Risk Factors For Breast Cancer

While an exact cause for breast cancer is still unknown, scientific research has revealed a number of controllable and uncontrollable factors that impact our risk of developing the disease. 

Risk Factors for Breast Cancer You Cannot Control

Although we are unable to modify the risks associated with the uncontrollable factors, it is important to understand how they may impact an individual’s risk for breast cancer.

Sex
Sex
aging
Aging
Family history
Family History
Density
Density
Breast Cancer History
Your History
Genes
Genes
menstruation
Menstruation

Risk Factors for Breast Cancer You Can Control

An estimated 30 percent of breast cancer cases are preventable through lifestyle changes [1]. Most breast cancers are estrogen-related which is why many of the risk factors we can control involve keeping estrogen levels low. Although exposures that influence risk accumulate throughout a woman’s life, research suggests that early life exposures during breast development may be particularly critical.

Nutrition
Nutrition
Obesity
Obesity
Exercise
Exercise
Alcohol
Alcohol
smoking
Smoking
Pregnancy
Pregnancy
breastfeeding
Breastfeeding
contraceptives
Contraceptives
Hormone Replacement Therapy
HRT

Sex Assigned at Birth

The main risk for breast cancer is sex assigned at birth. Women are at the greatest risk of developing breast cancer, with 99% of breast cancer diagnoses occurring in women. And 1 in 8 women will be diagnosed with breast cancer in her lifetime. Men can also get breast cancer, but makeup about 1% of all breast cancer cases [2].

Aging

As a person ages, their risk of developing breast cancer increases. This is a result of longer overall exposure to estrogen. Although a person’s risk of developing breast cancer increases with age, young women can also be at risk for breast cancer [2].

Family History

Anyone can get breast cancer, but if you have a family history of breast cancer that increases your personal risk. That risk increases with the number of family members diagnosed with breast cancer. In addition, your risk increases if you have a first degree relative with a history of breast cancer such as a parent, sibling, or child, especially if they were diagnosed at an age younger than fifty. The overwhelming majority of breast cancer patients have no family history of the disease [3].

Previous Breast Cancer History

An individual with a history of breast cancer is not only at risk of recurrence, but they are also at a greater risk of developing a new breast cancer [4]. Also, women with a history of ovarian cancer are at a greater risk of developing breast cancer [5].

Breast Density

Higher levels of breast density can increase your risk of breast cancer [6].  Dense breast tissue can also make it harder for cancer to be detected on a traditional mammogram. If your mammogram reveals you have very dense breasts, you should speak to your doctor about additional screening that may be needed.

Abnormal or Mutated Genes

Genetic mutations can affect a person’s risk of developing breast cancer, particularly certain common gene mutations on the BRCA1 and BRCA2 genes. An individual with a mutation in the BRCA1 may have a 72% risk of developing breast cancer. And an individual with a BCRA2 mutation may have a 69% risk. It is important to know your family history and how it may affect your personal risk [7].

Age at First Menstruation/Late Menopause

Getting your first period very early (younger than 12) or late menopause (older than 55) increases risk because of the overall lifetime exposure to estrogen [8].

Nutrition

A healthy eating pattern includes a diet rich in fruits and vegetables, whole grains, and healthy fats and low in red meat and overly processed foods. Healthy bodies need fat, but research suggests that eating a diet high in trans and saturated fats increases the risk of breast cancer [9]. Explore more content about how diet and nutrition can impact our breast cancer risk.

Obesity

Fat cells in the body store high levels of estrogen, which increases the threat of breast cancer. Thus, maintaining a normal body weight is a crucial component in decreasing your risk [10].

Exercise

30 minutes of moderate physical activity per day can help decrease your body fat percentage and the amount of estrogen in your body. It also strengthens your immune system, which enhances your body’s ability to recognize and eliminate early cancer cells [11].

Alcohol

Studies show that drinking alcohol—even just one drink per day—increases your risk for breast cancer. And it doesn’t matter what alcoholic drink you choose. They all impact your risk of developing breast cancer [12].

Smoking

Smoking and vaping exposes the body to carcinogens and accelerates cancer tumor growth. Studies indicate that people who smoke during their teen years significantly increase their risk for breast cancer compared to people who don’t [13].

