Breast cancer is the most common cancer among women worldwide, but not all women are at equal risk. Genetic, hormonal, and lifestyle-related factors impact your chances of getting breast cancer. Knowing your breast cancer risk factors is essential for determining appropriate breast cancer screening guidelines for early detection.
High-Risk Breast Cancer Overview
A combination of genetic predispositions, hormonal influences, and lifestyle choices influences breast cancer risk. Women at high risk for breast cancer typically have one or more factors that significantly increase their likelihood of developing the disease compared to the general population.
It is important to note that being high-risk doesn’t guarantee that you will get breast cancer. Recognizing these risk factors early can lead to better outcomes through enhanced screening, preventive measures, and consistent monitoring.
- Genetic mutations
- Family history of breast cancer
- Personal history of breast cancer
- Reproductive and hormonal factors
- Smoking
- Drinking alcohol regularly
- Obesity
Risk Factors for Breast Cancer
Breast cancer risk factors fall into three broad categories: genetics, hormonal factors, and lifestyle choices. Though not all of these factors can be avoided, knowing your risk level helps.
Genetic Breast Cancer Risk Factors
Genetic risk factors are among the most significant indicators for breast cancer. Mutations in the BRCA1 and BRCA2 genes are inherited and drastically increase the likelihood of both breast and ovarian cancer. When these genes are mutated, the body’s ability to repair DNA is compromised, leading to an increased likelihood of cancerous growths. The lifetime risk of breast cancer for women with a BRCA1 mutation ranges between 55% and 65%, while for those with a BRCA2 mutation, the risk ranges from 45% to 65%.
Women with a family history of breast cancer, especially those who have had relatives diagnosed at a young age, are often recommended to undergo genetic testing to determine if they carry these mutations.
Hormonal Breast Cancer Risk Factors
Hormonal influences also play a major role in breast cancer risk. Estrogen and progesterone stimulate the growth of cells in the breast, and when these hormones are present at high levels or for extended periods, it can promote the development of cancerous cells. The following factors increase these risks:
- Early menstruation (before age 12)
- Late menopause (after age 55)
- Childbirth later in life of not at all
- Polycystic Ovary Syndrome (PCOS)
- Hormonal birth control
- Use of Hormone Replacement Therapy (HRT) for more than 5 years
- Higher than normal estrogen levels, both natural and synthetic
Lifestyle Breast Cancer Risk Factors
Lifestyle factors can further heighten breast cancer risk. While these factors may not carry the same weight as genetic or hormonal risks, they are significant contributors that you can change with effort and support.
- Physical activity: Women who are less active are at a higher risk for breast cancer
- Obesity
- Smoking
- Alcohol consumption
- Reproductive and birth control choices as described above
How Do I Know If I Am High Risk For Breast Cancer
Most women have some breast cancer risk factors, but only 10-15% of women are considered to be in the high-risk category. Below are some strategies you can use to assess your specific breast cancer risk.
1. Use a Breast Cancer Risk Assessment Tool
Several online tools can help estimate your breast cancer risk over the next 5 years and throughout your lifetime. These models use personal health and family history information to calculate risk. Some of the commonly used tools include:
- The Gail Model: This online breast cancer risk assessment tool evaluates various factors, including age, family history, personal health history, and reproductive factors.
- Tyrer-Cuzick (IBIS) Model: This model is most widely used as it provides a more detailed risk assessment, especially for women with a strong family history of breast cancer. This model also takes into a account a woman’s breast density.
- Claus Model: This tool is primarily used for women with a family history of breast cancer and is particularly useful if genetic factors like BRCA mutations are suspected.
2. Consult with a Healthcare Professional
While online models can give you an estimate, a personalized assessment by a doctor or genetic counselor is often more accurate. They will consider the risk factors described above and create a personalized plan to help you understand your risk and decide the best breast cancer screening path for you.
3. Genetic Testing
If you have a strong family history of breast cancer, you might be at higher risk due to genetic mutations like BRCA1 and BRCA2. A genetic test can provide a more accurate risk percentage if you’re found to carry one of these mutations.
Understanding Your Results
After using a risk assessment tool or speaking with your doctor you’ll receive a risk percentage. This could be either the chance of developing breast cancer within the next 5 years (also known as your 5-year risk) or your risk of developing breast cancer by the age of 85 or 90 (lifetime risk).
The average woman in the U.S. has about a 12-13% lifetime risk of breast cancer. You would be considered high risk if your lifetime risk is 20% or higher. If you self-assess via an online calculator and find your risk to be 20% or higher, share those results with your doctor to discuss how to best use this information.
High Risk Breast Cancer Screening Guidelines
The standard recommendation is for women to begin routine mammograms around the age of 40, but if you have several breast cancer risk factors, you should follow more aggressive and frequent screening guidelines than women at average risk.
Breast MRIs and breast ultrasounds are often utilized in addition to mammograms for high-risk patients in order to get more detailed images and potentially identify cancer at earlier stages.
The timing and frequency of these tests are crucial. Early detection through consistent screening can significantly increase survival rates, as breast cancer caught at its earliest stages is far easier to treat.
Preventive Measures for High Risk: Lifestyle and Medical Options
Preventive measures for women at high risk of breast cancer include both lifestyle changes and medical interventions. The more risk factors you can get under control, the better your chances are of avoiding or treating breast cancer successfully.
Medical Interventions
Several procedures and medications are available to reduce genetic breast cancer risk factors. Medications such as tamoxifen or raloxifene, known as selective estrogen receptor modulators (SERMs), are often prescribed to women at high risk to lower their chances of developing the disease. Preventive mastectomies for women with genetic mutations can reduce the risk of breast cancer by up to 95%
Lifestyle Changes
Taking care of yourself and your body can drastically reduce lifestyle-related breast cancer risk factors. Get regular checkups that include mammograms and other breast cancer screening guidelines to monitor your breast health. Be sure to follow a healthy diet and exercise regularly. Ask your doctor if you need support to quit smoking or drinking or maintain a healthy weight.
Regular Monitoring: Importance of Follow-Up Care
Regular breast cancer screenings are important for all women, but consistent monitoring and follow-up care are especially essential for those with high risk for breast cancer. Early detection strategies need to be complemented by ongoing care, including discussions with healthcare providers about personal risk factors and the best methods of prevention.
If you are considered at a higher than average risk, it may be beneficial to work with a multidisciplinary team of healthcare professionals, including oncologists, genetic counselors, and primary care providers. Regular monitoring allows for early intervention, which is critical in improving breast cancer outcomes.
Take Control Of Your Breast Health
Being categorized as high risk for breast cancer is not a guarantee of developing the disease, but it does require proactive care and attention. High-risk patients can significantly improve their health outcomes through regular screenings, medical interventions, education, and lifestyle changes.
Follow our women’s health blog to learn more about how you can reduce your breast cancer risk and improve your overall health.
Resources
https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet
https://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm
![shutterstock_1299510538-[Converted]](https://magview.com/wp-content/uploads/2023/05/shutterstock_1299510538-Converted.jpg "monitoring breast density")
