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Sunday, March 24, 2013

Risk Factors for Breast Cancer

Posted by Prahallad Panda on 4:41 PM Comments

Breast cancer is a commonly diagnosed cancer in women after non-melanoma skin cancer, and it is the second leading cause of cancer deaths after lung cancer.

heredity and cancer, breast cancer, inherited ...
heredity and cancer, breast cancer, inherited factors vs. other factors (Photo credit: Wikipedia)
Family History of Breast Cancer
It has been seen in studies in adult populations, 5% to 10% of women have a mother or sister with breast cancer, and about twice as many have either a first-degree relative (FDR) or a second-degree relative with breast cancer.
Risk increases with the number of affected relatives, age at diagnosis, and the number of affected male relatives
Genetically predisposed/Inheritance
Autosomal dominant inheritance of breast cancer is characterized by transmission of cancer predisposition from generation to generation, through either the mother’s or the father’s side of the family, with the following characteristics:
  • Multiple cancers within a family.
  • Cancers typically occur at an earlier age than in sporadic cases (defined as cases not associated with genetic risk).
  • Two or more primary cancers in a single individual. These could be multiple primary cancers of the same type (e.g., bilateral breast cancer) or primary cancer of different types (e.g., breast cancer and ovarian cancer in the same individual).
  • Cases of male breast cancer.
Other Risk Factors for Breast Cancer include age, reproductive and menstrual history, hormone therapy, radiation exposure, mammographic breast density, alcohol intake, physical activity, anthropometric variables, and a history of benign breast disease
  • Age
·         Risk of breast cancer increases with age, with most breast cancers occurring after age 50 years. In women with a genetic susceptibility, breast cancer, tends to occur at an earlier age than in sporadic cases.
  • Use of Oral Contraceptives
·         Oral contraceptives use are not entirely consistent, however, use of OCs formulated before 1975 was associated with an increased risk of breast cancer.
·         Oral contraceptives (OCs) may produce a slight increase in breast cancer risk among long-term users, but this appears to be a short-term effect.
  • Hormone replacement therapy (HRT)
·         Data exist from both observational and randomized clinical trials regarding the association between postmenopausal HRT and breast cancer.
·         Short-term use of hormones for treatment of menopausal symptoms appears to confer little or no breast cancer risk.
·         Local use of hormone cream is safer than oral preparations.
  • Age at Menarche, Parity and Menopause.
·         In general, breast cancer risk increases with early menarche, late menopause; and is reduced by early first full-term pregnancy.
·         In contrast to ER-positive breast cancers, parity has been positively associated with triple-negative disease, with no association with ages at menarche and menopause.
  • Radiation exposure
·         Observations in survivors of the atomic bombings of Hiroshima and Nagasaki and in women who have received therapeutic radiation treatments to the chest and upper body document increased breast cancer risk as a result of radiation exposure.
·         The significance of this risk factor in women with a genetic susceptibility to breast cancer is unclear.
·         Frequent mammograms are also not recommended.
  • Alcohol intake
·         The risk of breast cancer increases by approximately 10% for each 10 g of daily alcohol intake (approximately one drink or less) in the general population. Prior studies of BRCA1/BRCA2 mutation carriers have found no increased risk associated with alcohol consumption.
  • Physical activity and anthropometry
·         Weight gain and being overweight are commonly recognized risk factors for breast cancer. In general, overweight women are most commonly observed to be at increased risk of postmenopausal breast cancer and at reduced risk of premenopausal breast cancer. Sedentary lifestyle may also be a risk factor. One study suggested a reduced risk of cancer associated with exercise among BRCA1 and BRCA2 mutation carriers.
  • Benign breast disease (BBD) and mammographic density
·         Benign breast disease (BBD) is a risk factor for breast cancer, independent of the effects of other major risk factors for breast cancer (age, age at menarche, age at first live birth, and family history of breast cancer). There may also be an association between BBD and family history of breast cancer.
·         An increased risk of breast cancer has also been demonstrated for women who have increased density of breast tissue as assessed by mammogram, and breast density is likely to have a genetic component in its etiology.
With a normal active lifestyle, balanced diet; and breast self examination can beat the dreaded cancer to a larger extent.

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