Breast cancer is truly unpredictable; it can strike without warning or discernible cause. While we cannot always anticipate its onset, we are better off prepared than caught off guard.
This page serves as a vital resource for women seeking to protect their health. By understanding the risk factors – from aging and genetics to lifestyle habits and treatment choices – New Hope Medical Center empowers women with awareness. In addition to risk factors, learning about the stages of breast cancer equips women with the necessary knowledge to recognize the warning signs and seek timely medical intervention.
Breast Cancer Risk Factors: A Complete Guide
A risk factor refers to any variable that increases a person’s chance of getting cancer. However, while these factors can influence cancer development, most do not cause cancer directly. Some women with several risk factors never acquire cancer, while others with no known risk factors do.
Nonetheless, understanding breast cancer’s risk factors and discussing them with a doctor can help in making the best lifestyle and healthcare choices. As the old saying goes, “prevention is better than cure.”
Uncontrollable Risk Factors of Breast Cancer
Below are the risk factors you CANNOT change or control.
1. Aging
As with most diseases, the risk of breast cancer increases with age.
According to the American Cancer Society, a woman’s breast cancer risk based on age is as follows:
- 20 years old: 0.1% (1 in 1,479 cases)
- 30 years old: 0.5% (1 in 209 cases)
- 40 years old: 1.5% (1 in 65 cases)
- 50 years old: 2.4% (1 in 42 cases)
- 60 years old: 3.5% (1 in 28 cases)
- 70 years old: 4.1% (1 in 25 cases)
- 80 years old: 3.0% (1 in 33 cases)
Although younger women are not exempt from breast cancer, it is rarer for them to get it. One explanation is that cell damage from physical, chemical, biological, infectious, nutritional, and immunological factors can build up through the years, sometimes leading to cancer. The aging immune system is also less capable of protecting against diseases and repairing genetic damage (mutations).
Simply put, women in their 50s and up generally accumulate more cell damage and have weaker immune systems than younger women. Therefore, their likelihood of developing breast cancer is greater.
Steps to Take
While you can’t hit pause on the aging process, you can detect breast cancer in its earliest, most treatable form by:
Checking your breasts for unusual changes every month 
To perform a self-breast exam:
- Position yourself shirtless and braless in front of a mirror. Keep both arms at your sides.
- Look for any dimpling, puckering, or changes in breast size, shape, or symmetry.
- Examine the nipples closely. Do they look different than they used to? Are they inverted?
- Raise your arms overhead, palms pressed together, and explore your breasts from another angle.
- Use both hands to elevate your breasts to assess the symmetry of the ridges along the lower contours.
- Gently palpate each breast in a circular motion using the opposite hand. Keep the adjacent arm raised during this process.
- Look and feel for any lumps, thickening, or changes in texture.
If you notice any changes or signs of breast cancer, consult a doctor for an accurate diagnosis.
Know more about the importance of breast self-exams here, including how to check the breasts while lying down or showering.
Getting a mammogram
A mammogram detects abnormalities that breast self-exams don’t. Using low-energy X-rays, it generates detailed images of the breasts, unveiling characteristic masses or microcalcifications before physical symptoms arise.
The American Cancer Society recommends women aged 50 to 54 to undergo a mammography each year, and women aged 55 and older every 1 to 2 years.
Learn more about mammography here.
Keep in mind that breast self-exams and mammograms are NOT exclusive to older, gracefully aging women. All women can begin practicing breast self-exams in their 20s and continue to do so throughout life. As for mammograms, a physician may recommend screening at a younger age based on individual risks, especially if it involves our next cancer risk factor.
2. Genetics and Family History
Between 5% and 10% of breast malignancies are hereditary, meaning children can inherit the genes responsible for abnormal cell growth. BRCA1 or BRCA2 mutations are the most common cause of hereditary breast cancer.
In addition, cancerous breast tumors may run in the family if:
- One or more blood relatives developed breast cancer at 45 or younger.
- One or more family members became diagnosed with breast cancer before 50, and there is an additional family history of related malignancies, such as in the ovaries, prostate, or pancreas.
- Either side of the family has a history of breast and/or ovarian cancers across multiple generations.
- A female blood relative developed recurrent or second breast cancer in either the same or other breast, or she has both breast and ovarian cancer.
- You have Ashkenazi Jewish ancestry. About 1 in 40 women of this descent has a BRCA gene mutation.
- One or more family members developed male breast cancer.
Steps to Take
Aside from performing monthly self-examinations and talking to a doctor about how soon and frequently to undergo mammograms, according to the National Cancer Institute, women with a very high risk of breast cancer may consider preventive mastectomy.
Should You Consider a Mastectomy?
