What are the risk fac­tors for breast can­cer?

Jamaica Gleaner - - BREAST CANCER AWARENESS MONTH FEATURE -

ARISK fac­tor is any­thing that in­creases a per­son’s chance of get­ting a dis­ease. Dif­fer­ent can­cers have dif­fer­ent risk fac­tors. How­ever, hav­ing a can­cer risk fac­tor, or even sev­eral of them, does not nec­es­sar­ily mean that a per­son will get can­cer. Some women with one or more breast can­cer risk fac­tors never de­velop breast can­cer, while about half of the women with breast can­cer have no ap­par­ent risk fac­tors.

SIG­NIF­I­CANTLY HIGHER RISK

His­tory – A woman with a his­tory of can­cer in one breast, such as duc­tal car­ci­noma in situ (DCIS) or in­va­sive breast can­cer, is three to four times more likely to de­velop a new breast can­cer, un­re­lated to the first one, in ei­ther the other breast or in an­other part of the same breast. This is dif­fer­ent from a re­cur­rence of the pre­vi­ous breast can­cer. Age – Your risk for breast can­cer in­creases as you age. About 77 per cent of women di­ag­nosed with breast can­cer each year are over age 50, and al­most 50 per cent are ages 65 and older. Con­sider this: In women ages 40 to 50, there is a one in 68 risk of de­vel­op­ing breast can­cer. From ages 50 to 60, that risk in­creases to one in 42. In the 60 to 70 age group, the risk is one in 28. In women ages 70 and older, one in 26 is at risk of de­vel­op­ing the dis­ease.

MOD­ER­ATELY HIGHER RISK

Di­rect fam­ily his­tory – Hav­ing a mother, sis­ter, or daugh­ter (‘first-de­gree’ rel­a­tive) who has breast can­cer puts a woman at higher risk for the dis­ease. The risk is even greater if this rel­a­tive de­vel­oped breast can­cer be­fore menopause and had can­cer in both breasts. Hav­ing one first-de­gree rel­a­tive with breast can­cer ap­prox­i­mately dou­bles a woman’s risk, and hav­ing two first-de­gree rel­a­tives triples her risk. Hav­ing a male blood rel­a­tive with breast can­cer will also in­crease a woman’s risk of the dis­ease.

Ge­net­ics – About five per cent to 10 per cent of breast can­cer cases are thought to be hered­i­tary. Car­ri­ers of al­ter­ations in ei­ther of two fa­mil­ial breast can­cer genes called BRCA1 or BRCA2 are at higher risk. Women with an in­her­ited al­ter­ation in the BRCA1 gene have a 55 per cent to 65 per cent chance of de­vel­op­ing breast can­cer dur­ing her life­time, and those with an in­her­ited al­ter­ation in the BRCA2 gene have up to a 45 per cent chance of de­vel­op­ing breast can­cer.

Breast le­sions – A pre­vi­ous breast biopsy re­sult of atyp­i­cal hy­per­pla­sia (lob­u­lar or duc­tal) or lob­u­lar car­ci­noma in situ in­creases a woman’s breast can­cer risk by four to five times.

SLIGHTLY HIGHER RISK

Dis­tant fam­ily his­tory – This refers to breast can­cer in sec­ond- or third-de­gree rel­a­tives such as aunts, grand­moth­ers, and cousins.

Pre­vi­ous ab­nor­mal breast biopsy – Women with ear­lier biop­sies show­ing any of the fol­low­ing have a slightly in­creased risk: fi­broade­no­mas with com­plex fea­tures, hy­per­pla­sia with­out atypia, scle­ros­ing adeno­sis, and soli­tary pa­pil­loma.

Age at child­birth – Hav­ing your first child af­ter age 35 or never hav­ing chil­dren puts you at higher risk.

Early men­stru­a­tion – Longer life­time ex­po­sure to en­doge­nous (your own) es­tro­gen in­creases your risk, such as start­ing to men­stru­ate be­fore age 12, start­ing menopause af­ter age 55, and never hav­ing had a preg­nancy.

Weight – Be­ing over­weight (es­pe­cially in the waist), with ex­cess caloric and fat in­take, in­creases your risk, es­pe­cially af­ter menopause.

Ex­ces­sive ra­di­a­tion – This is es­pe­cially true for women who were ex­posed to a large amount of ra­di­a­tion be­fore age 30, usu­ally as treat­ment for can­cers such as lym­phoma.

Other can­cer in the fam­ily – If a fam­ily mem­ber had ovar­ian can­cer un­der age 50, your risk is in­creased.

Al­co­hol – Use of al­co­hol is linked to in­creased risk of de­vel­op­ing breast can­cer. Com­pared with non-drinkers, women who con­sume one al­co­holic drink a day have a very small in­crease in risk, and those who have two to five drinks daily have about 1.5 times the risk of women who do not drink.

Race – Cau­casian women are at a slightly higher risk of de­vel­op­ing breast can­cer than are African-Amer­i­can, Asian, His­panic, and Na­tive Amer­i­can women. The ex­cep­tion to this is African-Amer­i­can women, who are more likely than Cau­casians to have breast can­cer un­der age 40.

Hor­mone Re­place­ment Ther­apy (HRT) – Long-term use of com­bined es­tro­gen and pro­ges­terone in­creases the risk of

breast can­cer. This risk seems to re­turn to that of the gen­eral pop­u­la­tion af­ter dis­con­tin­u­ing them for five years or longer.

LOW RISK

Less life­time ex­po­sure to en­doge­nous es­tro­gen – Hav­ing a preg­nancy be­fore age 18, start­ing menopause early, and hav­ing the ovaries re­moved be­fore age 37 de­creases the risk of de­vel­op­ing breast can­cer.

Fac­tors not re­lated to breast can­cer: Fi­bro­cys­tic breast changes Mul­ti­ple preg­nan­cies Cof­fee or caf­feine in­take Use of an­tiper­spi­rants Wear­ing un­der­wire bras Us­ing hair dye Hav­ing an abor­tion or mis­car­riage

Us­ing breast im­plants

BREAST CAN­CER is a kind of can­cer that de­vel­ops from breast cells.

Breast can­cer usu­ally starts off in the in­ner lin­ing of milk ducts or the lob­ules that sup­ply them with milk. A ma­lig­nant tu­mour can spread to other parts of the body. A breast can­cer that started off in the lob­ules is known as lob­u­lar car­ci­noma, while one that de­vel­oped from the ducts is called duc­tal car­ci­noma.

The vast ma­jor­ity of breast can­cer cases oc­cur in fe­males. Breast can­cer is the most com­mon in­va­sive can­cer in fe­males world­wide. It ac­counts for 16 per cent of all fe­male can­cers and 22.9 per cent of in­va­sive can­cers in women; 18.2 per cent of all can­cer deaths world­wide,

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