Breast Cancer Risk Factors
Family history of breast cancer, ovarian cancer, or other hereditary breast and ovarian syndrome- associated cancer
Known deleterious gene mutation
Prior breast biopsy with specific pathology
Atypical hyperplasia
Lobular carcinoma in situ
Prolonged interval between menarche and first pregnancy
Menopausal hormone therapy with estrogen and progestin
Not breastfeeding
Certain ethnicities
Higher body mass index
Prior exposure to high-dose therapeutic chest irradiation in young women
What Is The Outlook
The outlook has greatly improved in recent years. Deaths from breast cancer are now at the lowest ever in 40 years. This is mainly due to the improvements in the treatment of breast cancer. The outlook is best in those who are diagnosed when the cancer is still small and has not spread. More breast cancers are also now being diagnosed and treated at an early stage. In general, the more advanced the cancer then the less chance that treatment will be curative.
The treatment of cancer is a developing area of medicine. New treatments continue to be developed and the information on outlook above is very general. The specialist who knows your case can give more accurate information about your particular outlook and how well your type and stage of cancer is likely to respond to treatment.
Example Of The Impact Of A Relative Risk
Using our example of the exercise study above, we can show how absolute risks affect the number of extra cases.
Inactive women have a 25 percent higher risk of breast cancer than active women .
Since older women are more likely to get breast cancer, a lack of exercise has a greater impact on breast cancer risk in older women than in younger women.
First, lets look at the women in the study ages 70-74 years.
The study finds 500 women per 100,000 who are inactive develop breast cancer in one year. This is the absolute risk for women with the risk factor, lack of exercise.
The study also shows 400 women per 100,000 who are active develop breast cancer in one year. This is the absolute risk for women without the risk factor.
The relative risk is 1.25 for women who are inactive compared to those who are active.
Among women ages 70-74, being inactive led to 100 more cases of breast cancer per 100,000 women in one year .
Now lets look at the women in the study ages 20-29.
The study finds 5 women per 100,000 who were inactive developed breast cancer in one year. And, 4 women per 100,000 who were active got breast cancer.
Here again, the relative risk is 1.25.
However, in women ages 20-29, being inactive led to only 1 extra case of breast cancer per 100,000 women .
So, the same relative risk of 1.25 led to many more extra cases of breast cancer in the older women than in the younger women .
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What Is Invasive Breast Cancer
Most breast cancers are diagnosed when a tumour has grown from within a duct or lobule into the surrounding breast tissue. These are called invasive breast cancers:
- Invasive ductal breast cancers begin in one of the ducts of the breast . They account for as many of 8 in 10 of breast cancer cases.
- Invasive lobular breast cancers begins in one of the lobes of the breast. They account for about 1 in 10 of invasive breast cancers.
Invasive breast cancers are also divided into those where cancer cells have invaded into local blood or lymphatic vessels and those that have not. Invasive breast cancer is able to spread outside the breast.
Practical Problems Abound For Young Breast Cancer Patients
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In May, Elizabeth Bryndza, a 19-year-old sophomore at the College of New Jersey, underwent a bilateral mastectomy to remove both breasts. Two weeks before, she had found a lump of cancerous cells in her right breast.
“I never thought that I wouldn’t survive it,” said Bryndza, now 20. “I’m still going to be me, and I’ll fight as hard as I can.”
But there are practical problems that make younger women more vulnerable than older women to the challenges of a breast cancer diagnosis.
Young women are more likely to be treated aggressively for breast cancer than older women because, since they’ve rarely had regular screenings or mammograms, they are less likely to detect early-stage tumors. Young age is an independent risk factor for recurrent cancer, regardless of a family history of cancer, or a genetic predisposition to have BRCA gene mutations.
And since doctors see so few young women with breast cancer, there is a gap in research about fertility, early-onset menopause and other effects of diagnosis, treatment and outcomes in young women.
Young Women Feel More Invincible in the Face of Cancer
Chemotherapy may affect a young woman in many ways, including her ability to have children in the future. But for teenagers, concerns such as body image, sexuality, beauty and peers loom larger.
“At that time, as a teen, you think you’re invincible,” Bryndza said. “I sort of saw the whole thing as a big inconvenience.”
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Relative Risks Greater Than 1
A relative risk between 1 and 1.99 may be presented in several ways.
For example, in the exercise study above, the relative risk was 1.25.
You may see:
- Inactive women have a relative risk of 1.25 compared to active women.
- Inactive women have a 25 percent higher risk of breast cancer compared to active women.
