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).

Find out your family history of cancer and explore your genes.
(Photo by Antonino Visalli on Unsplash)

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.

Rethink your drink.
(Photo by Bermix Studio on Unsplash)

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.

Exercise Trumps Genes for Longevity

By now I’m probably sounding like a broken record about how important exercise is to all aspects of your life, but here I go again…

Although this is not specifically about cancer, an article recently published in the Journal of Aging and Physical Activity (Posis et al., 2022) scored another point for the benefits of maintaining an active lifestyle.

This study was conducted at the Herbert Wertheim School of Public Health and Human Longevity Science (University of California, San Diego), where the researchers examined the effect of physical activity/sedentary time on longevity in women. The 5400+ study participants spanned the entire range of genetic predispositions for longer or shorter lives. You can read a synopsis of the research here.

When in doubt, keep moving.

The results of this prospective study (2012-2020), while not surprising in the grand scheme of things, can be considered a wake-up call.

Regardless of their genetic predisposition, women who engaged in higher levels of activity had a lower mortality risk and those who were more sedentary had a higher risk. This is important, because it’s tempting to think that if your family members are long-lived, you will be too. However, your own activity levels do matter.

In addition, being physically active was effective in extending the lifespans even of those women whose genetics suggested a shorter life.

This can be considered promising news: you do have some control over your lifespan. Even when you’ve been dealt what may seem like a losing hand in terms of longevity or disease, providing your body with the supportive behaviors that it needs and deserves still makes things better.

It’s easy to forget this when we focus on the negatives in life. And while we do need to acknowledge our hardships and allow ourselves time to grieve for our losses, making choices that benefit our bodies and minds is a sign of respect for ourselves.

So go ahead, soak those tootsies…then get back outside for a walk. And don’t stop.

Unlike a glass of wine or a rich dessert, commonly considered an “indulgence”, self-care in the form of moving ourselves, step by step, day by day, closer to a healthier lifestyle is the kindest, most loving indulgent act you can ever do for yourself.

What one little thing can you do today that you didn’t offer to yourself yesterday that will move the needle further towards a more active life?

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References:

“Physical Activity May Have a Stronger Role than Genes in Longevity” by Yadira Galindo, UC San Diego News Center, August 24, 2022, https://ucsdnews.ucsd.edu/pressrelease/physical-activity-may-have-a-stronger-role-than-genes-in-longevity.

Posis et al., (2022) Associations of Accelerometer-Measured Physical Activity and Sedentary Time With All-Cause Mortality by Genetic Predisposition for Longevity, J Aging Phys Act, https://doi.org/10.1123/japa.2022-0067.