What You Should Know
Each year in the US, over 217,000 new cases of breast cancer are diagnosed. Breast cancer is the second leading cause of cancer death in women, accounting for over 40,000 deaths each year. Almost 500 men also die of this malignancy annually. One of the keys to success in reducing the number of these deaths is prevention. Early detection is integral to that process. An awareness of risk factors, a knowledge of signs of the disease, and adherence to screening guidelines can help reduce your chances of developing this malignancy. Two good places for more information on breast cancer are the National Cancer Institute of the National Institutes of Health at
www.cancer.gov and the American Cancer Society at
www.cancer.org
Risk Factors
Gender: Being female is the main risk factor for breast cancer; the malignancy is about 100 times for common among women than men.
Age: Risk increases with age; almost 80% of breast cancer cases are diagnosed in women = age 50.
Race: Risk is higher in Caucasian women compared to African-American, Latino-American, Native-American, or Asian women.
Genetic mutations: While only about 10% of breast cancer cases are hereditary as a result of genetic mutations--most often in the BRCA1 and BRCA2 genes-these women have a 50% to 85% risk of developing breast cancer.
Previous breast biopsy: A previous breast biopsy result of proliferative breast disease without atypia or usual hyperplasia increases risk about 1.5 to 2 times; a previous biopsy result of atypical hyperplasia increase risk about 4 to 5 times.
History of breast cancer: Women with cancer in one breast have a 3- to 4-fold increased risk of developing a new cancer in the other breast or in another part of the same breast.
Family history of breast cancer: Risk increases if:
- You have 2 or more relatives with breast or ovarian cancer.
- Your relative's breast cancer occurred before age 50; risk increases if your mother or sister has a history of breast cancer.
- You have relatives with both breast and ovarian cancer
- You have 1 or more relatives with 2 cancers (breast and ovarian, or 2 different breast cancers)
- You have male relatives with breast cancer
- You have a family history of breast or ovarian cancer and Ashkenazi Jewish heritage.
- You have a family history of diseases associated with hereditary breast cancer such as Li-Fraumeni or Cowden's syndromes.
Previous chest irradiation: Risk is increased if chest irradiation occurred in childhood or young adulthood as a result of treatment for nonbreast-related malignancies.
Menstrual periods: Risk increases with menstruation before age 12 or menopause after age 50.
Offspring: Childlessness or having a first child after age 30 slightly increases risk.
Oral contraceptive (OC) use: There remain no conclusions as to what definitive part OC use may play in increasing or decreasing breast cancer risk.
Hormone replacement therapy (HRT): Most studies, including the Women's Health Initiative (WHI), suggest that long-term postmenopausal HRT use may increase risk.
Alcohol: Alcohol use is slightly increased, about 1.5 times that of women who do not consume alcohol.
Obesity: Risk increases, particularly in postmenopausal women.
Physical activity: Recent studies have shown that vigorous exercise before adulthood and moderate to vigorous exercise in adulthood lowers risk.
Signs of Possible Breast Cancer
- breast lump or mass
- swelling of part of the breast
- skin irritation or dimpling
- nipple pain or the inward-turning nipple
- redness or scaliness of nipple and/or breast skin
- nipple discharge (other than breast milk)
- underarm lump
Adapted from the American Cancer Society (www.cancer.org) and the National Cancer Institute of the National Institutes of Health (www.cancer.gov). Please visit these Web sites for complete information
Screening Guidelines
The breast cancer screening guidelines shown below were developed by the American Cancer Society (
www.cancer.org). You can use this information to discuss your own screening options with your physician.
Women at Average Risk |
Mammography |
Annually at age 40 |
CBE |
Should be part of a periodic health examination, about every 3 years for women in their 20s and 30s and annually for women >- age 40 |
BSE |
Beginning in their 20s, women should be told about the benefits and limitation of BSE; it is acceptable for women to choose not to do BSE or to do it occasionally |
Older women and women with serious health problems |
Annual mammography, regardless of age, as long as a woman has no serious, chronic health problems. For those with serious health problems or short life expectancy, evaluate ongoing early detection testing |
CBE = clinical breast examination; BSE = breast self-examination.
Women at Known Increased Risk |
May benefit from earlier initiation of early detecting testing and/or the addition of breast ultrasound or MRI |
MRI = magnetic resonance imaging.
