Wellness Wednesday: There are Breast Cancer Risk Factors You Can Control

Many risk factors can increase your chance of developing breast cancer, but it is not yet known exactly how some of these risk factors cause cells to become cancerous. Hormones seem to play a role in many cases of breast cancer, but just how this happens is not fully understood.

breastcancereventNormal breast cells become cancerous because of changes in DNA. Some DNA changes are inherited. This means they are in every cell in your body and can dramatically increase the risk for developing certain cancers. They are responsible for many of the cancers that run in some families. But most DNA changes related to breast cancer are acquired in breast cells during a woman’s life rather than having been inherited.

There is no sure way to prevent breast cancer. You can’t change some factors, such as getting older or your family history. But there are things you can do that might lower your risk, such as changing risk factors that you can control.

Body weight, physical activity and diet have all been linked to breast cancer, so these might be areas where you can take action. Read the American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention to learn more.


“Controllable” Risk Factors

Drinking alcohol

Drinking alcohol is clearly linked to an increased risk of developing breast cancer. The risk increases with the amount of alcohol consumed. Compared with non-drinkers, women who have 1 alcoholic drink a day have a very small increase in risk. Those who have 2 to 5 drinks daily have about 1½ times the risk of women who don’t drink alcohol. Excessive alcohol consumption is known to increase the risk of other cancers, too.

The American Cancer Society recommends that women have no more than one alcoholic drink a day. A drink is 12 ounces of regular beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits.

Being overweight or obese

Being overweight or obese after menopause increases breast cancer risk. Before menopause, most estrogen is made in the ovaries, and fat tissue makes only a small amount. After menopause, most of a woman’s estrogen comes from fat tissue. Having more fat tissue after menopause can raise estrogen levels and increase your chance of getting breast cancer. Also, women who are overweight tend to have higher blood insulin levels. Higher insulin levels have been linked to some cancers, including breast cancer.

The American Cancer Society recommends you stay at a healthy weight throughout your life by balancing your food intake with physical activity and avoiding excessive weight gain.

Senior women exercising in the parkPhysical activity

Evidence is growing that exercise reduces breast cancer risk. But how much is needed to make a difference? In one study from the Women’s Health Initiative, as little as 1¼ to 2½ hours per week of brisk walking reduced a woman’s risk by 18 percent. Walking 10 hours a week reduced the risk a little more.

To reduce your risk of breast cancer, the American Cancer Society recommends that adults get at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity activity each week (or a combination of these), preferably spread throughout the week.

Having children

Women who have not had children or who had their first child after age 30 have a slightly higher breast cancer risk overall. Having multiple pregnancies and becoming pregnant at an early age reduces overall breast cancer risk  Still, the effect of pregnancy is different for different types of breast cancer.

Breastfeeding

Some studies suggest that breastfeeding may slightly lower breast cancer risk, especially if it’s continued for 1½ to 2 years. The explanation for this possible effect may be that breastfeeding reduces a woman’s total number of lifetime menstrual cycles. Women who choose to breastfeed for at even the first several months may also get an added benefit of reducing their breast cancer risk.

Birth control

Studies have found that women using oral contraceptives (birth control pills) have a slightly higher risk of breast cancer than women who have never used them. Once the pills are stopped, this risk seems to go back to normal over time.

Hormone therapy after menopause

Hormone therapy with estrogen (often combined with progesterone) has been used for many years to help relieve symptoms of menopause and help prevent osteoporosis. There are two main types of hormone therapy.

Combined hormone therapy (HT): Use of HT after menopause increases the risk of breast cancer. It may also increase the chances of dying from breast cancer. This increase in risk can be seen with as little as two (2) years of use. Combined HT also increases the likelihood that the cancer may be found at a more advanced stage. The decision to use HT should be made by a woman and her doctor after weighing the possible risks and benefits (including the severity of her menopausal symptoms), and considering her other risk factors for heart disease, breast cancer and osteoporosis.

