Risks of breast cancer

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NCI breast cancer risk calculator >>>> Most patients have no obvious predisposing factors but a minority have been caused by a lifestyle issues or inherited.

Lifestyle factors which increase the risk of breast cancer:

Certain

• Unhealthy diet (high in fat)
• Being overweight
• Excessive drinking of alcohol
• Smoking
• Lack of physical activity
• Long-term HRT (hormone replacement therapy or oral contraceptives)
• Personal history of breast cancer
• Being older, female, or white
• Previous exposure to radiation in the breast area  (previous treatment for Lymphoma)
• Frequent CT scan or xrays
• Early start of menstrual period (before age 12), or late menopause (after age 55)
• Having no children or having first child after age 30, not breastfeeding

Less certain: 

• Use of regular parabens and Aluminum deodorants >>
• Xenoestrogens in foods and pollution >>
• Vitamin D deficiency >>

Inherited (genetic) risks of breast cancer:

Less than half a percent of women carry the know genes for breast cancer particularly BCRA 1 or 2. Carrying these genes infers a significant lifestyle risk of breast cancer (>80%). Even in individuals who do not carry the gene the risks can be higher if they have a strong family history or any of the features listed below. Recent scientific trials have suggested there is a benefit for taking prophylactic medication to prevent breast cancer if the 5-year projected absolute risk of breast cancer is ≥ 1.66% (based on the National Cancer Institute BC Risk Assessment Tool or an equivalent measure) or women diagnosed with lobular carcinoma in situ. 

Factors which correlate with an increased genetic risk of breast cancer;

• Number of first degree relatives with breast cancer
• First degree relatives getting breast cancer at a young age
• relatives with bilateral breast cancer
• Male relatives with breast cancer

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.