April 19, 2014
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Breast Cancer

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Breast cancer facts and risk factors

How common is breast cancer?

Breast cancer is the cancer diagnosed most frequently in Canadian women. About 20,000 new cases are diagnosed in Canadian women each year and about 5,100 women die from the disease each year in Canada.

What is my risk of developing breast cancer?

One statistic that is often quoted is that women have a 1 in 9, or even a 1 in 8 chance of developing breast cancer. This number is alarming and needs some explanation. While it's true that a woman has a 1 in 9 (or 11%) chance of developing breast cancer, this is true only if she lives to the age of 90. Many women do not live to this age. A more useful way of assessing your risk for developing breast cancer is to know your risk over the next year, the next 5 years, or up to a certain age.

The chance of developing breast cancer increases with age. Therefore, your age at the present time very much determines your risk of breast cancer over the next year or 5 to 10 years.

Number of women per year at risk of developing breast cancer
Age Risk
30 1 in 6,000
40 1 in 1,200
50 1 in 550
60 1 in 400
70 1 in 300
80 1 in 250
Average woman's risk of developing breast cancer
Age Risk
25 under 1 in 1,000
50 1 in 63
75 1 in 15
90 1 in 9

Other risk factors, besides age, which add to the risk of developing breast cancer include the following:

Strong risk (greater than 4 times normal)

  • previous cancer in one breast (especially lobular carcinoma)
  • family history of breast cancer: pre-menopausal or in both breasts
  • past breast biopsy showing severely abnormal cells and hyperplasia (increased cell production)
  • positive for BRCA1/BRCA2 gene

Moderate risk (2 to 4 times normal)

  • advancing age
  • past breast biopsy: any sign of cell abnormality or hyperplasia
  • living in North America or northern Europe
  • family history of pre-menopausal breast cancer

Weak risk (up to 2 twice normal)

  • first menses before the age of 12 years
  • menopause after the age of 54 years
  • obesity in post-menopausal women
  • over 30 years old at birth of first child
  • post-menopausal obesity
  • diet (possibly)
  • family history of breast cancer: older post-menopausal
  • prolonged hormone use (more than 15 years)
  • moderate to heavy alcohol consumption (more than 3 drinks or 6 glasses of wine per week)

Risk factors that increase your chances of developing breast cancer:

Family history

A single case of breast cancer among close relatives (mother, sisters, daughters) can increase your personal risk by up to 9 times more than normal. The risk is smaller if the cancer was diagnosed when your relative was over 50 years old. However, the risk of a hereditary predisposition to cancer is higher if there are several cases of breast cancer in your family. This is especially true if any cases were diagnosed before age 50, or if anyone had cancer in both breasts.

Your menstrual and reproductive history

Prolonged exposure to estrogen increases your chance of developing breast cancer. Estrogen stimulates the cells in the breasts' milk ducts, from which cancers develop. The risk of breast cancer is increased:

  • if your periods started early (before age 12) and ended late (after age 54)
  • if you have not been pregnant or if you were older than 30 years old at the birth of your first child. An early first full term pregnancy (before age 20) seems to have a protective effect on the cells in the milk ducts and such women have a lower than average risk of breast cancer
  • if you used estrogen after menopause for a long time, longer than 15 years, this slightly increases the chance of breast cancer by 1.5-times more than normal

Previous breast biopsies

Most benign or fibrocystic changes seen in a breast biopsy are not indicators of future cancer. However, if the cells in the normal milk ducts are beginning to look abnormal (called atypia) or heap up in an abnormal number (called hyperplasia), the risk of developing breast cancer later is increased by a modest amount.

Lifestyle

The North American lifestyle results in higher rates of breast cancer than the lifestyles in Africa or Asia. This may be due to differences in menstrual and reproductive patterns, but affluence and diet are also likely important.

Diet

Regularly drinking more than 3 alcoholic drinks or 6 glasses of wine a week and obesity after menopause have been linked to higher rates of breast cancer. It is hard to define a specific "good' or "safe" diet but emphasizing green and yellow fruits and vegetables, reducing the number of total calories consumed, and exercising regularly to achieve an ideal body weight are most likely to be helpful.

 
Ivo Olivotto, MD 
in association with the MediResource Clinical Team 

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