Just in case you haven’t yet noticed all of the extra pink in the environment lately, you should know that October is Breast Cancer Awareness Month.

Muskogee Regional Medical Center has gotten into the act with a Breast Cancer Awareness reception and free clinical breast exams, and many other organizations and businesses have sponsored and are planning other awareness events.

This month is particularly meaningful to me, not only because I’m a gynecologist, but also because I’m a breast cancer survivor myself. I was diagnosed in 1998, when my sons were ages 7, 10, and 12.

I worried about breaking the news to my children, not knowing how much they would be traumatized by my absence during treatment. I decided to take them all out to dinner to discuss the situation, and after we had ordered our meal I explained what the problem was and what would happen.

There was little reaction from them, though I knew that they basically understood what I had said. “Do you have any questions?” I asked, probing for an insight into their thoughts.

They all considered carefully, and then the youngest suddenly shot up a hand. “I have a question!” he said. “Yes?” I asked, unsure of what to expect. He didn’t hesitate a moment. “When is my spaghetti gonna get here? I’m hungry!” I felt sure at that point that they would cope well with the situation.

My own diagnosis brings up some good points about the topic I’d like to discuss today-breast cancer prevention and detection. Is there anything I could have done differently to help keep from having breast cancer? I think all survivors ask themselves that question.

We know what the major risk factors for breast cancer are. The most important risk factor is age, which is something none of us can do anything about. Other important risk factors are race and family history, though we have no more control over the genes we inherit than we do over the passage of time.

There are other risk factors which we can control, though the extent of their effect on breast cancer risk is uncertain. A high-fat diet has been linked to a slightly higher risk. Regular exercise and breastfeeding are thought to be somewhat protective.

Where does that leave me? I exercise, I eat right, I breastfed all my children, and I have no significant family history. My only discernible risks factor is that I'm a white woman. I did do something very right, however — I got a mammogram as soon as I turned 40.

While we don’t know much about how to prevent breast cancer, we do know that detecting it at an early stage is vitally important. The earlier the cancer is detected, the greater the chance that it can be successfully treated and eradicated.

Detecting breast cancer involves three steps: annual mammograms, annual clinical breast exams, and monthly self breast exams. Think of these as the legs of a three-legged stool-it wobbles if any of the three is neglected.

Mammograms should begin at age 40, except for those women who have a close family history of breast cancer. Those women should begin mammograms five years earlier than the age at which their relative was diagnosed. If your mother or sister was diagnosed with breast cancer at age 40, for example, you should begin annual mammograms at age 35.

A clinical breast exam is an exam performed by a health professional, such as a physician. Of course, you should be visiting your physician annually for a pelvic exam and possibly a Pap smear anyway. A breast exam should be part of a comprehensive annual exam.

The topic of self breast exams has become somewhat controversial lately, with some studies suggesting that these exams cause too many unnecessary biopsies and don’t help to decrease deaths from breast cancer. I still recommend these exams to my patients, however. I feel that self-exams are an important part of taking charge of your own health and becoming familiar with your own body.