Breast Cancer is most common cancer in women.
1 in 28 women in India will be affected with this in their lifetime.
1 woman is diagnosed of breast cancer every 4 minutes.
1 woman dies of breast cancer every 8 minutes.
Myths and Facts
1. “I am already suffering from cancer; how will genetic counselling benefit me?”
- Genetic risk assessment and testing helps to better define cancer risks in the family.
- It can help establish cancer risks in family members who may benefit from cancer screening or preventive measures.
2. “There are so many cancers in my family that it is not a matter of IF I will get cancer, but WHEN!”
- A strong family history of cancer could impact your risk for developing the disease. But it may be possible that you do not inherit that mutation – that means the risk is similar to the general population.
- Even if you have inherited the familial mutation, it is not inevitable that you will develop cancer.
These can help in lowering the risk or preventing cancer altogether.
1. Diet and lifestyle modification
2. Preventive medicine
3. Preventive surgery
- There is also benefit from beginning cancer screening at an earlier age, screening more frequently. This way, it is more likely to be caught at an earlier stage, when treatment is more effective and outcomes, better.
3. “The breast cancer (and/or ovarian cancer) in my family is on my father’s side, so it does not matter!”
This is not true.
- Having a cancer history in your fathers’ side of breast and/or ovarian cancer can have a significant impact on your risk.
It is not uncommon for a man to carry a mutation in one of the breast and ovarian cancer genes and never develop cancer himself. However, he can pass this mutation on to his children, including his daughters.
4. “The cancer in my family only affects the men (or the cancer in my family only affects the women), so I am not at risk!”
If the cancers in the family have only affected men (or only affected women), it is possible that this is due to chance alone. The genetic mutation could be carried by either father or mother, and are cancer risks for both males and females who carry the genetic mutation
The following options may help reduce your risk of breast cancer for those at higher risk.
Lifestyle Choices to Lower Cancer Risk
One way to lower your risk of breast cancer is by getting regular physical activity. Studies suggest that 30 to 60 minutes per day of moderate to high intensity physical activity is associated with a lower breast cancer risk.
Other ways include:
- Staying at a healthy weight.
- Limiting the amount of alcohol you drink.
- Avoiding the use of post-menopausal hormone therapy to ease symptoms of menopause.
- Breastfeeding may also reduce a woman’s breast cancer risk.
Surgery to lower cancer risk
For women with BRCA1 or BRCA2 genetic mutations, which substantially increase the risk of breast cancer, preventive removal of the breasts may be considered. This procedure is called a Prophylactic Mastectomy. It appears to reduce the risk of developing breast cancer by at least 90% to 95%.
Women with these genetic mutations should also consider the preventive removal of the ovaries and fallopian tubes, called a prophylactic salpingo-oophorectomy. This procedure can reduce the risk of developing ovarian cancer, and possibly breast cancer, by stopping the ovaries from making estrogen.
It is also possible to remove just the fallopian tubes and preserve fertility, which
Drugs to lower cancer risk
Women who have a higher than usual risk of developing breast cancer can consider talking with their doctor about drugs that may help prevent breast cancer. This approach is called “endocrine prevention” or “chemoprevention.” For breast cancer, this is the use of hormone-blocking drugs to reduce cancer risk.
- Tamoxifen(available as a generic drug): Tamoxifen is a type of drug called a selective estrogen receptor modulator (SERM). It is often used as a treatment for breast cancer for women who already have the disease. Tamoxifen blocks the effects of estrogen on tumor growth.
Tamoxifen may be an option to help lower the risk of breast cancer, specifically ER-positive breast cancer for women who are age 35 or older.
It is not recommended for women with a history of blood clots, stroke, or who are immobilized (unable to move around) for a long time.
It is also not recommended for women who are pregnant or who may become pregnant, or for women who are breastfeeding.
The side effects of tamoxifen may include hot flashes, vaginal discharge, sexual side effects, mood changes, and a higher risk of developing uterine cancer, blood clots, and stroke.
- Raloxifene (Evista): Raloxifene is also a SERM. It is often used to prevent osteoporosis (thinning of the bones) for women who have gone through menopause.
Risk Factors for Breast Cancer
A Risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer.
Most breast cancers are sporadic, meaning they develop from damage to a person’s genes that occurs by chance after they are born. There is no risk of the person passing this gene on to their children, as the underlying cause of sporadic breast cancer is environmental factors.
Inherited breast cancers are less common, making up 5% to 10% of cancers. Inherited breast cancer occurs when gene changes called mutations are passed down within a family from parent to child.
When considering your breast cancer risk, it is important to remember that the overwhelming majority of women who develop breast cancer have no obvious risk factors and no family history of breast cancer. Multiple risk factors influence the development of breast cancer.
The Following Factors May Raise a Woman’s Risk of Developing Breast Cancer:
The risk of developing breast cancer increases as a woman grows older, with most cancers developing in women older than 50.
Personal History of Breast Cancer:
Woman who has had breast cancer in 1 breast has a higher risk of developing a new cancer in either breast.
