Down
Syndrome if I had eaten a better diet during pregnany (actually what they
say is that *they* don't have to worry about it because they eat a good diet
-- like I didn't, or like Down Syndrome was related to diet anyway, which it
isn't).  Your friend needs to do what she can to educate her daughters about
their risks, and keep an eye on the research frontiers -- I believe a test
for the gene will be available soon.  And of course they should be doing
breast self exams and be sure their doctors know the family history.  And
even if breastfeeding their own children won't protect them against the
familial kind, they will still benefit from its protection against the
regular garden-variety kind.

Kathy Dettwyler