Breast Cancer Risk Factors

All factors that can increase the likelihood of developing a disease are considered risk factors. However, the presence of a risk factor does not necessarily mean that they will get the disease, it simply indicates an increased probability relative to other people in general. There are different risk factors for different cancers.
It is possible to examine the risk factors associated with breast cancer in 2 groups as modifiable and non-modifiable risk factors. While there is nothing that can be done for risk factors that cannot be changed such as age, gender, genetic characteristics, there are also risk factors that can be changed by making some lifestyle choices. By choosing the healthiest lifestyle, you can ensure that your risk of breast cancer is as low as possible.

Risk factors

GENDER

Being a woman is the biggest risk factor for developing breast cancer. Less than 1% of breast cancers occur in men.

AGE

The risk of breast cancer increases with age. While two-thirds of breast cancers occur in women aged 55 and older, only a few occur under the age of 30.

FAMILY STORY

The risk is increased in women with a family history of breast cancer. While the risk increases 2 times in those with breast cancer in first-degree relatives (such as mother, sister and daughter), the risk of having cancer in 2 first-degree relatives increases 5 times. If breast cancer in the family started at a young age (pre-menopausal) and is bilateral, the risk increases even more.

GENETIC

About 5-10% of breast cancers are thought to develop as a result of an inherited disorder caused by abnormal genes passed from parent to child. Genes are short pieces of DNA (deoxyribonucleic acid) found in chromosomes.
DNA changes are divided into those that are hereditary and those that occur over time. Inherited DNA changes are passed from parent to child.
DNA changes that occur over a lifetime as a result of the natural aging process or exposure to chemicals in the environment are called somatic changes. Some DNA changes are harmless, while others can cause diseases. Changes in DNA that adversely affect health are called mutations.
Most inherited breast cancers are associated with mutations in the BRCA1 and BRCA2 genes. BRCA1 and BRCA2 mutations account for 10% of all breast cancers.
The BRCA1 and BRCA2 genes are found in all humans. The function of BRCA genes is to repair cell damage and ensure normal growth of breast, ovary and other cells. But when these genes contain mutations, the genes cannot function normally and the risk of developing breast, ovarian and other cancers increases.
Having a BRCA1 or BRCA2 mutation does not necessarily mean you will develop breast cancer, but your risk of breast cancer increases significantly. Women with a change in one of these genes have a lifetime risk of developing breast cancer between 50 and 85%.
Women with a BRCA1 or BRCA2 mutation and diagnosed with breast cancer often have a family history of breast cancer, ovarian cancer, and other cancers.
You are significantly more likely to have a genetic mutation linked to breast cancer if:
If you have a family history of breast cancer before the age of 50
If someone in the family has both breast and ovarian cancer
Have a relative(s) with triple negative breast cancer
If you have other cancers other than breast, such as prostate, melanoma, pancreas, stomach, uterus, thyroid, colon and/or sarcoma in your family
If women in your family have cancer in both breasts
If you were diagnosed with breast cancer before age 35
If a man in your family has breast cancer
If you have a known abnormal breast cancer gene in your family

BREAST CANCER STORY

Those who have cancer in one breast are 3-4 times more likely to develop a new cancer in the other breast or in a different part of the same breast. This is different from the risk of recurrence (relapse) of the disease.
If you have received radiation to your chest to treat another cancer (not breast cancer), such as Hodgkin’s disease or non-Hodgkin lymphoma, your risk of breast cancer is higher than average. If you had radiation to your face to treat acne as a teenager (something that is no longer done), you have a higher risk of developing breast cancer later in life. The amount of increased risk depends on how old you were when you received radiation. The increase in risk is greatest if you received radiation during adolescence, when your breasts are developing.
There are also concerns that women treated with radioactive iodine for thyroid disease may have a higher risk of breast cancer, but study results are mixed. Some research also suggests that there is something about the biology of thyroid cancer that may increase the risk of breast cancer.

