Currently, there are more than 2½ million breast cancer survivors in the United States. Chances are you know one of them … your grandmother, your best friend’s mom, or maybe your favorite high school math teacher. And like most people, you’ve probably wondered, “What caused it? Why her? Could it have been prevented?
Doctors estimate that 5 to 10 percent of breast cancers are linked to a gene mutation passed through generations of a family. But the exact causes of breast cancer are unknown. However, we do know that certain risk factors are linked to the disease. Some can easily be changed, like limiting alcohol and exercising more often. Others, like gender and genetics cannot. Medical experts explain that having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer.
While a laundry list of risks can seem scary and overwhelming, knowing about them saves lives. As the Director of the NYU Cancer Institute Breast Cancer Screening and Prevention Program, Dr. Julia Smith sees the importance of risk assessment to prevent breast cancer every single day. Dr. Smith says, “Compared to just 10 or 15 years ago, women diagnosed with breast cancer now have real hope for long term survival.”
Screening and prevention programs like Dr. Smith’s are available nationwide, especially in areas with major academic institutions. Dr. Smith urges women concerned about their risk to go and talk to a doctor. She explains, “Risk is not just a blood test for genetic mutation. That is a part of it. But the main issue is how to manage it so you can live your life.”
So what risks should you know about?
Being a woman is the main risk for breast cancer. “Breast cancer is an estrogen driven tumor, which is why you see it much more in women than in men.” explains Dr. Smith. While men also get the disease, the American Cancer Society says it’s about 100 times more common in women than in men.
According to Dr. Smith, there are several red flags that increase your risk:
• Breast cancer in a first degree relative (mother, sister, children)
• Premenopausal breast cancer in a relative under the age of 50
• Ovarian cancer in a relative
• Ovarian and breast cancer in the same relative
• Breast cancer in a male relative
• A relative with the BRCA gene mutation (According to the American Cancer Society, BRCA1 and BRCA2 are tumor suppressor genes — they keep cancer tumors from forming. When they are changed, they no longer cause cells to die at the right time, and cancer is more likely to develop. Mutation of these genes has been linked to hereditary breast and ovarian cancer. If you have a strong family history of breast cancer, your doctor may recommend a genetic test to help identify defective BRCA or other genes that are being passed through your family.)
• A relative with bilateral breast cancer (cancer in both breasts)
• Early prostate cancer (under the age of 60) in a male relative
• Premenopausal uterine or endometrial cancer in relative under the age of 50
• Early onset of colon cancer in a relative under the age of 60
Experts at the Mayo Clinic say that if you’ve had breast cancer in one breast, your risk of developing it in the other breast increases. Dr. Smith adds that women who had breast cancer are at risk for developing other forms of cancer and should work with her clinician to create a personalized prevention plan. A history of breast disease or biopsies on non-cancerous breast conditions may increase risk as well.
According to the American Cancer Society, white women are slightly more likely to develop breast cancer than African-American women. Asian, Hispanic, and Native-American women have a lower risk of getting breast cancer. In addition, Dr. Smith says that certain populations are at a higher risk, such as Ashkenazi Jews.
Once a woman starts menstruating, her breasts are exposed every month to a cycle of estrogen. Dr. Smith explains that the longer the breasts are exposed to that cycling of estrogen, the higher the risk. For example, a woman who began having her period at age 10, or who went through menopause after age 55 has a slightly increased risk of breast cancer. If a woman never has children, her breasts are exposed to hormones every month from her first period until menopause, unlike a woman that had several children and breast fed. Dr. Smith adds, “That’s a relative risk factor. It doesn’t mean that if you don’t have kids, you’ll get breast cancer.”
Many patients ask Dr. Smith if taking birth control pills has any effect on their risk for breast cancer. According to Dr. Smith, “It’s not clear there is a risk of cancer from current contraceptives. Even with the birth control pills used in the 1970s, which contained higher doses of hormones; we still don’t have real proof that they increased the risk of breast cancer.”
Dr. Smith often encourages young women to take oral contraceptives for at least five years if they have an elevated risk of ovarian cancer, as good data supports that it can lower risk. But when it comes to potentially causing or reducing risk for breast cancer, studies aren’t yet conclusive.
You know the saying, you are what you eat? A healthy, well balanced diet full of fruits and vegetables can lower risk.
Although breast cancer is a life-threatening disease, early detection can stop it in its tracks. Know your risks, talk to your doctor, follow prevention and screening guidelines and help other women in your community “think pink!”
For more information on the NYU Cancer Institute Breast Cancer Screening and Prevention Program, call 212-731-5452
Additional Resources for Breast Cancer Prevention:
Breast Cancer Assessment Tool for women over 35:
Jessica Solloway is a Washington, DC based writer and producer. From wedding planning to work, dating to dieting (and everything in between), she enjoys writing about lifestyle topics women want to know about. Jessica received her degree in Journalism from the University of Wisconsin-Madison. Check out her blog, The Savvy Mrs.