Breast Cancer

Can we prevent breast cancer? Probably not! Prevention implies complete protection from breast cancer. This is not possible. What is possible is to understand the risk factors and then try risk reduction.

What are the risk factors for breast cancer?

Being a woman is a risk factor. Men do get breast cancer. But of all breast cancers, only one percent is in men.

Age of the woman is another risk factor. Incidence of breast cancer has been rising in the North American women probably due to aging population. Breast cancer is uncommon at younger ages.

An article in the New England Journal of Medicine, written by researchers in Toronto, says that a woman entering her 30s has a 1 in 250 chance of breast cancer in the next 10 years. The risk of breast cancer increases with age, so that a woman entering her 40s has a 1 in 77 chance of the disease in the following decade. The risk of breast cancer in any decade of life never exceeds 1 in 34.

The cause of death among women at any age is always more likely to be something other than breast cancer. But proportionately, middle-aged ladies have more deaths due to breast cancer than older ladies, as tumours in younger women are more aggressive than older women.

Here are some interesting numbers on other factors that increase the risk of breast cancer: alcohol (more than 3 drinks/day) – 63 percent increased risk, lack of exercise – 59 percent increased risk, first birth after age 30 – 48 percent increased risk, weight gain (more than 20 kg) – 40 percent increased risk, late menopause – 28 percent increased risk, early menarche (before age 12) – 24 percent increased risk.

A family history of breast cancer is a well-known risk factor. The risk to a woman with a first-degree relative with breast cancer is generally reported to be two to three times higher than the risk to a woman with a negative family history. This is not something new. Physicians knew the familial occurrence of breast cancer as early as the year 100 A.D.

What about women with lumpy and granular breasts (fibrocystic changes)? Many attempts have been made to evaluate the relation between fibrocystic disease and cancer. There has been no clear cut evidence to suggest that fibrocystic changes in general predisposes to cancer. Once a woman has had a biopsy for benign disease, she is more likely to have a second biopsy, either because there is increased follow-up or there is distortion of tissue due to previous biopsy. Biopsy rate amongst women with fibrocystic changes is five times higher than other women.

When it comes to breast cancer, every woman is a potential target. Breast cancer is the leading cause of premature death in Alberta’s women. So, are there any strategies to reduce the risk of breast cancer?

Yes. In the next column, we will look at the recent research results that suggest that the risk of breast cancer can be reduced. So, stay tuned!

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