Estrogen therapy (ET): The use of estrogen alone after menopause does not seem to increase the risk of breast cancer much, if at all. But when used long term (for more than 10 years), ET has been found to increase the risk of ovarian and breast cancer in some studies.


Uncontrollable Risk Factors

The main risk factors for breast cancer are things you cannot change: being a woman, getting older, and having certain gene changes. These make your risk of breast cancer higher. But having a risk factor, or even many, does not mean that you are sure to get the disease.

istock_000006637453_largeBeing a woman

Men can have breast cancer; but this disease is about 100 times more common in women than in men. This might be because men have less of the female hormones estrogen and progesterone, which can promote breast cancer cell growth.

Getting older

As you get older, your risk of breast cancer goes up. Most invasive breast cancers are found in women age 55 and older.

Certain inherited genes

About 5% to 10% of breast cancer cases are thought to be hereditary, meaning that they result directly from gene defects (called mutations) passed on from a parent.

Early menstruation or late menopause

Women who have had more menstrual cycles because they started menstruating early (before age 12) or because they went through menopause later (after age 55) have a slightly higher risk of breast cancer. The increase in risk may be due to a longer lifetime exposure to the hormones estrogen and progesterone.

Having radiation to your chest

Women who as children or young adults were treated with radiation therapy to the chest for another cancer have a significantly higher risk for breast cancer. This varies with the patient’s age when they got radiation. And if you had chemotherapy with the radiation, it might have stopped ovarian hormone production for some time, which lowers the risk.


Conclusion

Most women who have one or more breast cancer risk factors never develop breast cancer, while many women with breast cancer have no known risk factors (other than being a woman and growing older). Even when a woman with risk factors develops breast cancer, it’s hard to know just how much these factors might have contributed.

The most important thing is to know your body and ask your doctor about any changes you might notice. Do breast self exams and don′t forget to schedule a mammogram. Preventive screenings are the best way to detect breast cancer early, when it is more easily and successfully treatable. Mammography can detect changes in breast tissue before you can even feel it.

The American Cancer Society released new recommendations* in 2015 for screening mammograms for women at average risk for breast cancer.

Women ages 40 to 44 should have the choice to start annual breast cancer screening with mammograms if they wish to do so. The risks of screening as well as the potential benefits should be considered.

Women age 45 to 54 should get mammograms every year.

Women age 55 and older should switch to mammograms every 2 years, or have the choice to continue yearly screening.

Mercy Health System offers free walk-in screening mammograms at Mercy Fitzgerald and Mercy Philadelphia Hospital each week. No appointment is necessary.

Mercy Fitzgerald Hospital Walk-In Screening Mammograms

breast-cancer-ribbonSr. Marie Lenahan Wellness Center
Women’s Imaging Suite
Every Wednesday, Thursday and Friday, 8 a.m. to 4 p.m.
Physician prescription, insurance card and photo ID required.
For more information, call 610.237.2525.

Mercy Philadelphia Hospital Walk-In Screening Mammograms

Medical Office Building
Radiology Registration
Wednesdays & Thursdays, 8 a.m. to 4 p.m.
Saturdays, 8 a.m. to 12 p.m.
Physician prescription, insurance card and photo ID required.
For more information, call 610.237.2525.

Sources: American Cancer Society, The Centers for Disease Control and Prevention

*Leading organizations differ on their recommendations for when to begin screening for mammography. This information should be reviewed with your personal physician to determine when is the right time for you to begin a screening regimen. 


Watch Mercy Health System’s 2016 Pink Glove Dance to support National Breast Cancer Awareness Month!


More Information

What Is Breast Cancer Screening?
Risk Factors for Breast Cancer in Young Women
Breast Cancer Risk Factors Breast Cancer Risk Factors [breastcancer.org]
Susan G. Komen Breast Cancer Risk Factors Table

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