A Woman's Guide to Breast Cancer

Though breast cancer is the most prevalent cancer among women, the odds are in your favor that you won’t get it.

After your annual mammogram screening, you spend a few nervous, nail-biting moments — or perhaps even several hand-wringing days — waiting for the results, wishing and hoping and praying that the breast cancer statistics you’ve heard so much about won’t apply to you. If one in eight American women can expect to develop breast cancer in a lifetime, what are the chances that it will happen to you?

Relax. Though this statistic sounds scary, it refers to a woman’s lifetime risk — the odds calculated over an 80-year lifespan. Another way to put it: The chance that you will never have breast cancer is seven out of eight.

If a mammogram does detect a suspicious lump and diagnostic testing shows that cancer is present, ease your mind with the knowledge that it’s likely to catch the disease in its earliest, most treatable stages, when the chances of treating it successfully are stacked in your favor. Plus, early detection often means less extensive surgery and, depending on the type of tumor, possibly less aggressive follow-up treatment.


More good news: For the past 20 years, death rates from breast cancer have been declining, thanks in part to earlier detection and better treatment. Plus, advances in genetics, molecular biology and immunology over the past 10 years are helping doctors better understand what causes breast cancer and which women are the most vulnerable. In fact, one of the first steps you can take to protect yourself is to know your own risk factors.


Understanding Your Risk
With the exception of gender, the single most important risk factor for breast cancer is advancing age. A majority of breast cancer cases are diagnosed in women who are 50 and over. As the risk rises after age 40, it is important to schedule your annual mammogram screenings and physical breast examinations with your health care provider on a yearly basis.

Other important risk factors include the following:

Your medical history: If you’ve already been diagnosed with breast cancer, you’re at a three- to four-fold greater risk of having a recurrence of the original cancer or of developing a new, unrelated cancer. Your doctor will monitor you more closely for the first several years after your initial diagnosis to help catch any new or recurring cancers. For women whose breast cancers contain receptors for either estrogen or HER2 (a growth-promoting protein found in about 15 to 25 percent of breast tumors), drug therapies can dramatically reduce the risk of a recurrence.


Your family history: If your mother or sister had breast cancer, your chances of getting it may be two or three times higher than they would be otherwise. But before you panic, consider this:
Although the vast majority of women with a family history of breast cancer won’t develop it, if one of your close relatives (mother, sister, father) has a bout with breast cancer, your risk does increase. It is important to speak to your health care provider about your family history of cancer so they can discuss your options for better management.


Your genes: When breast cancer affects more than one generation of women on either side of the family, or occurs at an early age (less than 50) or ovarian cancer is in the same side of the family, the risk is much greater than for women who have just one or two affected relatives. Thankfully, fewer than 10 percent of all cancers fit this hereditary pattern. Most of these breast cancers can be traced to genetic mutations; the most common are the BRCA1 and BRCA2 genes. A blood test may tell whether or not you have a genetic predisposition to developing breast cancer, but it is recommended only for women with family histories of breast cancer, particularly those whose relatives were diagnosed with breast cancer before age 50. Ask your doctor or a genetic counselor to help you decide whether you should be tested and what you can do with the information once you get the results.


Breast biopsy results: If you’ve had an abnormal breast biopsy, your risk of developing breast cancer may be two to four times higher than average, depending on the test results. Ask your doctor whether you fall into a high- risk category. If you do, your doctor may recommend more frequent mammograms and breast exams to help keep tabs on your condition.


Your menstrual and reproductive history: Starting your period before age 12 or having menopause after age 55 slightly increase the risk, as does having no children or having your first child after age 30. Conversely, breastfeeding a baby for 1 ½ to 2 years appears to lower the risk.

Other risk factors: Smoking, having more than two drinks per day and gaining weight in adulthood (especially after menopause) have also been linked to an increased risk, so quit smoking, drink alcohol in moderation (or not at all), and keep your weight in check.

Doctors have learned more about treating — and beating — breast cancer in the past 20 years than in the previous 200 years. The keys to surviving: early detection and prompt treatment. Protect yourself by finding out how at-risk you are, taking good care of yourself and, if you’re at high risk or over 40, having regular mammograms. You owe it to yourself.

How Your Risk Increases With Age
Age
Woman’s chance of having breast cancer
30-39
1 in 229
40-49
1 in 68
50-59
1 in 37
60-69
1 in 26
Lifetime Risk
1 in 8

Source: National Cancer Institute

Article was reviewed for accuracy by experts with the Women’s Cancer Prevention Program at the University of Connecticut Health Center.


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