Having Certain Benign Breast Conditions
Women diagnosed with certain types of benign breast conditions may have a higher risk of breast cancer. Some of these conditions are more closely linked to breast cancer risk than others. Doctors often divide benign breast conditions into different groups, depending on how they affect this risk.
Non-proliferative lesions: These conditions dont seem to affect breast cancer risk, or if they do, the increase in risk is very small. They include:
- Fibrosis and/or simple cysts
- Mild hyperplasia
- Epithelial-related calcifications
- Other tumors
Mastitis is not a tumor and does not increase the risk of breast cancer.
Proliferative lesions without atypia : In these conditions theres excessive growth of cells in the ducts or lobules of the breast, but the cells don’t look very abnormal. These conditions seem to raise a womans risk of breast cancer slightly. They include:
- Usual ductal hyperplasia
- Several papillomas
- Radial scar
Proliferative lesions with atypia: In these conditions, the cells in the ducts or lobules of the breast tissue grow excessively, and some of them no longer look normal. These types of lesions include:
Breast cancer risk is about 4 to 5 times higher than normal in women with these changes. If a woman also has a family history of breast cancer and either hyperplasia or atypical hyperplasia, she has an even higher risk of breast cancer.
Lobular carcinoma in situ
Testing For Mutations To Cancer
If youve recently been diagnosed with cancer, your healthcare providers may also recommend a different form of genetic testing known as genomictesting which examines the genetic makeup of cancer cells specifically.
These tests can come with many benefits. They may help better determine your prognosis, risk of cancer recurrence, and which treatments will work most effectively for your cancer type.
Which Environmental Factors Increase The Risk For Breast Cancer
A number of environmental exposures have been investigated in relation to breast cancer risk in humans, including the following :
Of these environmental exposures, only high doses of ionizing radiation to the chest area, particularly during puberty, have been unequivocally linked with an increased risk of breast cancer in adulthood. Because of the strong association between ionizing radiation exposure and breast cancer risk, medical diagnostic procedures are performed in such a way as to minimize exposure to the chest area, particularly during adolescence.
Women with a history of radiation exposure to the chest area should be examined and counseled regarding their risk of breast cancer on the basis of the timing and dose of the previous exposure. A patient treated for Hodgkin lymphoma with Mantel radiation that includes the breasts in the radiation field has a 5-fold higher risk of developing breast cancer. This risk increases markedly for women treated during adolescence evidence suggests that cumulative risk increases with age as a function of age of exposure and type of therapy.
Current evidence does not support a significant and reproducible link between other environmental exposures and breast cancer risk. Thus, a number of factors remain suspect but unproven.
Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer Statistics, 2021. CA Cancer J Clin. 2021 Jan. 71 :7-33. . .
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If Youve Never Had Breast Cancer
Early detection wont stop you from getting breast cancer, but it can help to ensure a better outcome. Talk with a doctor about how often you should get a mammogram. If you have dense breasts, getting regular ultrasounds may also be beneficial.
Adjustments to your lifestyle may also help. These include:
- Limit or stop drinking alcohol.
- Consider cutting down on smoking or nicotine products.
- Adopt an exercise regimen and a healthy diet.
What Is Niehs Doing
NIEHS plays a leadership role in funding and conducting studies on the ways in which environmental exposures increase breast cancer risk. This research seeks to understand the role of environmental agents, such as toxic chemicals, in the initiation and progression of cancer, as well as genetic susceptibility. Identifying and reducing contact with environmental factors linked to breast cancer presents tremendous opportunity to prevent this disease.
Sister Study The NIEHS Sister Study has recruited more than 50,000 sisters of women with breast cancer from the U.S. and Puerto Rico. This landmark observational study is looking at lifestyle and environmental exposures, as well as genetic and biological factors that may increase breast cancer risk. Important findings from this study follow.
Two Sister Study An offshoot of the Sister Study, this study focuses on breast cancer in women younger than 50, who may have different breast cancer risk factors than older women. Approximately 1,300 women with young-onset breast cancer are participating, along with their sisters from the Sister Study and their biological parents. Some results from the study include the following.
In-house NIEHS researchers have also studied how environmental exposures can interact with genetic factors to affect breast cancer risk.
Some hallmark findings from BCERP follow.
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Environmental And Life Style Risk Factors
- Lack of Physical Activity: A sedentary lifestyle with little physical activity can increase your risk for breast cancer.
- Poor Diet: A diet high in saturated fat and lacking fruits and vegetables can increase your risk for breast cancer.
- Being Overweight or Obese: Being overweight or obese can increase your risk for breast cancer. Your risk is increased if you have already gone through menopause.
