What is my risk for getting breast cancer?
How Individual Risk Works
Think of risk as putting tickets into a raffle. While you may have several tickets in the raffle, it doesn’t mean that you will be selected. And if you only have one ticket in the raffle, it doesn’t mean you can’t be selected. Risk works the same way.
Having several risk factors may make it more possible to develop breast cancer, but it doesn’t mean you will get it. Just as having very few risk factors doesn’t mean you can’t get it.
Why is it good to know your risk factors for breast cancer? It helps you to make decisions to reduce your risk where possible, and review your screening plan when your risk factors put you at a higher risk than the average population. Why? Because a higher risk could mean a different screening plan that manages your breast health in a better way for you.
9 Key Risk Factors for Breast Cancer
AGE
The higher your age, the higher your risk for breast cancer. The longer you are exposed to estrogen, the longer you’ve been exposed to the risk. Unless you know the secret to stop aging, you are at risk!
PERIODS
Periods increase the amount of estrogen in the body. The more periods you’ve had, the more exposure you’ve had. Things that can reduce your periods are breastfeeding and pregnancy.
The risk of breast cancer is lower for women who have had a baby before age 30–35. This is because breast cells are copied rapidly during pregnancy. The older the cells, the greater the chance of mutation, which may create more “bad” copies, leading to a slightly increased risk for breast cancer.
PILLS: HORMONE THERAPY & BIRTH CONTROL
Not all hormone pills or birth control pills increase your risk for breast cancer, but some can. Talk to your doctor about whether the medications you are taking have a breast cancer risk associated with them.
Some risk factors for breast cancer are within our control.
These give us an opportunity to reduce our risk through a healthy lifestyle. Think of it as "pulling a few tickets out of the raffle."
ALCOHOL & CIGARETTES
Consuming moderate to increased levels of alcohol, as well as smoking cigarettes, may increase your risk for breast cancer.
BEING OVERWEIGHT AFTER MENOPAUSE
Did you know that fat cells make and store estrogen? Your risk of breast cancer increases if you are overweight, especially after menopause. Maintaining a healthy weight can reduce your risk. Losing weight also means you lose the extra estrogen along with it!
SEDENTARY LIFESTYLE: EXERCISE!
Not exercising regularly, or being sedentary (holding still, sitting) for long periods of time can also contribute to your risk for breast cancer.
Many studies conducted over the past 20 years have shown consistently that an increase in physical activity is linked to a lower breast cancer risk. Any movement is good movement. It doesn't have to be running in your athletic wear. The key is to avoid sitting. If you are able, get up and move and enjoy your body.
Physical activity regulates hormones, including estrogen and insulin. These two hormones can fuel breast cancer growth. Regular exercise also helps women stay at a healthy weight, which also helps regulate hormones and keep the immune system healthier. (Source: ACS)
The American Cancer Society recommends all adults engage in at least 150 minutes of moderate-intensity exercise each week. This is about 20 minutes a day. They recommend 75 minutes of vigorous intensity each week, or 8 minutes a day, preferably spread throughout the week.
How does being sedentary affect your body?
You burn fewer calories. This makes you more likely to gain weight.
You may lose muscle strength and endurance because you are not using your muscles
Your bones may get weaker and lose some mineral content
Your metabolism may be affected, and your body may have more trouble breaking down fats and sugars
Your immune system may not work as well
You may have poor blood circulation
Your body may have more inflammation
You may develop a hormonal imbalance
Source from MedlinePlus.
What kind of breasts do you have?
There are three broad categories of breast type, with different risks for breast cancer. If you don't have any of these three, then you are in the “typical” category.
LUMPY BREASTS
Some breasts are lumpy, which is common. The medical term is “fibrocystic.” This can cause breast pain, tenderness, and lumpiness—but it doesn’t increase your risk for breast cancer and doesn't have an impact on screening.
This lumpiness can be seen in an ultrasound or noticed by the patient herself as tenderness. Tenderness and lumpiness increase as your period approaches. This is why you should do your self-exam after the end of your period, when things are the most "normal." Our app reminds you when the best time to self-exam is!
However, “atypical hyperplasia,” is a build-up of abnormal cells in the breast, that has a thicker lining. Over time, if atypical hyperplasia cells keep dividing and become more abnormal, they *might* turn into breast cancer.
This is why additional screening is recommended for this breast type. How do you know if you have this type? You will need a biopsy after a suspicious area shows up on a mammogram or ultrasound. (1)
DENSE BREASTS
Half of women over the age of 40 have dense breasts, which is more common in young and thin women (2). Denser breasts can make it difficult for mammograms to detect cancer. How do you know if you have dense breasts? Your mammography report will tell you. You cannot tell breast density by "feeling."
Here are the 4 different levels of breast density:
Talk to your doctor about additional screening options if your breasts are too dense for a mammogram to detect cancer, such as an Ultrasound (or ABUS) or a Breast MRI. 3-D Mammograms (known as “tomosynthesis”) can also help get a more detailed view of different angles of the breast.
See our blog for an in-depth and easy-to-understand explanation of breast density.
GENETIC MUTATION
About 5% to 10% of breast cancer cases are thought to be hereditary, meaning that they result directly from gene changes (mutations) passed on from a parent. (Source: ACS)
A family history of breast cancer, particularly if it is a first-degree relative (such as a mother or sister), increases your risk because you may share a genetic mutation.
However, about 85% of people with breast cancer do not have a family history of breast cancer. Talk to your doctor about genetic testing if it’s a concern in your family.
Here is a checklist to consider if genetics may be a factor for you:
Do you have:
blood relatives (grandmothers, mother, sisters, aunts) on either your mother’s or father’s side of the family, who had breast cancer before age 50?
both breast and ovarian cancer on the same side of the family, or in a single individual?
a relative with “triple-negative” breast cancer (a specific type of breast cancer that affects about 10-20% of patients)?
other cancers in your family in addition to breast, such as prostate, melanoma, pancreatic, stomach, uterine, thyroid, colon, and/or sarcoma?
women in your family with cancer in both breasts?
Ashkenazi Jewish (Eastern European) heritage?
African American heritage and diagnosed with breast cancer at age 35 or younger?
a man in your family who has had breast cancer?
an abnormal breast cancer gene in your family (such as: BRCA1, BRCA2, BTEN, TP53, PALB2, STK11, CHEK2, CDH1, NBN, BRIP1, BARD1, ATM)?
had radiation to the chest before age 30 (while breasts are still developing), can increase the risk of breast cancer due to possible mutations?
Note: If one family member has an abnormal breast cancer gene, it does not mean that all family members will have it. The reverse is also true. Individual testing is needed as genes are different for each person in a family.
Source of bullet points on genetics is from https://www.breastcancer.org/risk/risk-factors/genetics
Breast density image courtesy of radiopaedia.org