Breast Cancer accounts for 12% of all the cancers in females in India. The incidence is increasing every day mostly in Urban areas for unspecified reasons. Many of my patients and their relatives ask me

“Dr Why do I have to suffer from Breast cancer and Could I have done some thing to diagnose it early”

I am trying to write a note to explain the risk factors for breast cancer.

Is family history of breast cancer a risk factor?

Females with first degree relatives like mother and sister with history of Breast and Ovarian cancer are categorized under high risk. Certain genes like BRCA1, BRCA2, TP53 etc are responsible for breast cancer. The mutation of these genes are notorious for most of inherited Breast cancers. The family history characteristics associated with increased likelihood of BRCA1 and BRCA2 genes are

• Two or more family members under 50yrs of age with breast cancer.
• Both Breast and Ovary cancer in members of the family
• Male breast cancer

Hormonal Factors:

The female hormone called Estrogen is responsible for Breast Cancer. In fact estrogen is essential to be a female and still it is notorious in causing the deadly disease. All the factors which are responsible for a prolonged exposure are risk factor for causing breast Cancer.

• Early age of Menarchy (Starting of Menstrual cycle)
• Late age of Menopause (Stoping of Menstruation)
• Women with single full term pregnancy have 25% less risk of breast cancer in comparision to nulliparous women (Without a single full term Pregnancy)
• Late age of 1^st pregnancy i.e. women with 1^st pregnancy after 30 yr have 2-5 times more risk in comparison to women with 1^st pregnancy before 25yrs.
• Lactation and Breast feeding provide protection
• Increased use of OCP has increased risk especially those with positive family history
• Oophorectomy ( Surgical removal of Ovary) before the age of 50yrs is protective

Life style:

Today in this world of competition, maximum people are having a sedentary life style. But we don’t realize at present how much we put ourselves at risk of getting cancer. Though these factors are responsible for many cancers but I would like to highlight on factors responsible for breast cancer.

• High Vegetable diet is protective.
• Alcohol intake increases the risk. The risk increases with the increased duration of alcohol intake.
• Smoking. Risk increases with increased duration of use.
• Overweight and Sedentary life style increase the risk.
• Vitamin C, Folates etc are protective.
• Physical Exercise: Active women who lead a healthy life style have 30-70% decreased risk

Obesity:

In present times we find more of young female are overweight because of life style and food habits. I would like to emphasize on this independent risk factor for breast Cancer. Women with more Body mass index (calculated from the weight and height) have very high risk of getting breast Cancer. Women with BMI less than 30 have relative risk of 1.34 but women with BMI more than 40 have relative risk of 2.12, this is quite significant. The lethal combination of Obesity with increased alcohol consumption and sedentary life style increase the risk.

Radiation Exposure:

Previous exposure to ionizing radiation like nuclear explosion, medical diagnostics like X ray, CT Scan, Mammography etc, therapeutic (For treatment in child hood) can be responsible for breast cancer. In US  1% of all breast cancer attributes to diagnostic mammography.

I hope my article would help many people who are reading it. Plz feel free to put forward your comments, suggestions and questions.