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Breast Cancer: Risk Factors, Screening and Prevention

When breast cancer is discovered early, treatments are more likely to be successful, less disfiguring, and less disruptive to a woman and her family

Post by Dr. Tasaduk Hussain Itoo on Wednesday, October 26, 2022

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BREAST CANCER AWARENESS MONTH

 

Breast cancer is the most commonly diagnosed cancer and the second-most common cause of death from cancer in women. The frequency of breast cancer increases with age, with most women being diagnosed in menopause. When breast cancer is discovered early, treatments are more likely to be successful, less disfiguring, and less disruptive to a woman and her family. Most often a breast cancer appears as a painless lump in a woman’s breast or armpit.

 

MODIFIABLE RISK FACTORS

Alcohol

Drinking alcohol is clearly linked to an increased risk of breast cancer. The risk increases with the amount of alcohol consumed -- women who have 1 alcoholic drink a day have a small (about 7% to 10%) increase in risk compared with those who don't drink, while women who have 2 to 3 drinks a day have about a 20% higher risk. Alcohol is linked to an increased risk of other types of cancer, too. So, it is highly advisable to stop drinking alcohol to reduce the risk of many types of cancers, including breast cancer.

 

Overweight/Obesity

Being overweight or obese after menopause increases breast cancer risk. Having more fat tissue after menopause can raise oestrogen levels and increase the chances of getting breast cancer. Women who are overweight also tend to have higher blood insulin levels. Higher insulin levels have been linked to some cancers, including breast cancer. So, it is important to maintain a healthy weight throughout your life and avoid excess weight gain by balancing your food intake with physical activity.

 

Physical Inactivity

Evidence is growing that regular physical activity reduces breast cancer risk, especially in women past menopause. Studies have found that even as little as a couple of hours a week might be helpful, although more seems to be better -- The American Cancer Society recommends that adults get 150 to 300 minutes of moderate intensity or 75 to 150 minutes of vigorous intensity activity each week (or a combination of these).

 

Not Having Children

Women who have not had children or who had their first child after age 30 have a slightly higher breast cancer risk overall. Having many pregnancies and becoming pregnant at a young age reduces breast cancer risk.

 

Not Breastfeeding

Most studies suggest that breastfeeding may slightly lower breast cancer risk, especially if it continues for a year or more. A possible explanation for this effect is that breastfeeding reduces a woman’s total number of lifetime menstrual cycles (the same as starting menstrual periods at a later age or going through early menopause).

 

 

Birth Control Measures

Some birth control methods use hormones, which might increase breast cancer risk. Most studies have found that women using oral contraceptives (birth control pills) have a slightly higher risk of breast cancer than women who have never used them. Once the pills are stopped, this risk seems to go back to normal within about 10 years. Birth control implants, intrauterine devices (IUDs), skin patches, vaginal rings -- these forms of birth control also use hormones, which could fuel breast cancer growth. Moreover, use of combined hormone therapy after menopause increases the risk of breast cancer. A woman’s breast cancer risk seems to go back down within about 5 years of stopping treatment, although the increased risk does not go away completely.

 

NON-MODIFIABLE RISK FACTORS

Sex

This is the main risk factor for breast cancer. Men can get breast cancer, too, but this disease is much more common in women than in men.

 

Age

As you get older, your risk of breast cancer goes up. Most breast cancers are found in women age 55 and older.

 

Hereditary

About 5% to 10% of breast cancer cases are thought to be hereditary, meaning that they result directly from gene changes (mutations) passed on from a parent.

 

Family History

It’s important to note that most women who get breast cancer do not have a family history of the disease. But women who have close blood relatives with breast cancer have a higher risk -- having a first-degree relative (mother, sister, or daughter) with breast cancer almost doubles a woman’s risk. Having 2 first-degree relatives increases her risk by about 3-fold. Women with a father or brother who has had breast cancer also have a higher risk of breast cancer.

 

Personal History

A woman with cancer in one breast has a higher risk of developing a new cancer in the other breast or in another part of the same breast. (This is different from a recurrence or return of the first cancer.) Although this risk is low overall, it's even higher for younger women with breast cancer.

 

Height

Many studies have found that taller women have a higher risk of breast cancer than shorter women. The reasons for this aren’t exactly clear, but it may have something to do with factors that affect early growth, such as nutrition early in life, as well as hormonal or genetic factors.

 

Breast Density

Breasts are made up of fatty tissue, fibrous tissue, and glandular tissue. Breasts appear denser on a mammogram when they have more glandular and fibrous tissue and less fatty tissue. Women with dense breasts on mammogram have a higher risk of breast cancer than women with average breast density.

 

 

 

Benign Breast Conditions

Women diagnosed with certain types of benign (non-cancer) breast conditions may have a higher risk of breast cancer. Some of these conditions are more closely linked to breast cancer risk than others. 

 

Early Menstrual Periods

Women who have had more menstrual cycles because they started menstruating early (especially before age 12) have a slightly higher risk of breast cancer. The increase in risk may be due to a longer lifetime exposure to the hormones oestrogen and progesterone.

 

Later Menopause

Women who have had more menstrual cycles because they went through menopause later (typically after age 55) have a slightly higher risk of breast cancer. The increase in risk may be because they have a longer lifetime exposure to the hormones oestrogen and progesterone.

 

Breast Cancer Screening

There are three ways to detect breast changes that might be cancerous. Women should have knowledge about their breasts and what is normal for them. Many cases of breast cancer are discovered through self-examination. Adult women should have a clinical breast examination by a trained health-care professional at least once every year and should have a mammogram yearly past the age of 40 and every two years from age 50 to 79.

 

Prevention

Though many cancers have a genetic component and strong family history of certain types of cancer, including breast cancer--there are actions a women can take every day to reduce her risk.These include:

  • Eating a high-fiber diet rich in vegetables, fruits, whole grains, and healthy proteins.
  • Staying physically active.
  • Avoiding alcohol consumption.
  • Not smoking, and avoiding second-hand smoke.
  • Protecting your skin from the sun; this includes avoiding indoor and outdoor tanning.
  • Seeing your doctor regularly.
  • Avoiding stress by doing daily meditation, deep breathing and mindfulness exercises.
  • Getting recommended screening tests for cervical, breast, and colorectal cancers.

 

(Author is a medical doctor, columnist and public speaker. Email: drtasadukitoo@gmail.com)

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