Breast cancer awareness is a necessity…

Dr K K Aggarwal

Padma Shri and Dr B C Roy National Awardee
President, Heart Care Foundation of India

1. Breast cancer can occur in women who have no identifiable risk factors.
2. An average woman has 10 to 15 percent chance of developing breast cancer if she lives into her 90s.
3. The risk of breast cancer in a woman with a strong family history who has inherited one of the genes BRCA1 and BRCA20) that predispose her to breast cancer is over 50 percent.
4. The primary risk factor for breast cancer is older age.
5. Over 85 percent of cases occur in women 50 years of age and older.
6. Only 5 percent of breast cancers develop in women younger than age 40.
7. Women over age 50 should be screened for breast cancer every year.
8. Breast cancer screening of women in their 40s and over the age of 70 is controversial.
9. Women with family history of breast or ovarian cancer are at a higher risk.
10. Women with strong family history (two or more first-degree relatives [a mother, daughter, or sister] with breast or ovarian cancer, particularly before menopause) have a greater than 50 percent chance of developing breast cancer.
11. Women who have had cancer in one breast have an increased risk of developing cancer in the other breast. This is especially true if a woman has an inherited BRCA mutation.
12. Estrogen stimulates cells of the breast’s glandular tissue to divide. The longer a woman is exposed to estrogen, the greater her risk for breast cancer.
13. Estrogen exposure is increased if a woman began menstruating at or before 11 years of age, or if she experiences menopause at age 55 years or older.
14. Women who have never given birth are more likely to develop breast cancer after menopause than women who have given birth multiple times.
15. Women who have their first full-term pregnancy at the age of 30 years or older have an increased risk of breast cancer.



Reducing breast cancer risk

A number of lifestyle changes may reduce breast cancer risk:
1. Minimize the use of postmenopausal hormones. For osteoporosis one should give non-estrogen alternatives like bisphosphonate rather than hormones.

2. Having a first child at an earlier age may decrease risk.
3. Breast feeding for at least 12 months reduces the risk.
4. Avoid adult weight gain
5. Maintain a healthy weight reduces postmenopausal breast cancer risk.
6. Limit alcohol intake.
7. For those who drink, add folic acid to the diet.
8. Regular physical activity.
9. At risk women, the risk can be reduced by 50 percent by taking tamoxifen or raloxifene for five years.
10. The risk of death from breast cancer can be reduced with regular mammography screening.
11. Women with removed ovaries before age 35 are at lower risk of breast cancer. However, removal of the ovaries places women at higher risk for coronary heart disease and osteoporosis, and ovaries removal is not recommended for breast cancer prevention.
12. But women with the BRCA1 or BRCA2 gene mutation may be encouraged to have their ovaries removed.
13. Women with cancer of the uterus, ovary, or colon are more likely to develop breast cancer than women who do not have these cancers.

14. Women of high socioeconomic status are more likely to develop breast cancer.

15. Women who live in urban settings are more likely than women who live in rural settings to develop breast cancer.
16. There may be an association between exposure to light at night (such as with night shift work) and the risk of breast cancer.
17. Black women are more likely than Asian women to develop breast cancer before the age of 40 years, whereas White (non-Hispanic) women are more likely than Asian women to develop breast cancer at the age of 40 years and older.
18. Smoker women are at increased risk of breast cancer.