Breast cancer has become the most commonly diagnosed cancer globally as of 2021, accounting for 12% of all new annual cancer cases worldwide, according to the World Health Organization.
One in eight women will be diagnosed with breast cancer in their lifetime. The American Cancer Society estimates that in 2021, there will be 281,550 new cases of invasive breast cancer diagnosed in women in the United States, along with 49,290 new cases of noninvasive breast cancer.
While all women are at risk for breast cancer, some may be at a higher risk. Understanding your personal risk can provide crucial information and help determine next steps about screenings and ways to help reduce your risk.
What Are the Risk Factors?
The main risk factors for breast cancer include being a woman and getting older, according to the Centers for Disease Control and Prevention (CDC). But having a risk factor does not mean you will get the disease. Some women with no other risk factors will get breast cancer.
It’s important to note that breast cancer is not a disease that occurs only in women. Men also are born with a small amount of breast tissue. About one in 100 breast cancer cases in the U.S. is found in a man, according to the CDC.
According to Emilia Diego, MD, co-director of the UPMC Magee-Womens Breast Cancer Program and section chief for breast surgery at UPMC, there are two categories of breast cancer risk factors: those you cannot change and those you can.
“There are some risk factors that we don’t have control over. But we know these factors might increase the risk for breast cancer, and it’s important to be aware of these factors in general,” says Dr. Diego. “There is another group of risk factors, often called lifestyle choices, that we can change to help reduce breast cancer risk.”
Risk Factors You Cannot Change
- Gender assigned at birth. Women are at a higher risk for breast cancer than men, though men can develop breast cancer.
- Genetics. The genes you inherit from your parents and grandparents may put you at a higher risk of breast cancer.
- Family history. A woman’s risk for breast cancer is higher if she has a first-degree relative (mother, sister, or daughter) or any family members on either her maternal or paternal side who have had breast or ovarian cancer. Having a first-degree male relative with breast cancer also raises a woman’s risk.
- Personal history. Women who have had breast cancer may have a slightly higher risk of developing it a second time compared to a woman who has never had breast cancer. Some noncancerous breast diseases, such as atypical hyperplasia or lobular carcinoma in situ, are associated with a higher risk of breast cancer.
- Age. The risk for breast cancer increases with age; most breast cancers are diagnosed after age 50.
- Race. White women are slightly more likely to develop breast cancer than Black, Hispanic, and Asian women. But Black women are more likely to be diagnosed at a young age with a more aggressive, advanced-stage breast cancer.
- Reproductive history. Starting menstrual periods before age 12 and menopause after age 55 expose women to hormones longer, raising their risk.
- Dense breast tissue. Women with dense breasts are more likely to get breast cancer. Dense breasts have more connective tissue, which can sometimes make it hard to see tumors on a mammogram.
- Previous breast radiation. Women who have had radiation therapy to the chest or breasts before age 30 have a higher risk of getting breast cancer later in life.
Risk Factors You Can Change
- Reproductive history. Having your first pregnancy after age 30, not breastfeeding, and never having a full-term pregnancy can raise breast cancer risk. Breastfeeding can lower breast cancer risk, especially if a woman breastfeeds for longer than one year.
- Taking hormones. Some forms of hormone replacement therapy (those that include both estrogen and progesterone) during menopause can raise your risk for breast cancer when taken for more than five years. Certain oral contraceptives (birth control pills) have been found to increase breast cancer risk.
- Alcohol consumption. Studies show that a woman’s risk for breast cancer increases with the more alcohol she drinks.
- Being overweight or obese. Overweight and obese women have a higher risk for breast cancer compared to women who maintain a healthy weight, especially after menopause. Being overweight also can increase the risk of breast cancer recurring in women who have had the disease.
- Lack of exercise. Women who are not physically active have a higher risk of getting breast cancer.
- Smoking. Smoking causes many diseases and is linked to a higher risk of breast cancer in younger, premenopausal women. Research shows there may be a link between heavy second-hand smoke exposure and breast cancer risk in postmenopausal women.
BRCA Gene Mutations
BRCA is an abbreviation for BReast CAncer gene. BRCA1 and BRCA2 are different genes that can impact your chance of developing breast cancer.
Every human has the BRCA1 and BRCA2 genes. In their normal state, the BRCA1 and BRCA2 genes are tumor suppressor genes that help prevent tumors from forming in your body. However, when these genes don’t work properly, tumors can form.
“Having even one copy of a mutated gene, or what we will call a faulty or misbehaving BRCA1 or BRCA2 gene, can appear to confer up to an 80% chance of developing breast cancer in somebody’s lifetime,” says Dr. Diego.
Women with a mutated BRCA1 gene have a breast cancer risk of 55 to 65% and tend to develop breast cancer at an earlier age — even in someone younger than age 40. Women with a BRCA2 mutation have about a 45% breast cancer risk. Someone without BRCA gene mutations has only has a 12% lifetime risk of developing breast cancer.
“It’s important to note that only about 5 to 10% of breast cancer diagnoses are actually linked to gene mutations. That still means that 90% of the time, we are not able to identify a gene that caused breast cancer for most women,” says Dr. Diego. “It’s also important to know that both men and women can carry mutations in the breast cancer genes. Being a man doesn’t prevent you from being able to pass on BRCA1 or BRCA2 gene mutations to your children.”
Regular screenings and other forms of early detection are some of the best ways to increase your chances of surviving breast cancer. Knowing your risk(s) for breast cancer can inform the type of screening you may need, as well as how often that screening is necessary.
“When we talk about screening for breast cancer, a clinical breast exam by a doctor or an advanced practice provider is very important. Those should be done at least once a year,” says Dr. Diego. “While we usually recommend women start to have mammograms at age 40, you should have a conversation with your doctor about when the right time is for you.”
Sometimes women need other tests in addition to their mammogram, such as an ultrasound or MRI. For women and men with breast cancer or other breast problems, UPMC offers a number of convenient locations, including the new Magee-Womens Surgical Associates at UPMC St. Margaret.
The facility is open on the second and fourth Tuesday of each month from 8:30 a.m. to 2:30 p.m. To make an appointment, call 412-641-4274 and select option #1.
Magee-Womens Surgical Associates at UPMC St. Margaret is one of many expanded services UPMC offers residents in the Allegheny-Kiski Valley region.