Breast Cancer Risk: What you need to know

October is Breast Cancer Awareness Month (BCAM) and there is often a lot of discussion (and heightened anxiety) around breast cancer risk.

Risk is absolutely something we should talk about during BCAM, but before you work yourself into a panic, it’s important to understand the concept of “risk” and to know about breast cancer risk factors.

Understanding Your Risk of Breast Cancer

Young women especially have a tendency to overestimate their risk for developing breast cancer. The statistic that says 1 in 9 women will develop invasive breast cancer is well known. Many young women misinterpret this to mean that, on any given day, they and the women they know have a 1-in-9 risk of developing the disease.

In reality, about 1 in 9 women in Canada — 11%, or about 11 out of every 100 — can expect to develop breast cancer over the course of an entire lifetime (the stat is closer to 1 in 8 in the US). In Canada, an average lifetime for women is about 90 years. So, it’s more accurate to say that 1 in 9 women in Canada who reach the age of 90 can expect to develop breast cancer.

As for your risk as a young woman, 5% of breast cancer diagnoses will be women under 40 in Canada (5.7% in the US).

But don’t panic! Having several risk factors does not mean you will get breast cancer. It just means that your chances of getting the disease are higher than those who have fewer risk factors. Read on to understand risk, then speak with your doctor to determine your personal risk level.

FACTORS THAT MAY PUT YOU AT HIGH RISK 

Genetic Factors

Over the past decade, two breast cancer susceptibility genes have been discovered and characterized: BRCA-1 and BRCA-2 (also sometimes referred to as the “Angelina Jolie genes”). Certain inherited mutations, or changes, in either of these genes will increase a woman’s risk of developing breast and ovarian cancer. Still, those with a well-documented genetic predisposition to breast cancer only account for 5%-10% of cases diagnosed. Women who carry a mutation in their BRCA 1 or BRCA 2 genes have a 40%-85% chance of developing breast cancer in their lifetime, are more likely to develop breast cancer at a younger age (before menopause), and often have multiple family members with the disease. Although the BRCA genes are the most significant in influencing breast cancer risk, there are other genes that have been discovered that may increase your risk as well. If you are concerned about your genetic risk, talk to your doctor to learn more about your eligibility for genetic testing.

Family History

Most women who have breast cancer do not have breast cancer in their family history. However, women with close relatives who’ve had breast cancer have a higher risk of developing the disease themselves. If you’ve had one first-degree female relative (sister, mother, daughter) diagnosed with breast cancer, your risk is doubled. It is also important to know your family history of cancer on your father’s side too. If you’re unsure about your family’s medical history – ask! It’s always a good idea to know where you come from (and filling in the branches on your family tree makes for a great rainy day activity).

Exposure to Radiation

Women who have undergone radiation treatment to the chest, neck and armpit area are at higher risk for breast cancer. This risk factor is particularly evident in women who were treated for Hodgkin’s lymphoma when they were younger. If you were treated with radiation before age 30, chat with your doctor about your potential risk.

FACTORS THAT MAY PUT YOU AT MODERATE RISK 

Personal History

You have an elevated risk of developing breast cancer if:

• You have a personal history of breast or ovarian cancer
• You had a previous breast tissue biopsy showing abnormal cells
• You have high bone density
• You’re shown to have dense breast tissue on a mammogram

Hormonal Factors

Some of the factors that may increase your risk for breast cancer are hormonal and related to a woman’s reproductive history. The greatest risk results from breast tissue being consistently exposed to estrogen, as it is through long periods of uninterrupted menstrual or ovulatory cycles. Hormonal factors that increase risk include:

• Birth of a first child after the age of 30 or not having children at all
• Menstruation starting at an early age (before 12)
• Late menopause (after 55)
• Taking birth control pills and/or hormone replacement therapy (although debated, many experts say that this slightly increases one’s risk)

Lifestyle Factors

Evidence shows lifestyle factors that increase estrogen levels can increase your risk of developing breast cancer, for example:

• Drinking alcohol, including low levels of alcohol consumption (alcohol may raise estrogen in the blood)
• Obesity with excess caloric and fat intake (fatty tissue may raise estrogen levels)
• Sedentary lifestyle: women who exercise regularly are at lower risk for breast cancer than those who do not.

Emerging Risk Factors

In addition to known, established risk factors, ongoing research is identifying newly suspected risk factors. Emerging risk factors include: Low level of Vitamin D Light exposure, chemicals in food and water, chemicals in cosmetics and personal care products, chemicals in plastic, night-shift work, tobacco smoke and red meat intake.

Although it may seem that there are many risk factors for getting breast cancer, there are also several things you can do to lower that risk.