Breast cancer risks, a London specialist writes

Many women in London agonise over the questions; am I at risk of getting breast cancerAbnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body., what are my chances of getting breast cancer? Professor Kefah Mokbel, Consultant Breast Surgeon at St. George’s and The Princess Grace Hospitals in London has written extensively about the topic.

Here he sets out the risks. This piece should be read in conjunction with How Can I Reduce the Risk of Breast Cancer?

Age.

The risk of developing breast cancer increases significantly with age; an average European woman aged 25 years has a 1 in 15000 chance of developing breast cancer; for a 50-year-old woman the chance is 1 in 50, and at the age of 80 years the chance is 1 in 11.

Family History.

It is thought that up to 5% of all breast cancers are inherited due to the presence of abnormal genes passed on from mother to daughter. Having a first-degree relative (such as a sister or mother) with breast cancer will increase your chance of developing the disease.

A significant family history of prostateA gland that surrounds the urethra near the bladder. It produces a fluid that forms part of the semen. cancer is also associated with an increased risk of breast cancer.

Hormonal Risk Factors

Starting Periods before the Age of 11 Years

Women who have a history of starting their periods before the age of 11 years have a higher chance of developing breast cancer. This is thought to be due to their longer exposure to the female sex hormoneA substance produced by a gland in one part of the body and carried by the blood to the organs or tissues where it has an effect. oestrogenA hormone involved in female sexual development, produced by the ovaries., which is an established risk factor for breast cancer.

Later Pregnancy

The risk of developing breast cancer increases by 5% for each year of delay in having the first full-term pregnancythe period from conception to birth. Women who have their first child before the age of 30 years have a lower risk of developing breast cancer than those whose first pregnancy occurs after the age of 35 years. Recent research indicates that breast-feeding also reduces the risk of developing breast cancer.

Later Menopause

The average age of a woman upon reaching the menopauseThe time of a woman’s life when her ovaries stop releasing an egg (ovum) on a monthly cycle. in Western Europe is 50 years. Women who reach the menopauseThe time when a woman's periods permanently cease. after the age of 53 years have a higher chance of developing breast cancer. Delayed menopause prolongs a women's exposure to oestrogen – in the same way as starting periods before the age of 11 years.

The Oral Contraceptive Pill

Taking an oral contraceptiveA term used to describe something that prevents pregnancy. pill which contains oestrogen within the previous 10 years slightly increases the chance of developing breast cancer.  However, breast cancer that develops in contraceptive pill users seems to be less advanced than in non-users.

Hormone Replacement Therapy (HRTAbbreviation for hormone replacement therapy, the administration of female hormones in cases where they are not sufficiently produced by the body.)

Taking HRT after the menopause seems to increase the risk of developing breast cancer, especially if it is continued for more than 10 years. HRT, however, reduces the risk of brittle-bone disease (osteoporosisA condition resulting in brittle bones due to loss of bony tissue.), bone fractures and large bowelA common name for the large and/or small intestines. cancer. It also improves the symptoms of the menopause, such as vaginal dryness, hot flushes and depressionFeelings of sadness, hopelessness and a loss of interest in life, combined with a sense of reduced emotional well-being. It is currently thought that HRT should be avoided where possible in women with a personal or a significant family history of breast cancer.

Lifestyle Risk Factors

Obesity

Obesity after the menopause increases the risk of breast cancer in women. In post-menopausalAfter the menopause - technically only once a woman has had no menstrual period for one year. women the body fatOne of the three main food constituents (with carbohydrate and protein), and the main form in which energy is stored in the body. is the main source of oestrogen production; so obese women will have more oestrogen on board, thus increasing their breast cancer risk.

Diet

It is thought that a high intake of saturated animal fats and red meat (especially if overcooked) increases the risk of developing breast cancer.

Alcohol Consumption

Recent evidence suggests that excessive alcohol intake increases the likelihood of breast cancer. The risk seems to increase with all types of alcoholic drinks.

Smoking

There is increasing evidence that both active and passive smoking increase the risk of breast cancer especially in women younger than 50 years.

Other Risk Factors

Previous Benign Breast Biopsy

The presence of certain microscopic features in a breast biopsyThe removal of a small sample of cells or tissue so that it may be examined under a microscope. The term may also refer to the tissue sample itself. is associated with a higher risk. For example, the risk is increased by 4-5 times if a condition known as atypical epithelial hyperplasia is found in the breast biopsy.

Mammographic Density

Mammographic density in 75% or more of the breast is associated with an almost fivefold increased risk of breast cancer, and this risk persists for an extended period of time. In addition, for women with extensively dense breasts, the masking effect of dense breast tissueA group of cells with a similar structure and a specialised function. increases the odds more than 17 times of a cancer being missed and then detected by non-screeningA way to identify people who may have a certain condition, among a group of people who may or may not seem to methods. In such cases the addition of ultrasound scanThe process of using high-frequency sound waves to produce internal images of the body. and MRIAn abbreviation for magnetic resonance imaging, a technique for imaging the body that uses electromagnetic waves and a strong magnetic field. imaging to digital mammographyA diagnostic and screening test using low-dose X-rays to detect breast tumours should be considered.