What Puts You at High Risk for Breast Cancer?
While the cause of breast cancer is still unknown it is known that some factors can increase your risk of developing the disease. While some of these factors may be out of your control, others can be altered by making simple lifestyle choices. Known breast cancer risk factors include the following.
Being Female: Being a woman or a person assigned female at birth is the most significant risk factor for developing breast cancer. A woman’s average risk of breast cancer is 8-12% for the entire lifetime.
Age: Your risk of breast cancer increases as you age. About 2 out of every 3 invasive breast cancers are found in women 55 years or older. Breast cancer can occur in females of any age.
Family History: Those with close relatives who have been diagnosed with breast cancer have a higher risk of developing the disease. Mother, sister, daughter/ Father, brother, son are first-degree relatives.
Personal History: If you have been diagnosed with breast cancer, you may be more likely to develop a new cancer. This risk is about 0.25%/year following the diagnosis. Over the 10 years following diagnosis, this adds up to about 2.5%.
Genetics: It has been found that 5-10% of breast cancers are believed to be hereditary and linked to a specific gene. This means the person has inherited a change in a gene that causes cancer. Individuals with the BRCA 1 or BRCA 2 genes and other genes will be at higher risk.
Race/Ethnicity: Caucasian women have a slightly her risk of developing breast cancer compared to Hispanic, Black, and Asian women. However, Black women have a higher risk of developing more aggressive and advanced-stage breast cancer at a younger age.
Radiation: If you have had radiation to your chest or face to address another cancer before the age of 30, you have a higher risk of developing breast cancer.
Breast Changes: You may have a higher risk of breast cancer if you have been diagnosed with certain benign breast conditions like atypia.
Being Overweight: Women who are overweight or obese have a higher risk of breast cancer, especially after menopause. This translates to a 20-60% increase in risk of breast cancer.
Menstrual History: If you had your first period before you turned 12, you may have a higher risk of breast cancer later in life. Having a baby at an age >35 or not having children at all also contributes to increased risk. A later menopause also increases the risk.
Lifestyle: Drinking alcoholic beverages, lack of exercise, and smoking are all linked to a higher risk of breast cancer. Overall, choosing the healthiest lifestyle options available can empower you to ensure that your personal breast cancer risk is as low as possible.
Environmental Exposures: Certain environmental exposures may increase your risk of breast cancer. These may include chemical exposure to agents such as benzenes, pesticides, formaldehyde, nuclear plant work, and well water contaminated with chemicals.
Treatment Option for High-Risk Individuals
Antihormonal therapy (Chemoprevention)
Medications such as Tamoxifen and aromatase inhibitors like Letrozole (Femara) have been shown in long-term clinical research to reduce the risk of breast cancer. This type of therapy is traditionally called chemoprevention but does not involve chemoprevention. It can be called anti-hormonal therapy because both types of medication change the way estrogen is used or created in the body. They must be taken for 5 years for the full effect of a 45-60% reduction in lifetime risk for breast cancer. The benefit is thought to last for 20 years after stopping the medication. More recent studies show that lower doses of Tamoxifen in some patients may be equally effective with fewer side effects and complications.
Prophylactic or Risk Reducing Surgery
Risk Reducing mastectomy is very effective at minimizing the risk of breast cancer. It reduces the risk by about 95% for the remainder of the patient’s life. The risk for breast cancer will never be zero, it can still occur in the skin, lymph nodes, or elsewhere in the body even after extensive surgery.
While patients of low to moderate risk may choose this approach, it is only recommended for patients with high-risk gene mutations such as BRCA 1,2, TP53, and a few other mutations. In this highest-risk category, there is an improvement in survival for patients who choose mastectomy. For low to medium-risk patients, the benefits are less clear. At Tucson Breast Health Specialists, we will carefully review the risks and benefits of such a procedure with you.
Contralateral Prophylactic Mastectomy
This procedure is performed to remove the healthy breast (the other side or contralateral) in a woman who currently has or has had breast cancer in one breast. It may be recommended if you have a high-risk gene mutation such as BRCA or have a high risk of developing breast cancer from other factors. It is not routinely recommended for patients who do not have a genetic mutation or other very strong risk factors as the benefits are usually similar to the risks of surgery.
Bilateral Prophylactic Mastectomy
This procedure involves removing both breasts in women who do not currently have breast cancer to lower their chances of getting breast cancer. This can be done with skin-sparing or nipple-sparing techniques. Patients may also choose non-skin-sparing mastectomy or flat aesthetic closure.
Prophylactic Oophorectomy
Individuals with the BRCA1 or BRCA2 gene mutations have a higher risk of developing breast cancer and ovarian cancer. Many doctors recommend that these women have surgery to remove their ovaries -called bilateral salpingectomy and oophorectomy (BSO) once they are finished growing their families. The exact timing depends on both the patient’s and their relatives’ history. This procedure greatly reduces the risk of ovarian cancer; however, it will cause a pre-menopausal female to go into menopause. It is important to discuss your options with your healthcare team regarding this type of surgery.
Contact Us Today
If you are concerned regarding your breast cancer risk, do not hesitate to reach out to Tucson Breast Health Specialists in Tucson, AZ today. We will be happy to thoroughly discuss all of your options with you.
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