PREVIOUS RADIATION STORY

If you have received radiation to the chest and face for any reason (other than breast cancer), your risk of breast cancer is higher than average. The amount of increased risk depends on how old you were when you received radiation. Radiation received during adolescence, when the breasts are developing, poses the highest risk. Radiation therapy applied after the age of 40 does not increase the risk of breast cancer.

BENIGN BREAST CHANGES

Some benign breast conditions can lead to an increased risk of breast cancer. There are several types of benign breast conditions that affect breast cancer risk:
Overgrowth of normal-appearing cells (proliferative lesions without atypia):
These are the cases where there is excessive cell proliferation in the milk ducts and milk glands that make up the breast tissue, but the cells are normal. They increase the risk of breast cancer by 1.5-2 times. These:
ductal hyperplasia (without atypia)
complex fibroadenoma
sclerosing adenosis
papilloma or papillomatosis
radial scar

Overgrowth of abnormal-looking cells (proliferative lesions with atypia):
In these lesions, besides excessive cell proliferation in milk ducts and milk glands, abnormal structure is seen in the cells. They increase the risk of breast cancer 4-5 times. These;
atypical ductal hyperplasia
atypical lobular hyperplasia
Lobular carcinoma in situ (LKIS):
It is abnormal cell growth in breast lobules. Although it has the word “carcinoma” in its name, it is not a true breast cancer. It indicates a high risk of breast cancer, increases the risk of breast cancer 7-11 times. The risk is even greater if you have LCIS and a strong family history.

RACE

Breasts are composed of fibrous tissue (connective tissue), glandular tissue (milk-producing tissue) and adipose tissue. Excess of glandular tissue and fibrous tissue and less adipose tissue in the breast is called “dense breast tissue” or “fibroglandular tissue”. This increases the risk of breast cancer. Dense breast tissue also complicates the evaluation of mammograms.
Having dense breasts is normal, not a disease, and does not cause symptoms. It cannot be understood by touching the breast whether it has dense tissue. Dense breast tissue can only be seen on a mammogram.

DENSITY OF BREAST TISSUE (DENS BREAST)

Breasts are composed of fibrous tissue (connective tissue), glandular tissue (milk-producing tissue) and adipose tissue. Excess of glandular tissue and fibrous tissue and less adipose tissue in the breast is called “dense breast tissue” or “fibroglandular tissue”. This increases the risk of breast cancer. Dense breast tissue also complicates the evaluation of mammograms.
Having dense breasts is normal, not a disease, and does not cause symptoms. It cannot be understood by touching the breast whether it has dense tissue. Dense breast tissue can only be seen on a mammogram.

Menstrual History (EARLY MENARCH – LATE MENOPEASE)

Women who start menstruating early (under 12 years old) and go through late menopause (after 55 years) have a higher risk of breast cancer. Female hormones (estrogen and progesterone) play an important role in the development of breast cancer. The longer a woman menstruates, the higher her lifetime exposure to the hormones estrogen and progesterone.

FACTORS RELATED TO LIFESTYLE

BIRTH STORY

Having never given birth to a child or having your first child after age 30 increases the risk of breast cancer. Multiple pregnancies or pregnancies at a young age reduce the risk of breast cancer. Breast cells are initially immature and very active until the first birth. Immature breast cells respond to hormone-disrupting chemicals as well as estrogen. Childbirth allows breast cells to fully mature and grow more regularly. This is the main reason why pregnancy helps protect against breast cancer. Being pregnant also reduces the total number of menstrual cycles.

BREAST-FEEDING

In particular, breastfeeding for more than 1 year can reduce the risk of breast cancer. The protective effect here may be related to the decrease in menstrual periods during breastfeeding.

