Happy breast cancer awareness month

Today is the start of National Breast Cancer Awareness Month.

The campaign is now 25 years old, and its signature pink ribbon (shown) has become a talisman.

The good news this year is that the health reform law contains money to increase awareness of this disease among young women. It's rare among young women, but quite deadly.

Overall, deaths from breast cancer have been dropping for 20 years, and early detection is credited.

But is that the real answer?

There is a growing body of evidence that hormone replacement therapy may have been one factor responsible for the growth of the disease.

After studies pointed to a causality in 2002, for instance, cases among older women in Canada suddenly dropped 10%, as they simply stopped taking the drugs.

American rates of the disease are twice those of Brazil, three times that of China. New studies indicate that cutting back on alcohol and maintaining a healthy weight can cut your risk of developing breast cancer by 40%.

Then there is the controversy over regular screening, which is only growing.

Many women question the finding that regular mammograms for women over 40 may not be indicated, which was confirmed this week by a study in Norway.

As with prostate cancer, a key to understanding breast cancer may be knowing that it can vary in severity. Cutting off breasts and prostates because you hear the word "cancer," when you don't know how fast it's spreading or whether it might indeed just fade away, is not a life saver.

Instead, this may be a case where genetic medicine holds the promise of answers.

A mutation of the BRCA2 gene can increase your risk 60%. Such genetic tests can tell young women whether they need to get regular mammograms or not, and whether they need to take immediate action when the dread word cancer is spoken.

As I wrote here last year, save the ta-tas. Awareness, yes. Paranoia, no.

This post was originally published on Smartplanet.com