Know Your Risk
RISK FACTORS : Take home messages
Most Important :
- Breast cancer can also occur in women who have no identifiable risk factors.
- many women with risk factors never develop breast cancer
- Most risk factors are not reversible, but some can be modified.
- risk factors help to identify women who may benefit most from screening or other preventive measures. .
- Individual women should work with their clinicians to determine personal risk
- To calculate an individual woman’s estimated risk is very difficult then probabilities for the whole population. Real risk may be higher or lower depending on a number of known and unknown factors
- one out of every eight women born today will be diagnosed with breast cancer at some time during her life.
List of risk factors
- The strongest risk factors for breast cancer
- Risk increases as age increase. - Very Strong
- Being female - Very Strong
- BRCA1 or BRCA2 gene mutation -5–14 times greater
- Family history
- 2 immediate family members - 3–4 times greater
- Mother diagnosed before age 60 - 2–3 times greater
- Mother diagnosed after age 60 - 1 times greater
- High breast density
- Atypical Hyperplasia (benign breast condition) - 2–4 times greater
- Lobular carcinoma in situ (LCIS) - 7–10 times greater
- Personal history of cancer --2–6 times greater
- invasive breast cancer,
- Hodgkin's disease and
- other cancers
- Radiation treatment or frequent X-rays before the age of 30 ----
- Risk for breast cancer diagnosed at age 40 ---11 times greater
- Risk for breast cancer diagnosed at age 60----3.5 times greater
- Increased estrogen exposure
Reproductive Risk Factors
- First menstrual period.before 12 --1–1.5 times greater
- Starting menopause at a later age.
- Age 55 or older at menopause --2 times greater
- Being older at the birth of your first child.
- Never giving birth. compared with a woman who has her first child before 35- 1.5 times greater
- Not breastfeeding.- 1 times greater
- Long-term use of hormone-replacement therapy.- 1.5–2 times greater
- In utero exposure to diethystilbestrol
- Menopausal hormonal therapy - 1.5–2 times greater
- Using birth control pills (current or recent use)-- 1–1.5 times greater
Other Risk Factors
- Getting older.
- Age 30 . . . . . . 1 in 227
- Age 40 . . . . . . 1 in 68
- Age 50 . . . . . . 1 in 42
- Age 60 . . . . . . 1 in 28
- Age 70 . . . . . . 1 in 26
- Personal history of breast cancer or some non-cancerous breast diseases.
- who have had breast cancer are more likely to develop a second breast cancer
- Family history of breast cancer (mother, father, sister, brother, daughter, or son).
- a strong family history of the breast cancer who has inherited one of the genes that predispose to breast cancer is over 50 percent
- Other cancer in family- Ovary, Cervix ,Uterus, Colon
- Biopsy report: Changes that are associated with an increased risk of breast cancer include
- Atypical hyperplasia- --2–4 times greater
- a noncancerous condition in which cells have abnormal features and are increased in number
- Lobular carcinoma in situ (LCIS) -- 7-10 times greater
- abnormal cells are found in the lobules of the breast
- monitored carefully
- Ductal carcinoma in situ (DCIS;
- abnormal cells are found in the lining of breast ducts).
- some cases of DCIS will eventually become cancer
- Need , active treatment.
- Breast density by mammogram.
- The milk-producing and connective tissue of the breast are dense ( white on a mammogram)
- In contrast, fatty tissue of the breast is not dense and appears dark.
- As density increase risk increase
- tumors, in dense breasts can be difficult to detect because tumors often appear white.
- increases risk after menopause -- 1–1.5 times greater
- Inherited changes in breast cancer-related genes BRCA1 or BRCA2 and other.
- no more than about 10 percent of all breast cancers.
- However, women who carry changes in these genes have a much higher risk of breast cancer than women who do not carry these changes.
- Alcohol (2–4 drinks per day) -- 1.5 times greater
- Physical inactivity .-
- Lack of exercise 1 times greater
- Socioeconomic status
- High socioeconomic status---1–2 times greater
- Urban/ Rural
- Ashekenazi Jewish heritage --- 1 times greater
- Dietary pattern —
- diet composed predominantly of fruits and vegetables resulted in a lower risk
- Dietary fat intake - increase risk
- Treatment with radiation therapy to the breast/chest.
- before age 30 have an increased risk throughout their lives.
- younger a woman, the higher her risk
- Height: Tallness increased risk in postmenopausal women---1 times greater
- High bone density-- 2 times greater
REDUCING RISK of breast cancer
Screening mammography does not reduce the risk of developing breast cancer, but it decreases the risk of dying from breast cancer
Lifestyle changes — A number of lifestyle changes may reduce breast cancer risk:
- Planning for first child before the age of 30
- Breastfeeding for at least six months or more
- Avoidance or limited use of Hormone replacement therapy (postmenopausal hormone therapy)
- Radiation -Avoidance of unnecessary exposure (eg, inappropriate use of computed tomography)
- Healthy weight
- Smoking- Avoidance or cessation
- Limiting nocturnal shift work
- Alcohol- Limiting intake
- Physically active lifestyle.
- Limiting sedentary behavior
- Moderate intensity activity,- at least 150 minutes of weekly
- Vigorous intensity activity,75 minutes of weekly
- Some physical activity above one’s usual routine,