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In the Spotlight

Am I at Risk for Breast Cancer?

By Lee Phillips M.D.
Personal MD.com
Advisory Board

 

Age 25 1 in 19,608
Age 30 1 in 2,525
Age 35 1 in 622
age 40 1 in 217
age 45 1 in 93
age 50 1 in 50
age 55 1 in 33
age 60 1 in 24
age 65 1 in 17
age 70 1 in 14
age 75 1 in 11
age 80 1 in 10
age 85 1 in 9

Source: National Cancer Institute

Most women at some point in their lives wonder if they are at risk of developing breast cancer. In fact all women are at risk for breast cancer. The question is how much  and if you're like most, you don't have a realistic picture of your risk

Breast cancer is the most frequently diagnosed non-skin cancer in American women. Over the years, researchers have discovered "risk factors," that influence a woman's chance of getting the disease. About 5 to 10 percent of breast cancer cases are thought to be hereditary, occurring in women whose family members have either of two breast cancer susceptibility genes, BRCA­1 and BRCA­2.

About 50%-60% of women with inherited BRCA1 or BRCA2 mutations will develop breast cancer by the age of 70. Women with these inherited mutations also have an increased risk for ovarian cancer. The rest of the new cases (90-95%) diagnosed yearly are sporadic and most likely due to a complex interaction between genetic and other factors, including reproductive and hormonal history, lifestyle choices, diet and environmental toxins.

Many women who develop breast cancer have no known risk factors other than growing older, and many women with known risk factors do not get breast cancer. No one knows why some women develop breast cancer and others do not.

Every woman has heard the statistic, "one of every eight women will be diagnosed with cancer". The actual odds though refer to the lifetime risk for a woman who lives to the age of 85. Most women falsely overestimate their cancer risk. For most of your life the risk is significantly lower than the one-in-eight, but it does increase as you age.

The Breast Cancer Risk Assessment Tool is available to help your doctor assess your chance of breast cancer more accurately, based on certain risk factors. It estimates a woman's risk of developing breast cancer for two time periods: over the next five years and for her lifetime. The Breast Cancer Risk Assessment Tool is not accurate for women who are younger than age 20, who have already had a diagnosis of breast cancer or who are known to have the breast cancer susceptibility genes (BRCA1 or BRCA2).

The tool compares your risks to those of a woman of the same age with NO risk factors other than her age, and with the risk of women who were eligible to participate in the Breast Cancer Prevention Trial. The goal of the assessment is to give women a clearer picture of their individual risk and advise women about the option of using the drug tamoxifen. Some experts say a woman should have a risk of 1.7 before being given tamoxifen, which has been shown to reduce the chance of developing breast cancer in women at higher risk.

Breast Cancer Control Month

Many women are confused about what exactly are the risk factors for breast cancer. The risk assessment tool uses factors based upon a woman's age and race, her family's history of breast cancer, her reproductive history, whether a woman has had a breast biopsy, or has been previously diagnosed with ductal carcinoma in situ or lobular carcinoma in situ to assess her risk of developing breast cancer.

One of the most important risk factors for breast cancer is increasing age. The greatest number breast cancers occur in women older than age 50.

Ductal carcinoma in situ and lobular carcinoma in situ  are associated with increased risk for developing an invasive breast cancer.

The more monthly cycles you have in a lifetime, either by beginning menstruation at an early age or entering late menopause increases your risk for breast cancer. Having a first pregnancy after age 30 or having no children also increases your risk of breast cancer.

Having one or more first-degree blood relatives (sisters, mother, daughters) who have been diagnosed with breast cancer almost doubles a woman's chances of developing this disease, especially if they were diagnosed at an early age.

Women who have had breast biopsies have an increased risk of breast cancer, especially if the biopsy showed a change in breast tissue known as atypical hyperplasia. These women are at increased risk because of whatever prompted the biopsies, NOT because of the biopsies themselves. White women have greater risk of developing breast cancer than Black women (although Black women diagnosed with breast cancer are more likely to die of the disease).

There are other risk factors not included because either evidence that these factors play a part in breast cancer risk is not definite, or how much these factors contribute to breast cancer is not known. Such risk factors include: age at menopause, dense breast tissue, use of birth control pills or hormone replacement therapy, a high-fat diet, alcohol, radiation exposure, and environmental pollutants. An increased risk for breast cancer also has been identified among women of higher socioeconomic status, married women, women living in urban versus rural areas, and women living in northern States.

Women at high risk for breast cancer should be closely monitored and have regular medical checkups so that, if breast cancer develops, it is likely to be detected at an early stage. Women who are considering taking steps to reduce the risk of breast cancer should discuss their personal risk factors with their doctor. With any procedure or medicine, both the benefits and the risks must be considered. Any decision should be an individual one.

Source: National Cancer Institute

A woman with cancer in one breast has a 3- to 4-fold increased risk of developing a new cancer in the other breast.

The disease is about 100 times more common among women than men.

An estimated 178,700 American women will be diagnosed this year.

About 43,500 American women will die as a result of breast cancer this year.

About 2 million American women are breast cancer survivors.

Mastectomy has been replaced by less radical surgery for many women with early stage breast cancer. For early stage disease, studies have shown that long-term survival after lumpectomy plus radiation therapy is similar to survival after modified radical mastectomy. Two important genes, BRCA1 and BRCA2, are associated with most inherited breast cancers. Tamoxifen, taken for five years, has been shown to reduce the risk of recurrence of breast cancer. Tests are being developed to detect signs of breast cancer in blood, urine, or nipple fluid.

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