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Risk Factors: Breast CA

 

 

RISK FACTORS FOR BREAST CANCER

Risk factors for breast cancer can be easily identified. These factors are used to define Hisk Risk Patients for Breast Cancer.

Major Risk Factors By History

  • Family History: close family members such as mother, sister, aunt who have a documented history of breast cancer, place the patient at high risk to develop breast cancer. Prememopausal onset and bilaterallity increase these risks further.

  • Previous history of Breast Cancer: Any patient who has had breast cancer in the past is at risk to develop contralateral breast cancer. Non invasive carcinoma has the same effect, i.e. LCIS and DCIS

  • History of Breast Biopsy showing cellular atypia.

Major Risk Factors by Genetic Analysis

New genetic markers studies have shed some light on the genetic predisposition for breast cancer over the past few years. Genetic integrity for the genes BRAC 1 and 2 have a definite impact in the development of breast cancer. The overall picture is however very complex and may involve additional genes or factors not yet identified.

Women who have inherited a mutation in a breast cancer susceptibility gene as defined as BRAC 1 and BRAC 2 were found to have in early studies/analysis an 85 % of developing breast cancer along with a significant risk of developing ovarian cancer. Later studies are confirming there is a definite increased risk. However, this risk is now found to be much lower and in the 55 - 56% range for breast cancer before they reach age 70 and in 15 -16% range for ovariam breast cancer. Other studies are now postulating this risk may be even lower.

The problems with identifying these mutations is to not have specific guidelines for these patients and how to councel them. In addition, common routine screening of BRAC 1 and 2 mutations for the general population or for patients with a family history of breast cancer is wasteful and not recommended (in patients with a family history of breast cancer, it will be negative 9 out of 10 times).

See Chapter: Genetic Screening for Breast Cancer

Minor Risk Factors

Alcohol Intake

Early Menarche

Late Menopause

Obesity

Low dose Radiation

Diabetes

Chapter: Genetic Screening for Breast Cancer

1997 - New Eng J Med 336:1401-1408

1197 - New Eng J Med 336:1409-1415

1992 - New Eng J Med 327:319-328

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