- Inactive women have a 1.25-fold increased risk of breast cancer compared to active women.
When a relative risk is 2 or more, its often presented as the number of times the risk is increased.
For example, women with atypical hyperplasia have a relative risk of about 4 compared to women without atypical hyperplasia.
You may see:
- Women with atypical hyperplasia have 4 times the risk of breast cancer of women without atypical hyperplasia.
- Theres a 4-fold increase in the risk of breast cancer among women with atypical hyperplasia compared to women without atypical hyperplasia.
What Is The Chance I Could Die In The Next 5 Years
The average 5-year survival rate for all people with breast cancer is 89%. The 10-year rate is 83%, and the 15-year rate is 78%. If the cancer is located only in the breast , the 5-year survival rate is 99%. More than 70% of breast cancers are diagnosed at an Early Stage.
All survival statistics are primarily based on the stage of breast cancer when diagnosed. Some of the other important factors are also listed below that affect survival.
Stage 0 breast cancer can be also described as a pre-cancer. If you have DCIS you can be quite confident you will do well. DCIS does not spread to other organs. What can be concerning is when an invasive cancer grows back in the area of a prior lumpectomy for DCIS. This type of local recurrence does carry a risk to your life. Luckily, this does not happen frequently. Also, be aware that those who have had DCIS in the past are at a higher risk for developing an entirely new, invasive breast cancer. Take our video lesson on Non-Invasive DCIS to learn more.
Stage I invasive breast cancer has an excellent survival rate. The chance of dying of Stage I breast cancer within five years of diagnosis is 1 to 5% if you pursue recommended treatments.
Stage II breast cancer is also considered an early stage of breast cancer. There is a slightly increased risk to your life versus a Stage I breast cancer. Altogether, the risk of Stage II breast cancer threatening your life in the next 5 years is about 15%.
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Premenstrual Breast Pain And Swelling
- Main Symptom: breast fullness and pain.
- Cause: extra body fluid from female hormone cycles.
- Other symptoms: headache, swollen feet .
- Timing: mainly noticed in the week prior to menstrual periods.
- Course: improves during menstrual period and goes away between menstrual periods.
- Physical Findings: fullness that can be felt throughout both breasts.
- Onset: usually 2 years after onset of periods . Similar onset as for menstrual cramps.
- Frequency: 10% of teens and 50% of adult women.
- Treatment: mainly ibuprofen and support bra. If breast pain can’t be controlled with ibuprofen, 80% can be improved by birth control pills.
- Other treatments: daily exercise and getting enough sleep.
Relative Risks Less Than 1
A relative risk less than 1 means the risk factor lowers the risk of disease.
For example, women who breastfeed for a year have a relative risk of breast cancer of about 0.94 compared to women who dont breastfeed.
You may see:
- Women who breastfeed have a 6 percent lower risk of breast cancer compared to women who dont breastfeed.
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How Is Breast Cancer Treated
Treatment for breast cancer usually depends on the type of cancer and whether the cancer has spread outside of the breast to other parts of the body.
Here are some common treatments:
- lumpectomy , which removes the cancerous tumor from the breast. A woman usually has this surgery when the cancer is found early and when the lump is small and in only one part of the breast.
- mastectomy , which removes the whole breast. This surgery is done when cancer cells have spread through the breast or into other parts of the body. It’s a good way to remove all or most of the cancer, and can help prevent the cancer from spreading or coming back. Sometimes, a woman who has a mastectomy may choose to have an operation to reconstruct the breast, so her shape will be more like it was before.
- radiation therapy and chemotherapy, which are often used after lumpectomy or mastectomy to make sure that all the cancer cells are destroyed and do not grow back. Radiation therapy uses high-energy X-rays to kill the cancerous cells. Chemotherapy , or chemo, is special medicine that travels throughout the entire body and kills cancer cells.
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What Causes Breast Cancer In Your 20s And 30s
Breast cancer happens when cells in the breast begin to grow and multiply abnormally. Changes in DNA can cause normal breast cells to become abnormal.
The exact reason why normal cells turn into cancer is unclear, but researchers know that hormones, environmental factors, and genetics each play a role.
Roughly 5 to 10 percent of breast cancers are linked to inherited gene mutations. The most well-known are breast cancer gene 1 and breast cancer gene 2 . If you have a family history of breast or ovarian cancer, your doctor may suggest testing your blood for these specific mutations.
Breast cancer in your 20s and 30s has been found to differ biologically in some cases from the cancers found in older women. For example, younger women are more likely to be diagnosed with triple negative and HER2-positive breast cancers than older women.
