Risk of breast cancer
Most patients we see in the clinic thankfully don’t have cancer but majority have worry of developing it. The estimated lifetime risk of being diagnosed with breast cancer is 1 in 7 (15%) for females born after 1960 in the UK. Of these nearly a quarter of the cancers are preventable. 8% are caused by alcohol and another 8% by obesity.
Older age and being a woman are two biggest factors but these are not modifiable. Neither is the family history, cancer risk is around twice higher in women with one first-degree relative with breast cancer, versus women with no first-degree relatives. The risk is higher still with a larger number of affected first-degree relatives, or relatives affected aged under 50. However over 85% of women with a first-degree relative with breast cancer will never develop breast cancer themselves. 87% of women with breast cancer have no first-degree relatives with the disease. Women with a BRCA1 or BRCA2 mutation have a 45–65% chance of developing breast cancer by age 70. They affect an estimated 0.11% and 0.12% of the general population respectively, so it’s uncommon affecting 1 in 450 women and accounts for 2% of cancers.
DNA damage accumulates over time and can result from biological processes or from exposure to risk factors.
So let’s concentrate on modifiable causes as the biggest lesson of the pandemic is prevention is better than cure.
Breast cancer risk is 9% higher in women who consume up to 2 units of alcohol per day, 13–23% higher in women who consume around 1.5–6 units of alcohol per day, and 60% higher in women who consume 6+ units of alcohol per day, compared with non-drinkers.
Breast cancer risk is 7–13% higher in current smokers, and 6–9% higher in former smokers, compared with never-smokers and this amplified in BRCA2 carriers.
Alcohol consumption and smoking is associated with higher levels of sex hormones, which may partly explain the link.
Breast cancer risk among pre-menopausal women is 8% lower per 5-unit body mass index (BMI) increase, however among post-menopausal women is 13% higher per 5-unit body mass index (BMI) increase. Greater body fatness is associated with higher sex hormone levels (fatty tissue produces more oestrogen), which may partly explain the link between body fatness and breast cancer risk. Adult weight gain appears to be significant factor increasing the risk.
Breast cancer risk is 13% lower in women with the highest level of total physical activity (recreational, commuting, occupational and household) compared to women with the lowest level.
5% of breast cancer cases in the UK are caused by not breastfeeding. Breast cancer risk is 16% lower in women who have ever breastfed.
At least 2% of breast cancer cases in the UK are caused by post-menopausal hormones. Breast cancer risk. is 37% higher in oestrogen-only HRT current users versus never-users, and. 112% higher in oestrogen-progestogen HRT (combined HRT) current users versus never users specially if it’s used more than 10 years.
Less than 1% of breast cancer cases in the UK are caused by oral contraceptives.
Therefore the pros and cons have to be carefully evaluated when using oestrogen based products because there certainly some health benefits as well.
In short we would like to encourage all women to concentrate on modifiable risk factors which if we put simply is adopting a healthy lifestyle including healthy diet and being physically active.
This is the key for good cardiac and mental health as well.
#breastcancer , #breastcancerawareness , #cancercure , #cancerspecialist , #breastcancerhelp
