With breast cancer being one of the most commonly diagnosed cancers in women and with increasing rates of breast cancer diagnoses worldwide, all women should consider themselves at some risk for developing breast cancer in their lifetime. Of those diagnosed with breast cancer, only about 5-10% carry a gene associated with an increased breast cancer risk. And less than one third have a family history of breast cancer. So it is important to realize that many factors are involved in developing breast cancer. Some of these risk factors cannot be modified (things you can not change) while other risk factors can be modified (things you can change).
Non-modifiable risk factors/THINGS YOU CANNOT CHANGE:
- Race and ethnicity
- Family history
- Genetic mutation
- Early menarche (first period)
- Late menopause (last period)
- Benign breast disease (especially proliferative changes, atypia, and lobular carcinoma in-situ)
- High mammographic breast density
- Exposure to ionizing radiation for cancer treatment and other environmental exposures
Modifiable risk factors/THINGS YOU CAN CHANGE:
- Weight and body mass index (BMI)
- Physical activity
- Alcohol use
- Tobacco use (smoking cigarettes)
- Hormone replacement therapy (HRT) use
- Night shift work
- Environmental exposures to toxins
All women should make an effort to be physically active, limit alcohol intake, and not smoke cigarettes. Modest weight loss (5 to 10%) in overweight women leads to significant risk reduction for breast cancer. Recent studies suggest a link between smoking and an increased risk of breast cancer.
While not feasible for many, women may consider planning their first pregnancy and childbirth at any early age to reduce their risk of developing breast cancer. Postmenopausal women should make an effort to minimize use of combined estrogen/progesterone (hormone replacement therapy or HRT).
For those women with an increased risk for developing breast cancer due to a personal history of certain non-cancerous breast changes and/or a family history of breast or related cancers, additional measures may be taken to reduce the risk of developing breast cancer.
Medications may be taken to reduce the risk of developing hormone sensitive breast cancers. Tamoxifen, Raloxifene (Evista), and Exemestane (Aromasin) are drugs that can be used for breast cancer risk reduction.
In the highest risk patients, surgery may also be used to reduce the risk of breast cancer. Removal of breast tissue (called a prophylactic mastectomy, or preventative mastectomy) is associated with a significant decrease in the risk of developing all types of breast cancer. This removal may be done as a total mastectomy (removal of the breast tissue/skin/nipple areola complex), a skin sparing mastectomy (removal of the breast tissue/nipple areola complex), or a nipple sparing mastectomy (removal of breast tissue sparing the skin and nipple areola complex). Prophylactic mastectomies are often combined with breast reconstruction if desired by the patient. In addition, removal of both ovaries in a premenopausal woman may reduce the future risk of developing breast cancer in addition to reducing the risk of developing ovarian cancer.
Knowing that there are specific ways to reduce your risk of breast cancer gives you a chance to take a proactive role in your health, especially your breast health.