Meher Burki, MD
Hematology/Oncology
Chester County Hospital; West Chester, PA
Published: May 18, 2015
These days, it seems like most women have a friend or family member who is battling breast cancer. There is more scientific evidence related to screening for breast cancer, the most common non-skin cancer and second deadliest cancer in women, than there is for any other type. Currently 1 in every 8 women is at risk of developing breast cancer; this puts every female at a 12% lifetime risk.
The major personal risk factors of breast cancer are: age, family history, weight, alcohol usage, reproductive history, hormone use, diet and exposure to radiation. However, 70% of women who develop breast cancer do not have any risk factors, and 85% of women with breast cancer have no family history. Therefore, screening is essential for every woman, regardless of risk.
The most important risk factor is increasing age. Early menstruation and late menopause also increase the risk. Breastfeeding is thought to moderately reduce the risk.
In July 2002, it was discovered that Hormone Replacement Therapy also increased the risk of breast cancer. The increased risk of breast cancer with the use of oral contraceptive pills is now controversial, given the lower dose of estrogen in the newer formulations.
Having a first-degree relative with breast cancer doubles ones risk of getting breast cancer; having two first-degree relatives triples the risk. A woman with a personal history of breast cancer in the past is 3-to-4 times more likely to develop a second breast cancer.
Approximately 10% of breast cancers are hereditary. Although the BRCA1 and BRCA2 gene mutations are the most commonly known and understood, these are by no means the only mutations increasing breast cancer risk.
Alcohol use also increases the risk of breast cancer, as it is thought to increase the level of estrogen in the body.
To date, there are no foods that are known to reduce cancer risk. However, the combination of a nutritious diet, regular exercise and maintaining a healthy weight have been shown to reduce cancer risk. In addition to being a non-smoker, this 'health triangle' has been thought to be the most important step to prevent any kind of cancer.
It goes without saying that early detection is the key to a likely cure from breast cancer. For this reason, the American Cancer Society has specific guidelines for screening for breast cancer:
- Women, age 40 and over, should have a screening mammogram every year and should continue to do so for as long as they are in good health.
- Women in their 20s and 30s should have a clinical breast exam every three years by a health-care professional. Starting at age 40, women should have a clinical breast exam every year.
- Women who are at high risk for breast cancer should get yearly breast mammograms and MRI. High risk is defined as women who:
- have a life-time risk of 20% or 25% or more
- have a BRCA1 and BRCA2 mutation
- have a first-degree relative with the BRCA1 or BRCA2 mutation and who have not had genetic testing
- had radiation therapy to the chest between the ages of 10-30 years
- have Li-Fraumeni, Cowden or Banayan-Riley-Ruvalcaba syndromes, or have first-degree relatives with one of these syndromes.
Women can take action to reduce their chances of getting breast cancer by controlling the risk factors that they can, such as performing monthly breast self-examinations; having yearly clinical exams; following the mammogram screening guidelines; and talking to their health-care provider regarding the appropriateness of genetic testing.
This article was published as part of the Daily Local News Medical Column series which appears every Monday. It has been reprinted by permission of the Daily Local News.
Related Information from Chester County Hospital: