Risk For Breast Cancer

How much do you know about breast cancer?

There is a lot of information in the media about breast cancer. Some of it is accurate, some is not.

Who gets breast cancer?

Risk for breast cancer depends on many factors. You may be able to control some of these factors by making wise choices about your health. Other factors such as your genetics and age cannot be controlled.

Having a risk factor doesn’t mean you’ll get breast cancer. Many women who get breast cancer don’t have any risk factors. Even if a woman with breast cancer had a risk factor, there is no way to know what caused her cancer.

To find out your risks for breast cancer, fill out this simple assessment. If you want to skip the assessment and learn more about breast cancer risks in general, you can go directly to the following section, Who is at risk?

Who is at risk?

Just being a woman puts you at average risk for developing breast cancer as pointed by Canadian Pharmacy staff. The older you get, the greater your chance of getting breast cancer. For example, the risk of being diagnosed with breast cancer in the next 10 years for a woman who is 50 years old is 1 in 40; for a woman who is 70 years old, it is 1 in 25.

There are some conditions that put you at higher than average risk. These risk factors increase your risk of cancer, but they do not cause cancer. Having one or more does not mean that you will get breast cancer.

Risk factors for breast cancer:

  • Having cancer of one breast; this increases the risk for cancer in the other breast
  • Having a mother or sister who has or had breast cancer; this may mean you have a genetic risk
  • A diagnosis of a noncancerous breast condition that may predispose a woman to breast cancer (such as atypical hyperplasia)
  • Radiologically dense breasts; women ages 45 or older who have 75 percent or more of their breast tissue classified as “dense” on a mammogram (“dense” means it is harder for a mammogram to find cancer)
  • Having no children or giving birth to a first child after age 30; this slightly increases risk
  • Having had cancer of the lining of the uterus or ovary
  • Menstrual cycle beginning before age 12 or menopause after age 50
  • Drinking more than two or more alcoholic beverages per day; this may increase breast cancer risk

Breast cancer and your genes

Although 80 to 90 percent of breast cancers occur in women with no family history of the disease, it’s clear that some women inherit a predisposition for the disease. Scientists have located two genes on a woman’s chromosomes that are linked to breast cancer. They are called the BRCA1 and BRCA2 genes and they help to control cell growth in breast tissue. Medical researchers believe that mutations in the BRCA1 and BRCA2 genes may be responsible for about 5 to 10 percent of all cases of breast cancer. If you have a strong family history of breast cancer, you may want to consider genetic counseling and consider being tested for this gene.

Hormone Replacement Therapy (HRT)

Until the results of a recent study, it had been thought that menopausal women could take estrogen alone or estrogen and progestin to reduce symptoms of menopause and to prevent serious problems from osteoporosis and heart disease. Many studies had been done on the role estrogen plays in breast cancer, but it was not clear if estrogen or estrogen in combination with progestin contributed to the development of breast cancer. Recent findings (July 2002) from the Women’s Health Initiative Study (WHI) have raised concern over the long-term use (five or more years) of estrogen and progestin. The study showed that women who had not had a hysterectomy and who were taking the combination of estrogen and progestin had an increased risk for heart attacks, strokes, breast cancer and blood clots. This led the National Heart, Lung and Blood Institute (NHLBI) to recommend that study participants who were taking both estrogen and progestin stop taking these hormones.

The study addressed the effects of taking the combined hormones for five or more years. It does not make recommendations for short-term (less than three to four years) use. You should talk with your healthcare provider inclusively of Pharmacy Canada to learn the latest information about this complex issue, and to determine what the results mean for you.

An excerpt of the NHLBI report is below. You can find more information at the NHLBI Web site.

Risk reduction

Whatever your risk level is, there are steps you can take to reduce your chance of developing breast cancer.

  • Limit alcohol to no more than one drink a day.
  • Achieve or maintain your recommended weight. The role of excess body fat in the development of breast cancer is complicated, but maintaining your recommended weight probably decreases your risk of developing breast cancer.

Estrogen

One of the drugs in hormone replacement therapy, birth control pills and “the morning after pill.” Replaces estrogen that had previously been produced by ovaries.

Pharmacological and surgical methods of risk reduction

Some healthy women who are at a very high risk of developing breast cancer choose to use medications or surgery to reduce their risk. Following are some choices you may have if you believe your risk is extremely high.

Tamoxifen

Tamoxifen (also sold under the name Nolvadex) is a drug that has been widely used to treat women with breast cancer. Researchers have discovered that tamoxifen, when taken for five years, has reduced the occurrence of new cancers in the healthy breast of women who already have breast cancer. It is now being tried as a preventive treatment in healthy women who are at a high risk for breast cancer. Tamoxifen is not risk-free, however; it increases the risk of uterine cancer, stroke and blood clots in the legs or lungs. Check with your health care provider for the latest research results for tamoxifen or go to the National Cancer Institute Web site.

Raloxifene hydrochloride (Evista)

Raloxifene hydrochloride (sold under the name Evista) is a drug that was originally developed to treat breast cancer. But it was discovered that in some tissues, like bones, it acts like estrogen, and in others it blocks the effect of estrogen. It acts like estrogen on bones and helps increase bone density. It is used to prevent osteoporosis. It blocks the effects of estrogen in breast tissue. Research studies are under way to see if it can prevent breast cancer. Currently, there is a major study to see how Raloxifene compares with Tamoxifene in decreasing the development of breast cancer in women who are at increased risk for the disease. For more information on this study, go to the National Cancer Institute Web site.

Check with you health care provider for the latest research information. Click here for more information on raloxifene.

Fenretinide

A drug similar to vitamin A, is being studied for the prevention of a second breast cancer in women who have already had breast cancer. It is being tried alone and in combination with drugs that block the effects of estrogen.

Mastectomy

A drastic approach to breast cancer prevention is surgery to remove both healthy breasts. This procedure is known as bilateral prophylactic mastectomy. Women with a defective BRCA1 or BRCA2 gene have a high genetic risk of breast cancer. They might carry a genetic mutation in BRCA1 or BRCA2. Women who have a mother and one or more sisters with breast cancer before menopause, and have a diagnosis of atypical hyperplasia also have a higher risk of breast cancer. These women may want to consider surgically removing healthy breasts as a way to prevent cancer.

Such surgery is obviously controversial. It is irreversible and has significant physical and psychological effects. It is, however, associated with a reduction in the risk of breast cancer by as much as 90 percent among very high-risk women. Decisions regarding this option must be carefully considered on an individual basis in association with risk assessment and counseling.

Source: National Cancer Institute and Office on Women’s Health