- Question from My Day: I read somewhere that there is an increased chance of a lesbian contracting breast cancer. What is the reasoning behind these findings and what can I be doing to ensure I am minimizing my risks?
- Answers —Lisa Weissmann, M.D.: That is a common thought in the lesbian community, and there may be some truth to the possibility that lesbians as a group have a higher risk for developing breast cancer. This was first suggested by Dr. Suzanne Haynes, based on the data that was available at the time showing that lesbians had an increased number of risk factors for the future development of breast cancer, specifically obesity, increased alcohol consumption, lower rate of having children, and a lower rate of breast screening. Further studies by Doctors Dibble and Bowen suggest that while perhaps not all of these risk factors are present in the lesbian population, at least several may indeed increase our risks for the future development of breast cancer. However, until we have large national studies, we won't know for sure. Some of these risk factors are certainly in our individual control, such as alcohol consumption and obesity.
But it's really difficult to counsel lesbians to have children under the age of 25 to reduce their risks of breast cancer. Therefore, the same things that increase the risk for breast cancer in straight women similarly increase the risks for lesbian women. So it's not something unique to being a lesbian that confers the risk of breast cancer, but that lesbians as a group may have risk features at a higher percentage. For you as an individual, all the things that we have to be able to do to reduce the risk of breast cancer hold true, such as eating a healthy diet, avoidance of alcohol, exercise, and don't smoke. The statistics on alcohol would suggest drinking less than 3-5 drinks of alcohol per week.
- Marisa Weiss, M.D., president and founder: Also, I would add that whatever you can do to reduce the stress in your life and increase the enjoyment of your life will make you feel better in general. While no direct connection has been made between high stress and a high risk of breast cancer, it all makes sense that reducing the stress in your life will improve your health. Connecting with each other can make a big difference. The Mautner Project offers programs that allow you to develop this connection.
- Cheryl Pearson-Fields, M.P.H.: We offer support groups for lesbians with cancer. We also offer opportunities for lesbians to come together through volunteer work that creates an environment that is supportive of women in general.
- Marisa Weiss, M.D., president and founder: Breastcancer.org has ongoing discussion boards that enable women to connect with each other.
- Lisa Weissmann, M.D.: I'd like to talk a little about stress because one thing that all lesbians share is the stress of homophobia and that has not been researched. As lesbians in this homophobic country (some places more and some less), how does this stress affect our health? Is the obesity and smoking and alcohol a reaction to the external stress that we feel from homophobia, and how does that impact on our health?
- Cheryl Pearson-Fields, M.P.H.: In addition to the behavioral risk factors that Dr. Weissmann talked about earlier is that these factors are compounded by the barriers to accessing health care, so that even if all things are equal, lesbians tend to delay seeking health care because of those heterosexual assumptions and barriers related to homophobia. Often what happens is that cancers are found at later stages or lesbians put off going to the doctor until it's almost too late.
- Marisa Weiss, M.D., president and founder: I think as part of the critical issues to look at is how you view your own diagnosis of breast cancer relative to the guilt you may feel or a complex you might have in response to the homophobia. I've had patients who've admitted that they think their breast cancer occurred as punishment for being gay. This is a painful way to live. And these types of feelings often need to be addressed so that you can move through this experience to (hopefully) a better place.
- Cheryl Pearson-Fields, M.P.H.: Sometimes that victim blaming is external as well—messages are communicated that it's the patient's fault. And while not specific to breast cancer, physicians have told patients that their vaginal infections were due to abnormal sex practices; i.e., lesbian sex practices. That's a huge burden for a patient.
- Lisa Weissmann, M.D.: We all know there are people out there who will seek to assign blame to those groups that they fear. We need look no further than after 9/11 when Jerry Falwell decided it was the fault of the gays and lesbians—a retribution—for blowing up the World Trade Center.
On Wednesday, November 21, 2001, our Ask-the-Expert Online Conference was called Lesbians and Breast Cancer. Lisa Weissmann, M.D., Cheryl Pearson-Fields, M.P.H., and Marisa Weiss, M.D. answered your questions about being gay and having breast cancer.
The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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Lisa Weissmann, M.D. is an attending physician at Mount Auburn Hospital in Cambridge, Massachusetts, dedicated to breast cancer care, with an appointment at Harvard Medical School.
Marisa Weiss, M.D. is a radiation oncologist specializing in breast cancer and the founder, president, and guiding force behind Breastcancer.org.