- Drinking Alcohol: Frequent consumption of alcohol can increase your risk for breast cancer. The more alcohol you consume, the greater the risk.
- Radiation to the Chest: Having radiation therapy to the chest before the age of 30 can increase your risk for breast cancer.
- Combined Hormone Replacement Therapy : Taking combined hormone replacement therapy, as prescribed for menopause, can increase your risk for breast cancer and increases the risk that the cancer will be detected at a more advanced stage.
Factors That Cause Genetic Mutations
Many environmental and lifestyle factors can contribute to the development of cancer.
- Tobacco, which contains a slew of carcinogens, depending on the type, such as nicotine, benzene, and polycyclic aromatic hydrocarbons
- Exposure to asbestos, coal, radon, or other carcinogens where you work or live
- Advancing age
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Finding The Missing Heritability
The breast cancer genes identified thus far explain only about 30% of the heritability, which is the proportion of the phenotypic variance that can be attributed to genetic variation. There are several possible sources for the missing genes, and this is a subject of intense argument and ongoing research.
Preparing For Your Appointment
In advance of your appointment, you may want to collect information about your family history. Specifically, our genetic counsellors will be asking about the types and ages at diagnosis of cancer for your relatives. There may be some information you do not know, but any information you provide can be helpful.
If your appointment is a telephone consultation, you will be called at the number provided on your referral at the date and time of your appointment. Please note, all hospital phone numbers display as private numbers.
If this appointment is scheduled in person, please arrive 10 minutes prior to your scheduled appointment with your valid OHIP card. The Familial Breast Cancer Clinic is in the main Mount Sinai Hospital building at 600 University Avenue. Take the Murray street elevators to the 12th floor, and check-in at the Marvelle Koffler Breast Centre reception desk.
Appointments typically take approximately 30-60 minutes.
Cancer genetic testing is a laboratory test that reads our DNA to search for mutations in genes that can cause a higher risk to develop cancer. . It is important to know that not all breast cancers are hereditary. In fact, most cancers happen sporadically – due to environmental exposures, lifestyle factors, or by chance. It is possible that genetic testing will not show a mutation in the genes tested.
Individuals who are eligible for entry into this program are:
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Testing For Inherited Genes
With a referral from your healthcare provider, you can meet with a specialist for genetic counseling. If you determine you want to have genetic testing done, you can send off a blood or saliva sample to a lab. There, it can be examined for changes in your DNA that could indicate genetic mutations for different types of cancer.
Your genetic counselor can help you review your results to learn more about your hereditary cancer risk and next steps to consider to lower your cancer risk.
What Are The Risk Factors For Breast Cancer
Being a woman and getting older are the main risk factors for breast cancer.
Studies have shown that your risk for breast cancer is due to a combination of factors. The main factors that influence your risk include being a woman and getting older. Most breast cancers are found in women who are 50 years old or older.
Some women will get breast cancer even without any other risk factors that they know of. Having a risk factor does not mean you will get the disease, and not all risk factors have the same effect. Most women have some risk factors, but most women do not get breast cancer. If you have breast cancer risk factors, talk with your doctor about ways you can lower your risk and about screening for breast cancer.
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Breast Cancer And The Environment
Factors inside and outside our bodies affect our health. Those outside our bodies are often called environmental factors.
Theres no one scientific definition for the term environment. In health research, scientists may use different categories when deciding whether a risk factor is environmental.
Environmental factors may include things found in nature that we eat, drink, touch or breathe, as well as man-made factors. They may be passive or active .
Even medications, such as birth control pills or menopausal hormone therapy , are sometimes considered environmental exposures.
Factors such as age, hormones produced in our bodies and family history are considered personal or genetic factors rather than environmental factors. However, they can interact with environmental factors and affect our health.
Opportunities To Better Address Environmental Factors
When we asked how breast cancer organizations could better incorporate environmental factors into their work, some representatives wanted increased online and in-person access to experts who could answer their questions and speak to their members . Others communicated the need for an educational program on the environment and breast cancer they could easily adopt . As one stated, if there was a program even on the environment that was already structured that could just do, but I didnt have to work at putting it all together, that would be wonderful. Another echoed this saying,
For us, because we are volunteer survivor run, were limited as Ive heard multiple responses already. What would help is programs that are easy to promote and for us to get our hands on in order to put them into the community We are focused mainly on the survivorship portion. However, if there was an opportunity to tap into quality programs that were easy for us to understand and roll out with the programs that were already rolling out, that would be fine.
