Breast Cancer: Do You Know Your Risks?

^{(Title image: Photo by Michael Shannon on Unsplash)}

Since we’re creeping up on October, commonly known here as the very pink Breast Cancer Awareness Month, I thought it might be a good time to post the most common risk factors for breast cancer…and then explain the problem with focusing on them.

For reference, I used the risk factor list posted on the U.S. Centers for Disease Control and Prevention (CDC) website. The CDC’s list focuses on women, as they are the ones at greatest risk of developing breast cancer; a shocking 1 in 8 women (~12%) will develop breast cancer at some point in their lives.

But on to the list. The CDC divides breast cancer risk factors into two categories: risk factors that you cannot change and risk factors that you can change.

The ones that you cannot change are the following:

Age – The older you are, the greater the risk, with the majority of cases occuring in women aged 50 and above. Last I checked aging was still a thing, so we’re all heading in this direction.

Genes – BRCA1 and BRCA2 mutations put you at significantly greater risk for breast and ovarian cancer. This is one family heirloom that you’re better off not inheriting.

Age at first menstruation and menopause – Starting periods before age 12 and menopause after age 55 exposes you to higher levels of circulating female hormones for a longer time. The longer you steep in hormones, the more chance of developing the cancer. This is a little unfair, I think, because estrogen also helps maintain muscle mass, bone density and skin elasticity which are all good things, but that’s how it goes.

Breast density – The denser the breast tissue, the higher the risk. Denser tissue also potentially makes it more difficult to detect tumors. Dense breast tissue is less fatty and more fibrous and glandular…and more likely to occur in women with lower bodyfat, which is ironic considering it’s also better to leaner (see below).

Personal and family histories of cancer and other breast diseases – Having had previous breast cancer yourself or in a close family member (including ovarian cancer) may raise your risk. This is a great reason to make health a family affair and encourage everyone around you to do what they can to reduce their risks.

Early exposure to radiation therapy – Having had radiation treatments to the chest prior to age 30 may raise your risk of developing a tumor later on. This is a double-whammy: survive one cancer (like lymphoma) by going through treatment…and get smacked with breast cancer.

Diethylstilbestrol (DES) – If you were given DES (to reduce chances of miscarriage; no longer prescribed) or your mother took this drug when pregnant with you, it may have increased your breast cancer risk. Again, proof that life isn’t fair.

The risk factors that you have some control over:

Physical activity – Being sedentary is associated with higher risk. If you ever needed a wake-up call to get moving, this is it (and while you’re at it, have your family members join you).

Postmenopausal overweight or obesity – Being an older woman with a higher bodyfat percentage may increase your risk, so menopause is a great time to reevaluate your diet and consider why you’re eating what you’re eating—is it just out of habit? Boredom? Depression?

Hormone replacement therapy – Taking hormones post menopause for more than five years may increase the chances of developing breast cancer (see “Age at first menstruation and menopause” above). So unfortunately, hormone replacement treatment to help with menopausal symptoms may end up working against you.

Pregnancy history – Never having a full-term pregnancy, getting pregnant after age 30 or never breastfeeding may all affect your risk. To be fair, these can be more difficult to control and no one should ever feel guilty about any of them.

Alcohol – Drinking alcohol increases your risk of developing breast cancer. If you are using alcohol as a socially-accepted means of self-medication, consider quitting and using money you’d otherwise spend on drinks to find yourself a good therapist.

There are of course other, perhaps less well-established risk factors, but the above give an idea of the wide variety of different factors involved.

Okay, so what if you can say that you’re in the clear with most of these factors? I certainly did. Based on my lifestyle, I figured that breast cancer was something that I’d never have to worry about.

And I had reason to think this way. According to the National Cancer Institute’s risk calculator, at the time of my diagnosis, I had a 1.3% chance of developing breast cancer within the next five years. That is a very low percentage! And yet, I developed a tumor.

Does that mean the calculator’s answer isn’t meaningful or that risk factors don’t matter? Not at all. It means that your risk percentage is only that, your calculated risk. Everyone would be well-served to live as healthy a life as they can, keeping in mind that having a number of risk factors doesn’t definitively mean that you will get breast cancer.

At the same time, no one should assume that a low risk means you won’t get cancer. It’s still very important to get screened regularly and see your doctor about any lumps that you find, because while you might not be able to prevent breast cancer despite your best efforts, catching your tumor at an early stage provides you with the greastest chances for a positive outcome.