To raise the odds against future disease, some women opt to remove both breasts via a surgical procedure known as bilateral prophylactic mastectomy.
If you have one or more of these risk factors, you may elect this procedure with the guidance of medical professionals:
- BRCA or other gene mutations.
- Previous cancer in one breast and a high risk of cancer in the other.
- Previous exposure to chest radiation before turning 30.
- Strong family history of breast cancer, where multiple female relatives throughout generations, such as a mother, grandmother, and aunt, have all been diagnosed with breast cancer.
- History of lobular carcinoma in situ (LCIS) in addition to a family history of breast cancer.
Before proceeding with surgery, we recommend seeking genetic and psychological counseling to understand the procedure’s mental health implications and determine whether preventive mastectomy is appropriate.
3. Reproductive History
Prolonged exposure to the hormones produced in the ovaries, including endogenous estrogen and progesterone, increases a woman’s breast cancer risk. Early menstruation (before 12 years old) and late menopause (after age 55) are reproductive factors that increase the duration and levels of exposure to ovarian hormones, which can stimulate cell growth.
4. Having Naturally Dense Breasts
Being born with dense breasts – where a higher proportion of the breasts consist of glandular tissue and fibrous tissue – is a baffling breast cancer risk factor, especially since 40% of women aged 40 or older in the U.S. have naturally dense breasts. Having more glandular and fibrous tissue also makes it difficult to interpret mammogram results, leading to inaccurate breast cancer findings.
FDA regulations will soon oblige mammographers to inform female patients if they have dense breasts. This upcoming directive hopes to encourage more women to undergo further and more frequent tests to detect breast cancer early.
5. History of battling breast-related diseases
Women with a history of breast cancer or benign breast conditions, such as atypical hyperplasia or lobular carcinoma, face an increased risk for breast cancer. This heightened risk stems from the potential recurrence of breast cancer or the presence of cellular changes that may indicate a predisposition to malignancy.
Regular monitoring and risk assessment for women with these histories are crucial in early detection and prevention strategies to safeguard breast health.
6. Previous Exposure to Radiation Therapy
As mentioned earlier, receiving radiation therapy – a conventional treatment for previous breast cancer or other malignancies like Hodgkin’s lymphoma – may heighten the risk of breast cancer recurrence, especially if the patient was under 30 during treatment. Radiation causes acute and chronic tissue damage, leading to genetic mutations that may trigger cancerous growth later in life. This highlights the need for careful consideration of treatment options and the importance of informed decision-making, taking into account both the immediate and long-term implications.
7. Exposure to Diethylstilbestrol (DES)
Between 1940 and 1971, diethylstilbestrol was prescribed to pregnant women as a miscarriage prevention measure, not knowing that the drug elevated breast cancer risks. Moreover, women whose mothers received DES while carrying them in the womb may also be at risk of developing breast cancer.
8. Older Paternal Age
Research published in the journal of BMC Cancer revealed that premenopausal women whose fathers were over 40 years old during their birth had a higher risk for breast cancer than women whose fathers were younger than 30 at their birth. Moreover, having a personal or family history of breast cancer, long-term exposure to estrogen, and being over 30 at first full-term pregnancy increased the risk significantly.
Controllable Risk Factors of Breast Cancer
As for the risk factors you CAN change or control, they include:
1. Lifestyle Habits
-
- Watch what you eat: A high-fat diet may be related to breast cancer occurrence. Instead, consuming fruits, veggies, lean proteins, and whole grains while minimizing processed foods and saturated fats may contribute to a lower risk. Foods high in antioxidants and phytochemicals, including strawberries, cruciferous vegetables, and green tea, may reduce breast cancer risk.
- Exercise: Regular physical activity may help reduce the risk of breast tumors. According to the CDC, engaging in 150 minutes of moderate-intensity workouts or at least 75 minutes of vigorous-intensity exercise per week can help balance hormones and prevent unhealthy weight gain, which are important factors in breast cancer prevention.
- Attain and maintain a healthy body weight: Obesity or having more fatty tissue is a risk factor for ER‐positive breast cancer, particularly in postmenstrual women. Maintaining a BMI-approved weight through a combination of diet and exercise can lower overall risk. Weight management also helps regulate hormone levels, as excess body fat can lead to higher estrogen production, a hormone associated with breast cancer occurrence.
- Stop smoking: Tobacco exposure is a risk factor for lung, breast, and 14 other malignancies. So, quit smoking today.
- Limit alcohol consumption: Decades of research shows a strong and direct link between alcohol intake and breast cancer development. Cutting down or eliminating alcohol consumption can significantly lower this risk.