Late Pregnancy or No Pregnancy

Women who have children earlier in life have a reduced risk of breast cancer, compared to those who have children after age 35 or not at all [14].

Breastfeeding

Breastfeeding for a year or more reduces a woman’s overall risk of breast cancer.  The longer a woman breastfeeds, the lower her risk drops.  This seems to be most impactful on the risk of triple-negative breast cancer [15].

Hormonal Contraceptives

The use of oral contraceptives and hormonal intrauterine devices (IUD), have been shown to slightly increase the risk of breast cancer [16].

Combined Hormone Replacement Therapy

Use of combined HRT increases one’s risk of developing breast cancer and risk associated with HRT use never diminishes. It also increases the risk that breast cancer will be found at a more advanced stage and it may reduce the effectiveness of mammograms [17].

SOURCES
  1. Islami F, Goding Sauer A, Miller KD, et al. Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States. CA Cancer J Clin. 2018.
  2. American Cancer Society. Breast Cancer Facts & Figures 2019-2020. Atlanta: American Cancer Society, Inc. 2019.
  3. Shiyanbola OO, Arao RF, Miglioretti DL, et al. Emerging Trends in Family History of Breast Cancer and Associated Risk. Cancer Epidemiol Biomarkers Prev. 2017;26(12):1753-1760
  4. Kramer I, Schaapveld M, Oldenburg HSA, et al. The influence of adjuvant systemic regimens on contralateral breast cancer risk and receptor subtype. J Natl Cancer Inst. 2019;30:30.
  5. Kuchenbaecker KB, Hopper JL, Barnes DR, et al. Risks of Breast, Ovarian, and Contralateral Breast Cancer for BRCA1 and BRCA2 Mutation Carriers. JAMA. 2017;317(23):2402-2416.
  6. McCormack, V., dos Santos Silva. Breast Density and Parenchymal Patterns as Markers of Breast Cancer Risk: A Meta-analysis. Cancer Epidemiol Biomarkers Prev June 1 2006 (15) (6) 1159-1169.
  7. Schwartz GF, Hughes KS, Lynch HT, et al. Proceedings of the International Consensus Conference on Breast Cancer Risk, Genetics, & Risk Management, April, 2007. Cancer. 2008.
  8. Collaborative Group on Hormonal Factors in Breast Cancer. Menarche, menopause, and breast cancer risk: individual participant meta-analysis, including 118 964 women with breast cancer from 117 epidemiological studies. Lancet Oncol. 2012;13(11):1141-1151.
  9. Chlebowski RT, et al “Dietary modification and breast cancer mortality: long-term follow-up of the Women’s Health Initiative randomized trial” J Clin Oncol 2020; DOI: 10.1200/JCO.19.00435.
  10. Jiralerspong S, Goodwin PJ. Obesity and Breast Cancer Prognosis: Evidence, Challenges, and Opportunities. J Clin Oncol. 2016;34(35):4203-4216.
  11. Smith, Alma J et al. “The effects of aerobic exercise on estrogen metabolism in healthy premenopausal women.” Cancer epidemiology, biomarkers & prevention: a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology vol. 22,5 (2013).
  12. McDonald JA, Goyal A, Terry MB. Alcohol Intake and Breast Cancer Risk: Weighing the Overall Evidence. Curr Breast Cancer Rep. 2013;5(3):10.1007/s12609-013-0114-z. doi:10.1007/s12609-013-0114-z
  13. Jones, M.E., Schoemaker, M.J., Wright, L.B. et al. Smoking and risk of breast cancer in the Generations Study cohort. Breast Cancer Res 19, 118 (2017).
  14. Chakravarthi, Balabhadrapatruni V S K, and Sooryanarayana Varambally. “Targeting the link between late pregnancy and breast cancer.” eLife vol. 2 e01926. 31 Dec. 2013.
  15. Anstey, Erica H, and Ginny Kincaid. “Breastfeeding for Cancer Prevention.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 1 Aug. 2019.
  16. March,L., Skovlund,C., Hannaford,P. et al., Contemporary Hormonal Contraception and the Risk of Breast Cancer.The New England Journal of Medicine. Dec 7, 2017.
  17. Ravdin,P., Cronin, K.,Howlader, N., et al. The Decrease in Breast-Cancer Incidence in 2003 in the United States. The New England Journal of Medicine. Apr 19, 2007.