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Risk Factor of Breast Cancer


Breast cancer accounts for 21% of Cancer Cases diagnosed in women world-wide. In comparison to America or Europe the incidence of Breast Cancer is low in India & Asia. However over past decades the incidence of Breast Cancer is rising in urban & semi-urban areas of India.

Some of the factors associated with increased risk for breast cancer are briefly mentioned here.


ROLE OF HORMONES:

When levels of Estrone Or Estradiol levels in pre-menopausal women are high then they are at greater risk for breast cancer.

Use of hormone replacement therapy containing estrogen & progestin confers greater risk than replacements containing only oestrogen.

Women with early onset of menstrual cycles ( age 12 or younger) have fourfold higher risk as compared to women with onset of cycles at age 13 or later.

Women having menopause after age 55 have 20% higher risk compared to women having menopause at at 45.

Women who are younger at first child birth have lower risk.

Breast feeding delays ovulation & reduces exposure to oestrogen.


BODY MASS (BMI):

Obesity is associated with increased risk of breast cancer in post-menopausal women.

Over weight women , if they take hormone replacement therapy ( HRT ) , then it increases adiposity.


PHYSICAL ACTIVITY:

Increased physical activity can reduce breast cancer risk.

High total lifetime activity is found to reduce breast cancer risk by 30% in postmenopausal women.


ALCOHOL CONSUMPTION:

Compared to non drinkers daily consumption of one or two drinks is associated with increase in risk of breast cancer.

Alcohol increases circulating ovarian hormone levels.


ORAL CONTRACEPTIVES:

Oral Contraceptives modestly increase Brest cancer risk compared to never users.

The increased risk declines after stoping contraceptives & is practically zero after 10 years.


HORMONE REPLACEMENT THERAPY:

Long term use of combined oestrogen-progestin is more detrimental than use of oestrogen alone in HRT.


FAMILY HISTORY OF BREAST CANCER:

Family history is strongly associated with increased risk of breast cancer.

BRCA1 & BRCA2 are the only genes conclusively associated with breast cancer.

Women who inherit these genes have >80% lifetime risk of breast cancer.


DIET:

Increase in fat intake increases risk of breast cancer.

Diets high in fibre protect against breast cancer.

It can be observed that majority of risk factors are related to hormones . Many factors like age at first birth, breast feeding etc. are difficult to modify in view of prevailing social preferences. Future prevention strategies may involve reduction in hormones to achieve reduction in Breast Cancer Risk.



Dr. Bhargav Maharaja,

Cancer Surgeon,
Shrey Hospital,
Navrangpura,Ahmedabad.