Most patients have no obvious predisposing factors but a minority have been caused by a lifestyle issues or inherited.

Risks of breast cancer connected with lifestyle issues:

• Unhealthy diet (high in fat)
• Being overweight
• Excessive drinking of alcohol
• Smoking
• No physical activity
• Long-term HRT (hormone replacement therapy or oral contraceptives)
• Personal history of breast cancer
• Being older, female, or white
• Frequent previous exposure to radiation in the breast area
• Early start of menstrual period (before age 12), or late menopause (after age 55)
• Having no children or having first child after age 30, no breastfeeding

Inherited risks of breast cancer:

In a small number of cases there is a family history. The risk for an individual within these families can be categorised in the following groups:

• Very high

Individuals from families with 4 or more relatives affected with either breast or ovarian cancer in 3 generation and one alive affected individual.

It may be appropriate for these women to be referred for genetics testing which would included counseling and testing for the presence of the gene BRCA1 or BRCA2 . If found to be positive for these genes there is a very high chance of developing breast cancer (>80%) and prophylactic mastectomy may be advised.

•  High 

Three times higher tendency (or more ) than the general population.

[1] 3 first degree relatives (mother, sister or daughter) or second degree relatives (grandmother, granddaughter, aunt or niece) with breast or ovarian cancer on the same side of the family

[2] 2 first or second degree relatives with breast cancer diagnosed under 60 or ovarian cancer at any age in the same side of the family, or

[3] 1 first degree female relative with breast cancer diagnosed under 40 or 1 first degree male relative with breast cancer diagnosed at any age

[4] A first degree relative with bilateral breast cancer

The mainstay of management of women who fall into this category is intensive surveillance through regular clinical examination and mammography screening. For young women MRI scans are also recommended.