Weigh­ing the risk of breast can­cer... where do you stand?

Risks ex­pose you to dan­ger, harm or loss. Know­ing your risks of breast can­cer helps as you be­come more aware of the caus­ing fac­tors and more able to off­set them. Yet this doesn not mean that when hav­ing a risk fac­tor, or even many, you are sure to get bre

Malta Independent - - NEWS - Joseph Grech is a Prac­tice Nurse (Pub­lic Health) within Health Promotion and Dis­ease Preven­tion Direc­torate

Some risk fac­tors can­not be changed, such as be­ing fe­male (men can have breast can­cer too, but it is less com­mon) and ad­vanc­ing age, which is the big­gest risk fac­tor for breast can­cer. Others in­clude a fam­ily or per­sonal his­tory of breast can­cer, hav­ing cer­tain changes in genes, early men­stru­a­tion, late menopause and cer­tain hor­mone ther­a­pies. In­creased breast den­sity (de­tected only on mam­mo­grams), is also as­so­ci­ated with an in­creased risk. Other risk fac­tors can be mod­i­fied to re­duce your risk of breast can­cer, such as can­cer-caus­ing fac­tors re­lated to the en­vi­ron­ment or per­sonal choices. Chest ex­po­sure to ra­di­a­tion (which has the high­est ef­fect dur­ing breast de­vel­op­ment) and life­style are such ex­am­ples.

Twenty-one per cent of all breast can­cer deaths world­wide are at­trib­ut­able to be­ing over­weight and obe­sity (mostly), al­co­hol use, and phys­i­cal in­ac­tiv­ity. There is some ev­i­dence that smok­ing in­creases the risk of breast can­cer too.

Obe­sity is as­so­ci­ated with in­creased breast can­cer risk, es­pe­cially among post­menopausal women. Al­co­hol in­take is widely rec­og­nized as one of the be­hav­iours most con­sis­tently as­so­ci­ated with in­creased breast can­cer risk. It is clearly demon­strated that there is an in­creased risk, with in­creas­ing in­take, and a mod­est in­creased risk sug­gested at even low lev­els of al­co­hol in­take. Reg­u­lar ex­er­cise and a healthy, bal­anced diet rich in veg­eta­bles, fruits, poul­try, fish and low fat dairy prod­ucts are rec­om­mended for all women be­cause they can help pre­vent many con­di­tions, in­clud­ing heart dis­ease, di­a­betes and many forms of can­cer. A high veg­etable in­take, and high lev­els of vi­ta­min C and cer­tain carotenoids may also lower the risk of breast can­cer (carotenoids are found in deeply coloured plant foods).

Phys­i­cal ac­tiv­ity is pro­tec­tive against breast can­cer. Nu­mer­ous stud­ies have shown con­sis­tently that mod­er­ate to vig­or­ous phys­i­cal ac­tiv­ity is as­so­ci­ated with a de­creased breast can­cer risk amongst both pre­menopausal and post­menopausal women. Mod­er­ate ac­tiv­ity is any­thing that makes you breathe as hard as you do dur­ing a brisk walk. Dur­ing mod­er­ate ac­tiv­i­ties, you will no­tice a slight in­crease in heart rate and breath­ing. You should be able to talk, but not sing dur­ing the ac­tiv­ity!

There is strong ev­i­dence that breast­feed­ing re­duces breast can­cer risk. In ad­di­tion the ear­lier a woman has a child, the lower the risk of breast can­cer is.

Screen­ing by mam­mog­ra­phy is a very ef­fec­tive way of de­tect­ing breast can­cer in its early stages, thus im­prov­ing out­come. If you have an in­creased risk of de­vel­op­ing breast can­cer, speak to your fam­ily doc­tor for fur­ther ad­vice. There is sup­port and care avail­able to re­duce your risk fur­ther.

Joseph Grech

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