General Health

What factors are linked with a greater risk of breast cancer?

As the name suggests, breast cancer is an uncoordinated and uncontrolled excessive cancerous growth or mass forming in the cells of the breasts. It is the second most common cancer (after skin cancer) in women residing in the United States (US).

With rapid advancements in technology and the increased availability of mammograms, the survival rates of breast cancer have improved, with a steady decline in the mortality rates associated with the disease. Other tests used to diagnose breast cancer include ultrasound, magnetic resonance imaging and biopsy.

Breast cancer often commences in the cells of the milk-producing ducts and is referred to as invasive ductal carcinoma. However, cancer may begin in the glandular tissues known as lobules (referred to as invasive lobular carcinoma) or in other cells or tissues of the breast. Cancer may also spread to (metastasize) other parts of the body via lymph vessels or blood.

The different types of breast cancer include angiosarcoma, inflammatory breast cancer, ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS). Some other forms of breast cancer include male breast cancer, Paget’s disease of the breast and recurrent breast cancer.

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Breast cancer is most likely caused by a complex interplay of the genetic constitution of an individual and her environment with several factors such as hormonal and lifestyle factors contributing to the development of cancer.

Signs and symptoms of breast cancer

  1. A new lump in the breast or underarm that feels different from the surrounding tissue
  2. Thickening or swelling of part of the breast.
  3. Change in the shape, size, or appearance of the breast
  4. Changes on the skin over the breast, such as dimpling
  5. A newly inverted nipple
  6. Peeling, scaling, crusting or flaking of the pigmented area of the areola (skin surrounding the nipple) or skin of the breast
  7. Pitting or redness over the breast skin, similar to the skin of an orange
  8. Irritation of breast skin.
  9. Pain in the nipple area or pulling in of the nipple
  10. Nipple discharge other than breast milk, including blood.

The way your breasts look and feel can be affected by getting your menstrual periods, having a child, weight loss or gain, and medication use. Breasts also tend to change with ageing.

Risk factors for breast cancer

Factors associated with a greater risk of breast cancer include:

  1. Being female. The female gender is much more likely than males to develop breast cancer.
  2. Advancing age. The risk of breast cancer increases with age and most breast cancers are diagnosed after the age of 50
  3. Personal history of breast conditions. If you had breast biopsy in which LCIS or atypical hyperplasia of the breast was found, the risk of breast cancer is higher.
  4. Personal history of breast cancer. If you have had breast cancer in one breast, the risk of developing cancer in the other breast is higher.
  5. Positive family history. If you have strong family history of breast cancer i.e. sister, mother, or daughter (first-degree relative) was diagnosed with breast cancer, especially at a younger age, your risk of breast cancer is higher.
  6. Genetics. Certain genetic mutations in inherited genes increase the risk of breast cancer such as the BRCA1 and BRCA2 genes.
  7. Radiation exposure. If you have received radiation therapy to the chest for instance, treatment of Hodgkin’s lymphoma) before 30 years of age, the risk of breast cancer later in life is higher.
  8. Obesity. Women with obesity and lack of physical activity have an increased risk of breast cancer.
  9. Commencement of menstrual periods at a younger age. Beginning your menstrual period before 12 years of age increases the risk of breast cancer.
  10. Commencement of menopause at an advanced age. If menopause began at an after 55 years of age, the risk of breast cancer is increased.
  11. Giving birth to the first child at an advanced age. Women who give birth to the first child after 30 years of age may have an increased risk of breast cancer.
  12. No history of pregnancy. Women who have never been pregnant have an increased risk of breast cancer compared to women who have had ≥1 pregnancies.
  13. Medications. Women on hormone therapy medications (estrogen and progesterone combinations) for >5 years to treat the clinical signs and symptoms of menopause are at an increased risk of breast cancer. Certain oral contraceptives (birth control pills) also have been found to raise breast cancer risk. Women who have taken medications such as diethylstilbestrol (DES)  are at an increased risk of breast cancer.
  14. Alcohol consumption. Drinking alcohol elevates breast cancer risk.
  15. Having dense breasts. Dense breasts have more connective tissue than fatty tissue, which can make it more difficult to detect cancers on mammograms.

Research has indicated factors such as smoking and being exposed to chemicals can also increase the risk of breast cancer.

References

1.     Breast cancer – Symptoms and causes – Mayo Clinic

2.     What Is Breast Cancer? | CDC

3.     What Is Breast Cancer? | American Cancer Society

4.     Breast Cancer—Patient Version – NCI

Author

Pooja Toshniwal Paharia

Dr. Pooja Toshniwal Paharia is a Consultant Oral and Maxillofacial Physician and Radiologist, M.DS (Oral Medicine and Radiology) from Mumbai. She strongly believes in evidence-based radiodiagnosis and therapeutic regimens for benign, potentially malignant, or malignant lesions and conditions either arising from the oral and maxillofacial structures or manifesting in the associated regions.

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