Breast Cancer

The term “breast cancer” refers to a malignant tumor that has developed from cells in the breast. Usually breast cancer either begins in the cells of the lobules, which are the milk-producing glands, or the ducts, the passages that drain milk from the lobules to the nipple. Less commonly, breast cancer can begin in the stromal tissues, which include the fatty and fibrous connective tissues of the breast. Breast cancer is always caused by a genetic abnormality (a “mistake” in the genetic material). However, only 5-10% of cancers are due to an abnormality inherited from your mother or father. About 90% of breast cancers are due to genetic abnormalities that happen as a result of the aging process and the “wear and tear” of life in general. As breast cancer pertains to race, White women are slightly more likely to develop breast cancer than African American women. But African American women are more likely to die of this cancer because their cancers are often diagnosed later and at an advanced stage when they are harder to treat and cure. There is also some question about whether African American women have more aggressive tumors. Asian, Hispanic and Native American women have a lower risk of developing breast cancer.

A breast self-exam and a clinical breast exam are not substitutes for mammograms.

There are things you can do to find breast cancer early:

• Get a mammogram. It is the best way to find out if you have breast cancer. A mammogram is an x-ray picture of the breast. It can find breast cancer that is too small for you or your doctor to feel. All women starting at age 40 should get a mammogram every one to two years. Talk to your doctor about how often you need a mammogram. If your mother or sister had breast cancer, you may need to start getting mammograms earlier.

• Get a clinical breast exam. This is a breast exam done by your doctor or nurse. She or he will check your breasts and underarms for any lumps, nipple discharge, or other changes. The breast exam should be part of a routine checkup.

• Get to know your breasts. You may do monthly breast self-exams to check for any changes in your breasts. If you find a change, see your doctor right away.

Lifestyle-related Risk Factors

Alcohol
Alcohol use is linked to a slightly increased risk of developing breast cancer. Compared with nondrinkers, women who consume one alcoholic drink a day have a very small increase in risk, and those who have 2 to 5 drinks daily have about 1.5 times the risk of women who drink no alcohol.

Hormone replacement therapy
Long-term use of hormone replacement therapy (HRT) after menopause, particularly estrogens and progesterone combined, increase the risk of breast cancer.

Not having children
Women who have had no children or who had their first child after age 30 have a slightly higher breast cancer risk.

Obesity and high-fat diets
There are various factors involved with breast cancer and diet—age when weight gain occurred, excess fat in the waist or hips, type of diet and intake of saturated vs. polysaturated fats. While researchers have found differing results, it is agreed that a healthy diet and physical activity will help lower the risk of other diseases such as heart disease, high blood pressure and diabetes.

Breastfeeding
Some studies suggest that breastfeeding may slightly lower breast cancer risk, especially if breastfeeding is continued for 1.5 to 2 years. Other studies found no impact on breast cancer risk.

Smoking
To date, no studies have definitively linked cigarette smoking to breast cancer, however, smoking affects overall health and increased the risk for many other cancers, as well as heart disease.

Unchangeable Risk Factors

Aging
The risk of developing breast cancer increases with age. The approximate chances of a woman developing invasive
breast cancer in her lifetime is 1 in 257 for women ages 30 to 39; 1 in 67 for women ages 40 to 49; 1 in 36 for women ages 50 to 59; 1 in 28 for women ages 60 to 69 and 1 in 24 for women ages 70 to 80.

Family history of breast cancer
The risk of breast cancer is higher among women whose close blood relatives have this disease—mother, aunt, sister or grandmother. Having one first-degree relative (mother, sister or daughter) with breast cancer approximately doubles a woman’s risk, and having two first-degree relatives increases her risk 5-fold. Anywhere from 20 to 30 percent of women with breast cancer have a family member with this disease.

Gender
Being a woman is the main risk factor for developing breast cancer—about 100 times more common than breast cancer in men.

Genetic risk factors
Mutations in certain genes, such as those in the breast cancer genes BRCA1 and BRCA2, increase some women’s risk.

Menstrual periods
Women who started menstruating before the age of 12 or who went through menopause after age 55 have a slightly higher risk of breast cancer.

Personal history of breast cancer
A woman with cancer in one breast has a 3- to 4-fold increased risk of developing a new cancer in the other breast or in another part of the same breast. This is different from a recurrence (return) of the first cancer.

Previous breast radiation
Women who, as children or young adults, have had radiation therapy to the chest area as treatment for another cancer (such as Hodgkin’s disease or non-Hodgkin’s lymphoma) have a significantly increased risk for breast cancer.

Race
White women are slightly more likely to develop breast cancer than African American women. But African American women are more likely to die of this cancer because their cancers are often diagnosed later and at an advanced stage when they are harder to treat and cure. There is also some question about whether African

American women have more aggressive tumors. Asian, Hispanic and Native American women have a lower risk of developing breast cancer.

We do not know how to prevent breast cancer. But there are things you can do to reduce your risk, such as keeping a healthy weight and limiting how much alcohol you drink. Breast cancer is never anyone's fault. Feeling guilty, or telling yourself that breast cancer happened because of something you or anyone else did, is not productive.

Sources
Breast Cancer: A Resource Guide for Minority Women
U.S. Department of Health and Human Services

Minority Health Today Archive