Breast cancer is the most common cancer in women, and the second-leading cause of cancer death. However, death due to breast cancer has been decreasing since 1989, thanks to early detection and advances in treatment.
The most significant risks for developing breast cancer are gender and age. Being a woman means that you have a 12% chance of developing breast cancer in your lifetime, and it is more likely to develop in later years.
Early detection is your best chance of survival – with screening mammograms, breast self-exams and annual clinical breast exams. For women with an average risk of breast cancer, annual screening mammograms should begin at age 40. For women with increased risk, screening should begin at an earlier age dependent upon risk factors. Discuss this with your doctor and develop a screening plan.
Additional risk factors include certain hereditary genetic mutations, a personal history of breast cancer, family history of breast cancer, personal history of radiation to the chest wall or face before age 30, certain types of fibrocystic breast changes, use of hormone replacement therapy after menopause, being overweight, alcohol use, cigarette smoking and dense breast tissue.
Race/ethnicity also impact your risk. White women are slightly more likely to develop breast cancer, but
African-American women are more likely to develop more aggressive breast cancer diagnosed at a more advanced stage and at a younger age. Screening is critical to cause a change in this paradigm.
Although you hear a lot about family history and gene mutations as risk factors, it is important to know that less than 15% of women who develop breast cancer have anyone in their family with the disease, and only 5% to 10% of breast cancers are due to a gene mutation inherited from the father or mother. That means that about 85% of women with breast cancer have no family history of the disease. This is why screening is so important.
Your gender, age and family history can’t be changed; however, other risk factors can be modified.
• Regular, moderate exercise for 4-7 hours per week lowers the risk of breast cancer.
• Hormone replacement therapy after menopause increases the risk by 75% (so instead of 12% lifetime risk of breast cancer, the lifetime risk would be 21%).
• Smoking cigarettes is linked to a higher risk of breast cancer, particularly in younger premenopausal women.
• Reducing alcohol consumption also lowers risk; women who drink two or more alcoholic drinks per day (wine, beer or liquor) are 50% more likely to develop breast cancer than women who don’t drink alcohol.
• Having a full-term pregnancy prior to age 30 and breastfeeding reduce the risk of breast cancer (but these are not necessarily decisions that are made purely for the purpose of reducing breast cancer risk and are very personal).
By Dr. Rhonda Wachsmuth, a breast surgeon affiliated with Northside Hospital Cherokee and Georgia Breast Care in Marietta and Woodstock.