There is a long list of items that can put you at greater risk for breast cancer. Some – like your family’s history of cancer – you cannot control. Yet, McLeod Surgeon Amanda Turbeville, MD, says there are many breast cancer risk factors you CAN control:
Here’s a summary of Dr. Turbeville’s presentation:
Risk factors are exposures that either increase your risk of having breast cancer or can decrease your risk of having breast cancer. There are a number of things we cannot change, and some things we can. Five to 10 breast cancer cases are related to genes or hereditary family type breast cancers. Those are very popular in the news, but they are a small subset of the actual breast cancer in the world. These mutations, BRCA1 and BRCA2, are genes in the body that can turn off different regulators to allow tumors to grow unchecked. This is why if you have a breast cancer at a very young age, we check you for the mutation because it can be passed on through your family to daughters and sons who can be carriers so you want them to be screened early.
Family history: people who have a blood relative and then develop breast cancer are at a three to fourfold risk of having another cancer in their lifetime.
Certain non-cancerous breast problems, called atypical ductal hyperplasia affects the ducts that take the milk down to the nipple. They can get slightly atypical and although this is not a cancer if left alone it can turn into a cancer. If a biopsy comes back as atypical, we usually remove that area to prevent a breast cancer in the future.
Too much radiation can also increase your risk. Today, X-rays are a great deal more efficient, giving you a much lower dose of radiation. People who had childhood cancer and required a lot of radiation are children that are at a slightly higher risk for breast cancer.
Hormonal replacement therapy. If you have a family history or a personal history of breast cancer, hormonal therapy is probably not the best thing for you.
Hormonal contraceptives: this is kind of plus or minus. I think once you stop using them the risk decreases.
African-American women are at a slightly higher risk of breast cancer. We do not really have a good answer for why that is. They are also a little more likely to die of breast cancer. I think this has to do with lack of access to screening, which is something that we are trying to improve so women have a chance to survive.
Dense breast tissue. This is related to young women with breast masses. Mammograms can be very difficult, because mammograms read shades of gray. Calcium shows up white; fat as black. Everything else is a different shade of gray. For young women with very dense breasts, mammograms are not always the best study for them because you cannot always differentiate between those shades of gray. We can also use ultrasounds to look at denser breasts.
Not having children or having them later in life can increase your risk of breast cancer and that is simply related to a woman’s limited exposure to estrogen. When you are pregnant you actually have less of an exposure to estrogen over your lifetime because the pregnancy protects you. Also, girls who start having menstrual cycles at a very early age start getting exposed to estrogen earlier than young women who have menstrual cycles that begin at an older age.
Physical activity. The more active you are, the less risk you have. I think that is true with everything. I find that even in colon cancer. Experts say 150 minutes of activity a week is a good way to stay active and help prevent these cancers.
Excessive weight is another risk. Maintaining a healthy weight can help you reduce your risk of breast cancer and other cancers, such as colon cancer.
Alcohol is linked to cancer risk. The more you drink, the higher your risk. For women, the general rule is: one serving of alcohol a day is okay — this can be a shot of liquor, a glass of wine or a single beer.
Have a question? Ask a cancer specialist.