- Manage stress: Stress can trigger all five aforementioned habits that raise breast cancer risks. Point in case, when stressed, we tend to overeat or choose unhealthy food options, lack motivation to exercise, and gain weight. In severe cases, some of us drink and/or smoke to alleviate stress, which does more harm than good. Chronic stress also impacts the immune system and promotes inflammation, explaining its link to cancer. To mitigate stress’s adverse effects, adopt stress-management techniques such as mindfulness, regular exercise, adequate sleep, and seeking support from loved ones or professionals.
- Opt to work during the day: Women working night shifts for several years have a small but discernible increase in breast cancer risk.
2. Planning for Pregnancy
Some pregnancy-related factors may increase breast cancer risks. Therefore, women hoping to get pregnant in the future must consider the following:
- Age during the first childbirth. Women older than 30 at the time of their first childbirth are more likely to develop a malignant breast tumor than women who have never given birth.
- Recent childbirth. After pregnancy and childbirth, women’s breast cancer risk may surge, although it gradually declines within 10 years. This heightened risk may be due to hormonal fluctuations or the rapid growth of breast duct cells during pregnancy.
3. Hormone Replacement Therapy (HRT)
Hormone therapy with estrogen and progesterone, commonly used to manage menopausal symptoms, contributes to elevated breast cancer risks. The longer someone receives HRT, the more likely they are to develop breast cancer. However, once they stop HRT, their risk will also begin to drop.
Women should discuss alternative treatments with their healthcare providers and use HRT only when necessary and at the lowest effective dose.
4. Oral Birth Control
Using oral contraceptives, a.k.a. “The Pill,” slightly increases breast cancer risk due to hormonal changes. Estrogen and progestogen in some formulations can induce breast cell growth, which may lead to cancerous changes. However, the overall risk increase is diminutive, especially in younger women, and preventing unwanted pregnancies often outweighs the minimal risk.
For concerns about cancer and birth control pills, consult a healthcare provider for personalized advice.
When Cancer Occurs: Breast Cancer Staging
Now that we have discussed the various risk factors of breast cancer, let us transition our focus toward its stages. Comprehending breast cancer’s stages is crucial for deciding the appropriate treatment course and ensuring the best possible outcomes for all women diagnosed with this disease.
- Stage 0: Also called pre-invasive cancer, pre-cancer, or breast carcinoma in situ, in stage 0, abnormal cells in the breast possess cancer traits, but they have yet to spread into other tissues or organs. Stage 0 breast cancer typically has no symptoms, but a small lump may be present. To reiterate, women over 20 should perform monthly self-exams to detect lumps or masses in the breasts.
- Stage I: This stage indicates that breast cancer has spread farther from the tissue where it originated. It has two substages:
- Stage IA is when cancer spreads to the fatty breast tissue, but it is still within the breast. Here, the tumor is about the same size as a pea.
- Stage IB is when clusters of cancer cells reach the lymph nodes.
- Stage II: At this stage, cancer begins growing or spreading. It has two substages:
- Stage IIA is when a tumor may not be in the breast, but cancer cells have spread to 1 or 3 lymph nodes. Oncologists refer to this stage as lymph node involvement or regional metastasis.
- Stage IIB is when the tumor is around 2 to 5 cm, and cancer cells have reached 1 or 3 axillary lymph nodes. The tumor may also be bigger than 5 cm (about the size of a lime) but has not reached the axillary lymph nodes.
- Stage III: Also called locally advanced breast cancer (LABC), the tumor is around two inches in diameter in this stage. Cancer has made its way from the breast to the lymph nodes, to the skin of the breast, near the breast, or to the chest wall. It has three substages:
- Stage IIIA indicates at least nine affected lymph nodes.
- Stage IIIB is when the tumor has developed in the skin around the breast.
- Stage IIIC is when breast cancer has manifested in 10 or more lymph nodes.
- Stage IV: Referred to as metastatic breast cancer (the most advanced stage), cancerous cells have spread (metastasized) beyond the breast. The common areas of the body that breast cancer cells spread to include the lungs, brain, bones, and liver. The survival rate at this stage is low, but shrinking the tumor can help delay further progression, allowing the patient to feel better and live longer.
Also read: Hope on the Horizon: Breast Cancer News 2023
Prevention and Treatment
Since many of the risk factors are uncontrollable, the best preventative measure is to get breast examinations regularly. Women over 40 can get a mammogram every three years, while women at high risk and above age 50 should commit to annual breast examinations. In between waiting, all women over 20 should perform monthly breast self-exams at home. If you detect changes or signs of breast cancer, visit a doctor to confirm the diagnosis.
Women in need of alternative treatment options for breast cancer can visit New Hope Medical Center, where the collective goal is to reduce the physical symptoms of cancer and promote mental, emotional, and spiritual well-being. Contact us now for more information on how we can help.