WHAT ARE MY RISK FACTORS FOR ACQUIRING BREAST CANCER?

                                                      
(separating FACT from FICTION!!!)

 
As breast cancer is the most frequently diagnosed cancer in American women (175,000 cases in 1999 with over 43,000 deaths), it is quite natural for women to question the risk factors for acquiring this very devastating disease. Perhaps most important to understand, first off, is that of those breast cancers diagnosed EVERY year, over 70 PERCENT of patients have NO identifiable risk factor. This is not to say though that certain types of behavior and genetic predispositions don’t elevate one’s risk. So, what might and do elevate womens’ ONE IN EIGHT lifetime chance of acquiring breast cancer????----

1) AGE: Your risk of developing breast cancer increases as you age. The majority of breast cancer cases occur in women over age 50. More than half the risk is incurred after age 60 and one third after age 75. Although rare, younger women also can get breast cancer. See attached table-----

2) FAMILY HISTORY: Having a mother, sister or daughter who has had breast cancer is an important risk factor. The risk is higher if the relative’s cancer developed before menopause or if it affected both breasts. (see link to genetics of breast cancer)

3) MENSTRUAL AND REPRODUCTIVE FACTORS: It has been known for many years that the occurrence of breast cancer is related to the presence of the hormone estrogen. As such, one of the strongest associations established to date is the age at menarche and age at menopause (thus the years of ovarian function become critical). Early age at menarche (under 12) and late age at menopause (over 55) are both firmly established as modest factors for the appearance of breast cancer. Each advancing year of menarche and delaying year of menopause elevates risk by 4 to 5 percent. Additionally, other well-established risk factors in this field relate to the age at first childbirth and overall parity (having children). Age at first childbirth of under 20 can reduce breast cancer risk approximately 50 percent compared with first birth beyond age 35. Furthermore, overall high parity appears to be associated with a reduced risk of breast cancer.

4)  DIET: While significant weakness does exist in the evidence that diet has an influence of breast cancer incidence, high fat diets have shown to include marginally higher risks. The American Cancer Society advises a high fiber, low-fat diet rich in fruits and vegetables to try and minimize one’s risk. Additionally, some studies show that women who drink alcohol have a slightly higher risk of breast cancer.

Other INCONCLUSIVE RISK FACTORS:

5) POSTMENOPAUSAL HORMONE REPLACEMENT THERAPY: While PHRT   has several obvious benefits (relieving menopausal symptoms like osteoporosis and hot flashes), it has been worried that extra estrogen might have carcinogenic (cancer-causing) effects. To date, the studies are inconclusive, showing NO  to MINIMAL increased risk from such therapy.

6) ORAL CONTRACEPTIVES: To date, most research studies have NOT found an increased risk of breast cancer in women who have used birth control pills. Studies are ongoing.

7)  ALTERNATIVE LIFESTYLES: While some have suggested a possible relationship between lesbianism and breast cancer, studies show NO direct link. Possible reasons for lesbians indeed having higher instances of breast cancer include---a) not visiting their doctors (mammograms, etc.) as frequently and b) not having children of their own. Remember though, lesbianism itself does NOT cause breast cancer.
 

TABLE:

     AGE-SPECIFIC PROBABILITIES OF DEVELOPING BREAST CANCER:
 

    If current age is---            Then probability of developing breast           or 1 in---
                                                    Cancer in next 10 years is----

        20                                                            .05 %                                          2,187
        30                                                            .39%                                              258
        40                                                            1.48%                                              67
        50                                                            2.67%                                              38
        60                                                            3.42%                                              29
        70                                                            7.14%                                              14
        80                                                            10.0%                                              10