Family History of Breast Cancer:
Breast cancer may run in the family in any of these situations:
- 1 or more women are diagnosed with breast cancer at age 45 or younger
- 1 or more women are diagnosed with breast cancer before age 50 with an additional family history of cancer, such as Ovarian Cancer, Metastatic Prostate cancer, and Pancreatic cancer
- There are breast and/or ovarian cancers in multiple generations on one side of the family, such as having both a grandmother and an aunt on the father’s side of the family who were both diagnosed with 1 of these cancers
- A woman in the family is diagnosed with second breast cancer in the same or the other breast or has both breast and ovarian cancer
- A Male relative is diagnosed with breast cancer
- There is at least 1 close relative who was diagnosed with breast cancer at age 50 or younger, or ovarian cancer, prostate cancer, and/or pancreatic cancer.
When looking at family history, it’s also important to consider your father’s side of the family. Your father’s side is equally important as your mother’s side in determining your personal risk for developing breast cancer.
Inherited risk / Genetic predisposition:
There are several inherited genes linked with an increased risk of breast cancer, as well as other types of cancer. BRCA1 or BRCA2 are the most commonly known mutations. Mutations in these genes are linked to an increased risk of breast and ovarian cancers, as well as other types of cancer.
Other gene mutations or hereditary conditions can increase a person’s risk of breast cancer. They are far less common than BRCA1 or BRCA2, and they do not increase the risk of breast cancer as much.
Personal history of Ovarian Cancer:
BRCA1 and BRCA2 gene mutations greatly increase the risk of ovarian cancer and breast cancer. Therefore, women diagnosed with hereditary ovarian cancer caused by a BRCA gene mutation have an increased risk of breast cancer as well.
Early Menstruation and Late Menopause:
Women who began menstruating before ages 11 or 12 or went through menopause after age 55 have a somewhat higher risk of breast cancer. This is because their breast cells have been exposed to estrogen and progesterone for a longer time.
Estrogen and progesterone are hormones in women that control the development of secondary sex characteristics, such as breast development, and pregnancy. Longer exposure to these hormones increases breast cancer risk.
Timing of Pregnancy:
Women who had their first pregnancy after age 35 or who have never had a full-term pregnancy have a higher risk of breast cancer. Pregnancy may help protect against breast cancer because it pushes breast cells into their final phase of maturation.
Hormone Replacement therapy after Menopause:
Using hormone therapy with both estrogen and progestin after menopause, often called postmenopausal hormone therapy or hormone replacement therapy, within the past 5 years or for several years increases a woman’s risk of breast cancer.
However, women who have taken only estrogen, without previously receiving progestin, for up to 5 years (because they had their uterus removed for other reasons) appear to have a slightly lower risk of breast cancer.
Race and Ethnicity:
Breast cancer is the most common cancer diagnosis in women, other than skin cancer, regardless of race. White women are more likely to develop breast cancer than Black women, but among women younger than 45, the disease is more common in Black women than in white women. Black women are also more likely to die from the disease. Reasons for survival differences may include differences in biology, other health conditions, and socioeconomic factors affecting access to, and use of, medical care.
Atypical Hyperplasia of the Breast:
This diagnosis increases the risk of developing breast cancer in the future. It is characterized by abnormal, but not cancerous, cells found in a biopsy of the breast.
Lobular Carcinoma in Situ (LCIS):
LCIS refers to abnormal cells found in the lobules or glands of the breast. It is not considered cancer. However, LCIS in 1 breast increases the risk of developing invasive breast cancer in either breast in the future.
As with other types of cancer, studies continue to show that various lifestyle factors may contribute to the development of breast cancer.
- Recent studies have shown that postmenopausal women who are overweight or obese have an increased risk of breast cancer. These women also have a higher risk of having the cancer come back after treatment.
- Physical activity: Lower amounts of Physical activity is associated with an increased risk of developing breast cancer and a higher risk of having the cancer come back after treatment. Regular physical activity, such as 3 to 4 hours of moderate exercise per week, may protect against breast cancer by helping women maintain a healthy body weight, lowering hormone levels, or causing changes in a woman’s metabolism or immune factors
Maintaining a healthy body weight may also protect against the cancer coming back after a breast cancer diagnosis.
- Current research suggests that having more than 1 to 2 servings of Alcohol, including beer, wine, and spirits, per day raises the risk of breast cancer, as well as the risk of having the cancer come back after treatment.
More affluent women in all racial and ethnic groups have a higher risk of developing breast cancer than less affluent women in the same groups. These differences may be due to variations in diet, environmental exposures, and other risk factors.
Women living in poverty are more likely to be diagnosed at an advanced stage and are less likely to survive the disease than more affluent women. Access to health care and the availability of treatment play additional roles.
Radiation Exposure at a Young Age:
Exposure to ionizing radiation at a young age may increase a woman’s risk of breast cancer. For example, therapeutic radiation to the chest for Hodgkin lymphoma may increase breast cancer risk in both breasts.
The very small amount of radiation a woman receives during a mammogram has not been linked to an increased risk of breast cancer.