HORMONE REPLACEMENT THERAPY (HRT)

Women who use or have recently used postmenopausal hormone therapy have a higher risk of developing breast cancer. Before the relationship between HRT and breast cancer risk was understood, HRT was widely used to relieve menopausal symptoms (hot flashes, fatigue) and reduce bone loss. After 2002, when the risk posed by HRT was understood, its use declined significantly.

OVER WEIGHT AND OBESITY

Overweight and obese women (with a BMI over 25) have a higher risk of breast cancer compared to women who maintain a healthy weight, especially after menopause. Being overweight can also increase the risk of recurrence (recurrence) in women with breast cancer.
Up until menopause, the majority of estrogen is produced in the ovaries, while adipose tissue produces very little estrogen. After menopause, estrogen production from the ovaries stops and adipose tissue becomes the main source for this hormone. More adipose tissue means higher estrogen levels and a greater risk of breast cancer. Still, the link between overweight and breast cancer is complex and influenced by other factors. For example, the location of excess fat is also important. Excess fat around the abdomen is riskier than the same amount of excess fat around the thighs or hips.

ALCOHOL CONSUMPTION

Drinking alcohol can increase the risk of breast cancer. Alcohol can increase estrogen and other hormone levels, as well as increase the risk of breast cancer by damaging the DNA in cells. Compared to women who never drink, women who drink three alcoholic drinks per week have a 15% higher risk of breast cancer.

LACK OF PHYSICAL ACTIVITY

There is increasing evidence that regular exercise reduces the risk of breast cancer. Regular exercise at a moderate or intense level for 4-7 hours a week has been shown to reduce the risk of breast cancer. People who exercise regularly tend to be healthier and more likely to maintain a healthy weight and have less fat than people who don’t exercise.

CIGARET

Smoking increases the risk of many diseases and increases the risk of breast cancer in young, premenopausal women. It has also been shown that there may be a link between exposure to very heavy cigarette smoke and the risk of breast cancer in postmenopausal women.
Smoking can also cause problems in women undergoing breast cancer treatment, such as difficulty recovering from surgery, increasing the risk of blood clots during hormone therapy, and increased lung damage from radiotherapy.

NEW POSSIBLE RISKS

VITAMIN D DEFICIENCY

It is thought that the risk of breast cancer is increased in women with reduced vitamin D. Vitamin D may play a role in controlling normal breast cell growth and preventing the growth of breast cancer cells.
Vitamin D plays a very important role in bone health by helping our body absorb calcium. It also helps the immune, muscular and nervous systems function properly.
Most of the vitamin D is synthesized in the skin by sunlight. Smaller amounts are taken with food. Vitamin D deficiency has become a common problem today, as our contact with the sun is gradually decreasing.

HIGH FAT DIET

Diet is thought to be partially responsible for about 30-40% of all cancers. No food or diet can prevent you from getting breast cancer. But a healthy diet can boost your immune system and help keep your risk of breast cancer as low as possible.
The relationship between high dietary fat and breast cancer risk has not been clearly demonstrated. Studies suggest that the incidence of breast cancer is lower in societies with low dietary fat and a diet rich in vegetables and fruits. More research is needed to better understand the impact of diet on breast cancer risk. But because fat is an important source of calories, high-fat diets can cause obesity or obesity, a risk factor for breast cancer.

NIGHT EXPOSURE TO LIGHT

Studies show that women who work at night and live in areas with high levels of light have a higher risk of breast cancer. This increase is thought to be related to melatonin levels. Melatonin is a hormone that plays a role in regulating the body’s sleep cycle. Melatonin production peaks at night, but is lower during the day and when the eyes are exposed to light. Melatonin levels tend to stay low in women who work at night or are exposed to external light at night.

CHEMICALS

In daily life, people are exposed to different chemicals while consuming or using many products such as water, foods, plastic products, sunscreens, antiperspirants and cosmetics. Their relationship with breast cancer risk has been the subject of numerous studies and studies are still ongoing.
There is no evidence to support claims that antiperspirants, underwire bras, and wearing a bra at night cause breast cancer.

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