Laparoscopic surgery

Breast Cancer Risk

BREAST CANCER RISK

Michael.McFarlane, Contributor 

 

 

Breast cancer is the most common cancer among women in Jamaica and it is followed only in incidence by cancer of the cervix, the large bowel and uterus.

 

It is considered to be the second leading cause of cancer death in women and is probably the leading cause of all death among women aged 40-59 years.

 

The lifetime risk of a woman being diagnosed with a breast cancer is about 14%.  In Jamaica the incidence of breast cancer falls in the intermediate range when compared with high-risk countries with about 43 new cases of breast cancer being diagnosed per 100,000 of the population each year.  All women can be considered to be at risk for developing a breast cancer and while men may develop a breast cancer they are a hundred times less likely to develop a breast cancer than a woman.

 

The actual cause of breast cancer still remains a mystery and in the majority of cases results from pure statistical chance.

 

Age is probably the most significant risk factor. The risk of a 50 year old developing a breast cancer in 20 years is about 2% and increases to 4% if a first degree relative (mother, sister, daughter) had a breast cancer. A 60-year-old woman would have a 3% risk of breast cancer over the following 10 years and a 7% risk over the next 20 years.

 

Only 5 – 10% of breast cancers are due to inherited changes and 80% of women who develop a breast cancer will not have any genetic abnormality whatsoever.

 

Breast cancer risk appears to be higher among women whose close blood relatives have the disease.  It is generally felt that the relatives, who have influence on the breast cancer risk, are from the mothers’ side of the family but recent research is suggesting that a significant family history on the fathers’ side of the family is also relevant.

 

A mother or a sister or a daughter with breast cancer doubles a woman’s risk of developing a breast cancer.  Individuals who have two first-degree relatives have a three times risk and those with three or more first-degree relatives have quadrupled the risk.  A younger age of diagnosis of breast cancer in a family member is also associated with an increased risk of breast cancer. However this increase in risk seems to apply only to first-degree relatives.

 

Individuals who have been previously diagnosed with breast cancer also have a greater chance of developing a new cancer in the opposite breast or sometimes in another part of the same breast. 

 

Increased breast density identified on mammography has been shown to have some importance with denser breast tissue having a greater risk of developing breast cancer. 

 

Patients who have benign breast disease such as fibroadenomas or cysts have not been shown to have an increased risk of breast cancer, however adverse pathological changes on biopsy may increase the risk significantly.

 

Women who begin having periods early, before 12 years or have a late menopause, after 55 years are at increased risk. Early menarche is associated with a 4% per year increase in the relative risk whereas late menopause is associated with a 3% per year increase.

 

Radiation treatment to the chest in childhood may increase risk but this risk decreases after the age of 40.

 

Apart from these risk factors there are risk factors associated with lifestyle choices over which the individual has some control.

 

Not having children, or having children later in life is associated with a slight increase in breast cancer risk. Similarly multiple pregnancies also reduce a woman’s risk.  Women who have had their first child after age 30 have only a very slight increase in risk.

 

Use of birth control pills has been shown to be associated with only a small increase in the risk of breast cancer. The risk seems to return to normal when the woman stops using contraceptives. Postmenopausal hormone replacement therapy increases the risk by one to two percent per year but the risk disappears 5 years after stopping treatment.

 

Some studies have shown that breast-feeding slightly lowers the risk of breast cancer especially if the breast-feeding is prolonged.

 

Women who have one drink per day have a very small risk whereas those who have 2-5 drinks daily have about one and half times the risk of women who do not drink alcohol. 

 

Limiting alcohol use, regular exercise, adopting a healthy weight have been shown to lower the risk of getting breast cancer.  Similarly adopting breast-feeding following pregnancy and avoiding continuous use of hormone therapy may also be important.  Exercising for one to two hours per week or brisk walking several times weekly reduces the breast cancer risk by 18%. Early detection and screening for breast cancer has been shown to provide the best approach to management of women who are at high risk. 

 

 Published in The Jamaica Gleaner Cancer Awareness Month supplement on April 21, 2011

 


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