Doctors don’t know why one woman gets breast cancer and another
doesn’t, but there are some things you can do to reduce your risk and
help make sure that any cancer can be detected early. Some of the most
common risk factors for breast cancer are described below. Note that
even if you have several of these factors, you may not develop breast
Risk Factors You Can’t Change
Gender: Breast cancer is far more prevalent among women.
Age: The risk of developing breast cancer increases as you age.
Menstrual periods: Your risk increases if you began menstruating before age 12 or reached menopause after age 55.
Personal history of breast cancer: If you’ve already had breast cancer, you’re at increased risk of getting additional tumors in either breast.
Family history of breast cancer: If your mother,
daughter or sister has had breast cancer, you are at greater risk. But
note that most women who are diagnosed with breast cancer do not have a
family history of the disease.
Genetics: You may be at risk for inherited breast
cancer if you have abnormalities or mutations in breast cancer gene one
(BRCA1) or breast cancer gene two (BRCA2). About 5 to 10 percent of
breast cancer cases are thought to be hereditary.
Race and ethnicity: White women are slightly more
likely to develop breast cancer than are African-American women,
although African-American women are more likely to die of this cancer.
Asian, Hispanic and Native-American women have a lower risk.
Previous radiation therapy: You are at significantly
increased risk for breast cancer if you are a woman who had radiation
therapy for another cancer, such as Hodgkin disease, when you were a
child or young adult.
Delayed childbirth: Your risk increases if you never gave birth or had your first child after age 30.
Hormone replacement therapy: Studies have shown a link between long-term hormone replacement therapy and breast cancer.
Alcohol: Drinking alcohol is linked to an increased risk of developing breast cancer. The more alcohol consumed, the greater the risk.
Overweight: Being overweight or obese has been found to increase breast cancer risk, especially for postmenopausal women.
Screening & Diagnosis
Screening tests identify signs of breast cancer that might otherwise
go unnoticed. When breast cancer is found and treated early, a woman has
more treatment options and a better chance of a cure. The following
tests are recommended as a routine part of every woman’s healthcare.
Your healthcare provider can show you how to effectively examine your
own breasts. When you are familiar with how your breasts normally
feel, you are much more likely to identify lumps or other changes that
may be symptoms of breast cancer.
Clinical Breast Examination
This physical test is performed by a physician or nurse practitioner,
often as a part of an annual check-up. The American Cancer Society
recommends that women in their 20s and 30s have a clinical breast exam
every three years.
A mammogram uses X-rays to produce an image of the breast and to
detect abnormalities in the breast that may be too small to see or feel.
On average, mammograms detect 80 to 90 percent of breast cancers in
women without symptoms. The American Cancer Society recommends that
women age 40 or older have a screening mammogram every year. Seattle
Cancer Care Alliance (SCCA) was the first in the region offer digital
mammography, a technique that captures X-ray images digitally for a more
accurate diagnosis. Studies have shown that digital mammography detects
up to 28 percent more cancers than traditional mammography. Diagnostic
Once breast cancer is suspected, the following diagnostic tests may be used.
A diagnostic mammogram is used to evaluate a woman with a breast
problem or symptom or an abnormal finding on a screening mammogram. It
usually includes additional views of one or both breasts.
Ultrasound uses high-frequency sound waves to form an image that is
displayed on a video screen and photographed for analysis. Because of
the different ways various tissue components interact with sound waves,
ultrasound can often reveal whether a lump is solid or a fluid-filled,
non-cancerous cyst. As a result, breast ultrasound is generally used to
examine a suspicious area found on a mammogram.
When a screening or other diagnostic test finds an abnormality that
could be cancer, a biopsy may be performed. In a biopsy, a doctor
removes a sample of the suspicious area which is then examined under a
microscope. A biopsy is the only way to tell if cancer is really
present. There are several types of biopsies.
Fine Needle Biopsy
A fine-needle biopsy involves the extraction of fluid or cells from a
lump that can be felt or seen with ultrasound or on a mammogram. A
local anesthetic numbs the area before the needle is inserted. If you
have a cyst, fluid will come out and the lump will disappear. If the
needle extracts cells, the sample is inspected by a pathologist to
determine if it is benign (not cancer) or malignant (cancer).
A core biopsy is nearly the same as the fine needle biopsy, but a
larger needle is used to remove a small cylinder of breast tissue.
Stereo-tactic Needle Biopsy
This type of biopsy is done when the lump is so small that the doctor
cannot insert the biopsy needle accurately. In this procedure, you lie
face down on a special table with an opening that lets the breast hang
down. A mammogram shows the location of the lump and a computer guides
In this type of biopsy, all or part of a breast lump is removed
surgically for microscopic examination to determine whether cancer is
Magnetic Resonance Imaging
SCCA has long been a leader in the diagnosis and care of breast
cancer, most recently in the use of magnetic resonance imaging (MRI) as a diagnostic tool. According to a study led by SCCA’s Dr. Constance D. Lehman, MD, PhD,
MRI scans of women who were diagnosed with cancer in one breast
detected over 90 percent of cancers in the other breast that were missed
by mammography and clinical breast exam at initial diagnosis. In
conjunction with this news, the American Cancer Society announced new
recommendations for use of MRI for women at increased risk for breast
cancer. An expert panel, of which Lehman is a member, recommended annual
screening using MRI in addition to mammography for women with a 20 to
25 percent or greater lifetime risk of the disease. For more information
about the use of MRI as a diagnostic tool for breast cancer, see magnetic resonance imaging in our digital mammography section.
Exciting New Research for Early Detection
Early detection through blood test will hopefully become standard practice.
Interesting Prevention Article