Breast cancer is a global health problem, affecting millions of women around the world. In India alone, data from the World Health Organization’s GLOBOCAN 2022 database revealed more than 1.99 million new cases of breast cancer in 2022, and nearly 98,000 deaths. Despite being so common, many people still do not clearly understand what causes it and who is most at risk. The good news is that knowing the right information, early detection, and how to reduce our risk can save us lives. This guide Top Medical Oncologist, Dr. Ashok Vaidya and Dr. Chandragowda D. Provides information from A to Z to help you understand the risks of breast cancer.
Why Does Breast Cancer Occur
Cancer is not just a disease; It is a group of different diseases. Many types of cancer can occur in every organ. Doctors often say that there is no single cause of cancer, rather many factors work together. In fact, cancer begins with changes inside our body, such as mutations in our DNA. DNA is the blueprint for life, constantly making copies. Sometimes, mistakes are made during this copy making process. When these mistakes are not noticed, the cells start growing uncontrollably, leading to cancer.
Many things can impact these changes:
- Our genes: We get genes from our parents. Some genes can increase our chances of getting cancer.
- Environment: What we breathe, eat and drink may also play a role. This includes air pollution, pesticides and processed foods.
- Lifestyle: Our daily habits, diet, and how much we walk also matter.
Who Is At Higher Risk Of Breast Cancer
Although breast cancer is more common in women, it is important to understand that not all women are at the same risk. There is a higher chance of it happening in certain groups.
Age and family history
- Age: In women, the risk of breast cancer typically increases after age 40 or 50.
- Family history: If your mother, sister, or other close relatives have breast cancer, your risk may be higher. This often happens because of inherited genes. Doctors check for special genes named BRCA1 and BRCA2. These genes are usually involved in correcting bad DNA. If these get worse, the body cannot properly correct DNA mistakes, which can lead to cancer. These genes can be tested with a simple blood test, especially if the family history is strong.
Hormonal effects
Hormones play a big role in the risk of breast cancer in women. In particular, the female hormones estrogen and progesterone can affect breast tissue. The longer a woman’s body remains exposed to these hormones, the greater her risk may be.
Factors that increase exposure to hormones include:
- Early periods: Starting periods before age 12 means longer exposure to estrogen.
- Late menopause: If periods stop after age 55, it also means longer exposure.
- First pregnancy late or no pregnancy: Pregnancy can alter a woman’s hormonal balance, providing some protection. Having a first child after age 30 or never getting pregnant can increase the risk.
- Hormone replacement therapy (HRT): Certain types and combinations of HRT, especially if used long after menopause, can increase the risk.
However, doctors prescribe HRT only when necessary and for a specific period of time.
Lifestyle choices and health conditions
Your daily habits and overall health have a huge impact on your breast cancer risk.
- Weight: Overweight or obesity can cause hormonal changes that increase the risk of breast cancer. More fat cells can make more estrogen.
- Alcohol consumption: Now even small amounts of alcohol are considered unsafe in terms of cancer risk. Doctors used to say that a glass of wine can be good for the heart, but this idea is no longer supported to prevent cancer. No amount of alcohol is safe in terms of cancer risk; it can directly harm DNA.
- Tobacco consumption: Smoking or chewing tobacco has been linked to several cancers, including breast cancer. Quitting tobacco can significantly reduce your risk.
- Exercise: Regular physical activity helps maintain a healthy weight and overall can reduce cancer risk.
- Diet: Eating a balanced diet and limiting processed foods can overall support health and reduce cancer risk.
- Certain breast conditions: Certain non-cancerous (benign) breast conditions, such as certain types of lumps or dense breasts, may increase the risk in the future. It is very important to see a doctor for any new or unusual breast lump. Although breast pain is not usually a sign of early cancer, any persistent pain or changes should be checked by a doctor.
Environmental factors
The world around us also creates risks that we cannot always control. Includes:
- Air pollution: Contaminants in the air can affect our health.