One participant, however, pointed out the importance of ensuring that resources are tailored for particular communities. As she stated,
In particular, participants said that they would like more resources in Spanish and other languages to share with their communities. As one stated,
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Issues In Environmental Epidemiology Of Any Chronic Disease
There are many methodologic issues that make environmental epidemiology of chronic diseases especially challenging. These mainly center around problems of exposure measurement. First, in most circumstances, pollutants are ubiquitous and occur in the ambient environment at very low levels. Therefore, exposure is hard to measure accurately, and it may be difficult to identify an unexposed population. An exception is the evaluation of major releases of contaminants due to an event such as an industrial accident or the atomic bomb. Low-level exposures are also often associated with small hypothesized relative risks that are difficult to assess statistically in small studies.
Biomarker studies are one approach to avoid the problems of individual exposure assessment. Concentrations of a pollutant or its metabolites in biological media measure internal dose, and if the chemical has a long half-life cumulative exposure over time can be assessed as well.
Genetic Testing For Cancer
If youre concerned about your cancer risk due to your family history, a healthcare provider can help you determine whether genetic testing for cancer is right for you. Depending on your individual situation, the results of your genetic testing may empower you to take steps to reduce your risk or to schedule cancer screenings for earlier detection and treatment.
That said, genetic testing is not alwayshelpful and cant predict the futurewhich means your test results could also lead to stress and anxiety or even a misunderstanding of the results. According to the American Cancer Society , its best to talk to a trained genetic counselor rather than diving in on your own with an at-home genetic test.
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Data Harmonization And Variable Definitions
Data from different studies were harmonized according to a common data dictionary. A quality assurance procedure was applied which included range and logic checks and comparisons of variable distributions within and between studies. Time-dependent variables were assessed at a reference date defined as the date of diagnosis for cases and the date of interview for controls in case-control studies. For cohort studies, the Melbourne Collaborative Cohort Study and the UK Breakthrough Generations Study , the reference date was the date of last follow-up questionnaire if data were available otherwise date of baseline questionnaire was used as the reference. The median time between the dates of latest interview and diagnosis for cohort study participants was 2.0 years for UKBGS and 7.5 years for MCCS. Because we did not have data on menopausal status, we used the median age as a surrogate: women aged < 54 years were considered premenopausal and women aged 54 years postmenopausal.
Focus Groups And Interviews
We conducted two focus groups and 20 semi-structured interviews with representatives from U.S. breast cancer organizations between November 2016December 2018 to understand the programmatic priorities of grassroots breast cancer organizations and the potential for them to incorporate information on prevention.
We recruited participants by personalized emails. We randomly sampled potential participants from our database of breast cancer organizations described above. Additional participants were recruited using snowball sampling methods, where colleagues working with breast cancer organizations recommended participants, and targeted sampling from our database to include breast cancer organizations that serve diverse ethnic, racial, and linguistic populations.
Interviews were conducted by phone and lasted approximately 45min. We asked interviewees about the areas of focus for their organizations work, whether any work has centered on breast cancer prevention and/or environmental factors, and barriers for considering environmental factors as part of their organizations scope.
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Genetics And Bowel Cancer
Bowel cancer is the second most common cancer in Australia after prostate cancer. There are almost 3,500 cases diagnosed in Australia each year. The biggest single risk factor is age. More than eight out of 10 bowel cancers are diagnosed in the over-60s. The risk of getting this disease increases as you get older. It is estimated that about two out of three bowel cancers could be prevented with changes in diet and lifestyle.
Risk Factors You Can Change
- Not being physically active. Women who are not physically active have a higher risk of getting breast cancer.
- Being overweight or obese after menopause. Older women who are overweight or obese have a higher risk of getting breast cancer than those at a normal weight.
- Taking hormones. Some forms of hormone replacement therapy taken during menopause can raise risk for breast cancer when taken for more than five years. Certain oral contraceptives also have been found to raise breast cancer risk.
- Reproductive history. Having the first pregnancy after age 30, not breastfeeding, and never having a full-term pregnancy can raise breast cancer risk.
- Drinking alcohol. Studies show that a womans risk for breast cancer increases with the more alcohol she drinks.
Research suggests that other factors such as smoking, being exposed to chemicals that can cause cancer, and changes in other hormones due to night shift working also may increase breast cancer risk.
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Breast Cancer: Risk Factors And Prevention
Have questions about breast cancer? Ask here.
ON THIS PAGE: You will find out more about the factors that increase the chance of developing breast cancer. Use the menu to see other pages.
A risk factor is anything that increases a persons chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. Knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.
Most breast cancers are sporadic, meaning they develop from damage to a persons 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. Many of those mutations are in tumor suppressor genes, such as BRCA1, BRCA2, and PALB2. These genes normally keep cells from growing out of control and turning into cancer. But when these cells have a mutation, it can cause them to grow out of control.
The following factors may raise a womans risk of developing breast cancer: