Understanding your breast cancer risk
Carcinoma-lobular - risk; DCIS; LCIS - risk; Ductal carcinoma in situ - risk; Lobular carcinoma in situ - risk; Breast cancer - prevention; BRCA - breast cancer riskBreast cancer risk factors are things that increase the chance that you could get cancer. Some risk factors you can control, such as drinking alcohol. Others, such as family history, you cannot control.
The more risk factors you have, the more your risk increases. However, it does not mean you absolutely will get cancer. Many women who get breast cancer do not have any known risk factors or a family history.
Breast cancer
Breast cancer is cancer that starts in the tissues of the breast. There are two main types of breast cancer:Ductal carcinoma starts in the tubes (du...
Read Article Now Book Mark ArticleUnderstanding your risk factors can give you a better picture of what you can do to help prevent breast cancer.
Risk Factors You Cannot Control
Risk factors you cannot control include:
- Age. Your risk for breast cancer increases as you age. Most cancers are found in women age 55 and older.
- Gene mutations. Changes in genes linked with breast cancer, such as BRCA1, BRCA2, and others increase your risk. Gene mutations account for about 10% of all breast cancer cases.
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Dense breast tissue. Having more dense breast tissue and less fat breast tissue increases risk. Also, dense breast tissue can make tumors hard to see using mammography.
Mammography
A mammogram is an x-ray picture of the breasts. It is used to evaluate some breast symptoms and to find breast cancer in women with no symptoms....
Read Article Now Book Mark Article - Radiation exposure. Treatment involving radiation therapy to the chest wall as a child can increase your risk.
- Family history of breast cancer. If your mother, sister, or daughter was diagnosed with breast cancer, you have a higher risk.
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Personal history of breast cancer. If you have had breast cancer, you are at risk for breast cancer coming back.
Breast cancer coming back
One of the most common fears for people who have had cancer is that it may return after initial treatment. When cancer comes back, it is called recu...
Read Article Now Book Mark Article - Personal history of ovarian cancer.
- Abnormal cells found during biopsy. If your breast tissue was examined in a lab and had abnormal features (but not cancer), your risk is higher.
- Reproductive and menstrual history. Getting your period before age 12, starting menopause after age 55, getting pregnant after age 30, or never getting pregnant all increase your risk.
- DES (Diethylstilbestrol). This was a drug given to pregnant women between 1940 and 1971. Women who took DES during pregnancy to prevent miscarriage had a slightly higher risk. Women exposed to the drug in the womb also had a slightly higher risk.
Risk Factors You Can Control
Risk factors you can control include:
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Radiation therapy
. Radiation therapy to the chest area before age 30 increases your risk.
Radiation therapy
Radiation therapy uses high-powered radiation (such as x-rays or gamma rays), particles, or radioactive seeds to kill cancer cells.
Read Article Now Book Mark Article - Alcohol intake. The more alcohol you drink, the greater your risk.
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Long-term use of
hormone therapy. Taking estrogen and progestin together for menopause for 5 years or more increases your risk. It is not clear if, or how much, taking birth control pills that contain estrogen increases your risk.
Hormone therapy
Hormone therapy (HT) uses one or more hormones to treat symptoms of menopause. HT uses estrogen, progestin (a type of progesterone), or both. Somet...
Read Article Now Book Mark Article - Weight. Overweight women or women with obesity who have had menopause have a higher risk than women at healthy weights.
- Physical inactivity. Women who do not exercise regularly throughout life may have an increased risk.
How to Reduce Your Risk
Just because you have risk factors you cannot control does not mean you cannot take steps to lower your risk. Start by making certain lifestyle changes and working with your health care provider. Here are some things you can do to lower your risk for breast cancer:
- Maintain a healthy weight.
- Exercise at least 4 hours a week.
- Avoid alcohol, or have no more than 1 alcoholic drink in a day.
- If possible, limit or reduce radiation from imaging tests, especially during puberty.
Radiation
Radiology is a branch of medicine that uses imaging technology to diagnose and treat disease. Radiology may be divided into two different areas, diag...
Read Article Now Book Mark Article - Breastfeeding, if possible, may decrease your risk.
- Talk with your provider about the risks and benefits before taking hormone therapy. You may want to avoid taking estrogen combined with progesterone or progestin.
Hormone therapy
Hormone therapy (HT) uses one or more hormones to treat symptoms of menopause.
Read Article Now Book Mark Article - If you have a family history of breast cancer, ask your provider about genetic testing.
Genetic testing
The BRCA1 and BRCA2 gene test is a blood test that can tell you if you have a higher risk of getting cancer. The name BRCA comes from the first two ...
Read Article Now Book Mark Article - If you are over age 35, and have a high risk for breast cancer, talk to your provider about medicines to reduce breast cancer risk by blocking or reducing estrogens in the body. They include tamoxifen, raloxifene, and aromatase inhibitors.
- If you are at high risk, talk with your provider about preventive surgery to remove breast tissue (mastectomy). It can reduce your risk by as much as 90%.
Mastectomy
A mastectomy is surgery to remove the breast tissue. Some of the skin and the nipple may also be removed. The surgery is most often done to treat b...
Read Article Now Book Mark Article - If you are at high risk, consider surgery to remove your ovaries. It will lower estrogen in the body and can reduce your risk for breast cancer by as much as 50%.
Some areas are unknown or not yet proven. Studies are looking at things like smoking, diet, chemicals, and types of birth control pills as potential risk factors. Talk to your provider if you are interested in joining a clinical trial for breast cancer prevention.
Clinical trial
If you have cancer, a clinical trial may be an option for managing your cancer. A clinical trial is a study using people who agree to participate in...
Read Article Now Book Mark ArticleWhen to Call the Doctor
Contact your provider if:
- You have questions or concerns about your breast cancer risk.
- You are interested in genetic testing, preventive medicines, or treatments.
- You are due for a mammogram.
References
Henry NL, Shah PD, Haider I, Freer PE, Jagsi R, Sabel MS. Cancer of the breast. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 88.
National Cancer Institute website. Breast cancer prevention (PDQ) - health professional version. www.cancer.gov/types/breast/hp/breast-prevention-pdq. Updated October 7, 2022. Accessed October 21, 2022.
US Preventive Services Task Force; Owens DK, Davidson KW, Krist AH, et al. Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2019;322(7):652-665. PMID: 31429903 pubmed.ncbi.nlm.nih.gov/31429903/.
U.S. Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force final recommendation statement. www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening. Updated January 11, 2016. Accessed November 19, 2022.
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Review Date: 8/15/2022
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.