- “Forever Chemicals”: Synthetic chemicals found in plastics can enter and stay in our bodies, because the body has no way to flush them out. Residues were found in breast tissue from previous use of pesticides such as DDT. These environmental toxins overall contribute to cancer risk.
Can Men Get Breast Cancer
Yes, men can also get breast cancer, although it is much less common than women. Although breast cancer is mostly associated with women, many people are surprised to know that men also have breast tissues and can develop cancer.
- Prevalence: About 0.5% to 1% of all breast cancer cases occur in men. About one in every 100 women with breast cancer has the disease.
- Why it’s less common in men: Women develop more breast tissue and have higher levels of estrogen and progesterone, which promote breast tissue growth and may increase the risk of cancer.
Causes in men:
- High levels of estrogen: If a man has higher than normal levels of estrogen, his risk increases.
- Liver failure: Conditions such as liver failure (from alcohol or hepatitis) can cause the body to convert excess testosterone into estrogen, increasing the risk. Studies in areas with high rates of hepatitis and liver failure, such as Tanzania, reveal higher rates of breast cancer in men.
- Testicular problems: Problems with the testicles, such as the testicles not coming down since childhood (cryptorchidism), can lower testosterone levels and increase estrogen levels, increasing the risk.
- Genetic conditions: A genetic condition called Klinefelter syndrome (XXY chromosome instead of XY) can increase estrogen levels in men and increase the risk of breast cancer.
It is important to note that “men’s breasts” (gynecomastia), which can develop during puberty or due to obesity, usually do not directly increase the risk of breast cancer, unless they are caused by underlying problems with the liver or testicles.
Non-Modifiable Vs Modifiable Risk Factors
Doctors divide the risk factors for breast cancer into two groups:
Non-modifiable risk factors (which you cannot change)
These are factors you can’t control, but knowing about them helps in screening and early detection.
- Age: Your age as you get older.
- Gender: Being female is a main risk factor.
- Ethnicity: Some ethnic groups have different risk profiles.
- Genetics: inherited genes like BRCA1 and BRCA2.
Modifiable risk factors (which you can change)
These are factors that you can influence with your lifestyle choices. Paying attention to these can reduce your risk significantly.
- Managing weight: Maintain healthy body weight through diet and exercise. Obesity is associated with about 20% of cancers.
- Physical activity: Do regular exercise. It not only helps in reducing weight but also reduces the risk of many other diseases.
- Healthy diet: Eat a balanced diet consisting of whole grains, and limit processed foods.
- Avoid alcohol: Stay away from alcohol altogether, as it is now classified as a cancer-causing agent.
- No tobacco: Do not use any tobacco (smoking, chewing). Tobacco is linked to more than a dozen types of cancer.
- Breastfeeding: If possible, breastfeeding protects against breast cancer due to hormonal changes that occur during this period.
Genetic Testing And Prevention
Genetic testing of genes such as BRCA1 and BRCA2 may be very important for people who have had the disease in their family history. If a woman tests positive for one of these bad jeans, her risk of getting breast cancer can be as high as 60-80%, and the risk of ovarian cancer can be 40-50%.
Genetic counseling is very important before testing. A counselor will explain its advantages and disadvantages, which will help people understand what positive results can mean for their future, especially if they are young and have not yet completed their family.
If a positive result occurs, the prevention methods are:
- Early screening: Women with BRCA gene mutations can start mammograms and second screenings much earlier than normal people (like, 10 years before the age their mother got the disease).
- Surgery to protect: After completing their family, some women choose to have surgery to protect, such as removing both breasts (mastectomy) and ovaries (oophorectomy). These surgeries can reduce the risk of breast cancer by 98% and also give great protection against ovarian cancer.
Conclusion
Breast cancer is a complex disease that has many causes. Although some risks, such as age and genetics, are beyond our control, many risks can be managed by making lifestyle changes. By making informed decisions about our diet, exercise, drinking alcohol and tobacco use, we can actively work to reduce our risk. Regular check-ups and understanding your family history are also important steps for early detection and prevention. The more we know, the better we will be able to save ourselves and our loved ones.
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