Breast cancer is the most common cancer in women, affecting approximately 11% of women during their lifetime. The chances of cure when detected in its early stages can reach 90% or higher. This emphasizes the importance of early diagnosis. It is crucial to note that most women do not have risk factors for breast cancer, so regular monitoring is essential for every woman. However, it is also important to be aware of various risk factors.
Family History:
A significant risk factor for breast cancer is a family history of the disease. If your mother, sister, or daughter had breast cancer, you are considered to be at increased risk. The age at which your relative was diagnosed is crucial in assessing your risk. For instance, if your mother was diagnosed with breast cancer at the age of 70, your additional risk is almost negligible, around 1%. In such cases, it is recommended to be under regular surveillance, but the level of risk should not cause undue concern.
On the other hand, if a first-degree relative was diagnosed with breast cancer at a young age, if a bilateral growth is detected, or if they experienced recurrent growths, your risk level is higher, and you should have regular medical follow-up. As for second-degree relatives, such as a grandmother or aunt, if only one relative had breast cancer, you are not part of the high-risk group. However, if you have two or more second-degree relatives with breast cancer, you are considered to be at increased risk. If it is challenging for the breast clinic team to determine your increased risk or assess your risk level, they may refer you to genetic counseling for further evaluation.
BRCA Mutations:
Around 3% of women in the population (mostly of Ashkenazi Jewish and Iraqi descent in Israel) have mutations in the BRCA gene, which puts them at increased risk of developing breast cancer at a young age. The risk for carriers of the mutation to develop breast cancer is about 5%. Additionally, carriers are exposed to a significantly higher risk (30%-50%) of developing ovarian cancer. Testing for carriers (usually done through a blood sample) is typically performed in women who have had breast cancer or ovarian cancer, close relatives of mutation carriers, and women from families with a high incidence of breast or ovarian cancer. The advantages of knowing about the mutation include options for closer surveillance and advanced means such as magnetic resonance imaging funded by the health fund. Moreover, there are effective prevention options, both medicinal and others.
Hormonal Alternative Therapy during Menopause:
Hormonal alternative therapy, given for five years or more to women after menopause, increases the risk of breast cancer by about 50%. The treatment aims to reduce the physical symptoms associated with menopause. The decision to provide treatment is based on the severity of menopausal symptoms and the balance between the expected improvement in quality of life and the risks associated with the treatment. Although the tendency is to try and avoid hormonal alternative therapy in women at increased risk of breast cancer, recent research suggests that low-dose treatments might be effective without increasing the risk of developing breast cancer. Nevertheless, if treatment is given, the aim is to limit it in time and maintain a closer follow-up for early detection of breast cancer, such as through mammograms every year.
Prolonged Menstrual Cycle:
When the menstrual cycle continues for many more years (early start of menstruation and late end of menstruation) and comes regularly without disruptions (absence of pregnancies/breastfeeding/few pregnancies/late age at first pregnancy), the risk of breast cancer is slightly higher than in the general population. The additional risk is not significant, and multiple pregnancies and a young age at first pregnancy are not protective against the disease.
Alcohol and Fats:
Excess weight, a high-fat diet, and alcohol consumption are three known factors that increase the risk of breast cancer, as well as other types of cancer.
Changes in Breast Tissue:
Rarely, despite a benign biopsy (tissue sample), risk factors for developing breast cancer in the future can be identified. If your biopsy form states the presence of "lobular neoplasia in situ" or "atypical ductal hyperplasia," you are at risk of developing breast cancer, and you should be under regular appropriate medical follow-up.
Uncertain Risk Factors:
Birth control pills, fertility treatments, and other possible risk factors. Numerous studies investigate the use of birth control pills and fertility treatments as risk factors for breast cancer, some show an increased risk, while others exclude it. Currently, there is no conclusive evidence for significant risk associated with contraceptive use. Other studies are continuously trying to identify additional risk factors for breast cancer. Many of the identified risk factors have limited weight, and sometimes, there are other reasons for considering them.