Here are some statistics about breast cancer in women under 40:
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More Information About The Tnm Staging System
The T category describes the original tumor:
- TX means the tumor can’t be assessed.
- T0 means there isn’t any evidence of the primary tumor.
- Tis means the cancer is “in situ” .
- T1, T2, T3, T4: These numbers are based on the size of the tumor and the extent to which it has grown into neighboring breast tissue. The higher the T number, the larger the tumor and/or the more it may have grown into the breast tissue.
The N category describes whether or not the cancer has reached nearby lymph nodes:
- NX means the nearby lymph nodes can’t be assessed, for example, if they were previously removed.
- N0 means nearby lymph nodes do not contain cancer.
- N1, N2, N3: These numbers are based on the number of lymph nodes involved and how much cancer is found in them. The higher the N number, the greater the extent of the lymph node involvement.
The M category tells whether or not there is evidence that the cancer has traveled to other parts of the body:
- MX means metastasis can’t be assessed.
- M0 means there is no distant metastasis.
- M1 means that distant metastasis is present.
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- Other breast lumps
- Could be pregnant
- Change in shape or appearance of breast
- Nipple discharge that is clear or milky
- Breast pain and cause is unknown. Exception: continue if only occurs before menstrual periods or with vigorous exercise.
- Age 13 or older with no breast buds or breast tissue
- You have other questions or concerns
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Causes Of Breast Cancer
No one knows the exact cause of breast cancer, but there are known risk factors such as:
- Changes to your genes: Known as genetic mutations
- Family history of breast cancer: If your mother or grandmother had breast cancer, you might be terrified you will get it too. But only about 5% to 10% of people diagnosed with breast cancer have a family history of this disease.
- More dense breasts: Breasts with higher amounts of connective tissue vs. fat can mask cancers.
- Personal history of cancer
- Prior exposure to radiation: Young women who have had radiation therapy for another condition, like Hodgkin lymphoma, are especially at high risk.
- Smoking
- Obesity: Being overweight or obese heightens the risk of breast cancer after menopause.
- Sedentary lifestyle
Some factors like smoking, obesity, and alcohol use are preventable factors, while others like older age and genetics are out of your control.
Relative Risks In Research
You can put your knowledge of relative risks to work right away.
Our Breast Cancer Research Studies section has research summary tables on topics ranging from risk factors to treatment to social support.
These tables show research behind many recommendations and standards of care related to breast cancer discussed in this section.
If you dont know how the research process works , our How to read a research table section is a good place to start before looking at the tables.
Learn more about breast cancer research.
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Can Breast Cancer Be Prevented
A lot of breast cancers are detected at an early stage, by breast screening. However, a small number are not. Some women may have developed breast cancer before they have their first mammogram and some may develop breast cancer between mammograms. All women of every age should be breast aware. That is, get to know how your breasts and nipples normally look and feel. Try to recognise any changes that occur before and after your periods. See your GP if you notice any changes, lumps, or other abnormalities in your breasts or nipples. Don’t wait until your next scheduled screening appointment.
There is some evidence that regular exercise may reduce your risk of breast cancer by as much as a third. If you have been through the menopause, it is particularly important you are not overweight or obese. This is because being overweight causes more oestrogen to be produced, which can increase the risk of breast cancer.
Studies have shown that women who breast-feed their children are less likely to develop breast cancer than those who do not. The most likely reason for this is that women do not produce an egg as regularly while they are breast-feeding and oestrogen levels remain stable.
Checking Yourself For Breast Cancer
Breast self-exams to check for lumps and other changes can help women detect the early signs of cancer.
Even more important than looking for specific changes is knowing how your breasts feel normally. A change in their shape or texture, a new lump, or other significant change could signal a problem, including cancer.
Women should also get regular breast exams from their doctor. Those at high risk of breast cancer may need annual mammograms, although teens almost never fall into this category.
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Why Do Girls Need Them
Most teens don’t need breast exams. That’s because it’s rare for girls to have breast problems. Doctors usually just look at a girl’s breasts during her yearly gyn checkup to see where she is in her development. But if you have a family history of breast problems, your doctor or nurse might give you a breast exam.
What Do Lumps In My Breast Mean
Many conditions can cause lumps in the breast, including cancer. But most breast lumps are caused by other medical conditions. The two most common causes of breast lumps are fibrocystic breast condition and cysts. Fibrocystic condition causes noncancerous changes in the breast that can make them lumpy, tender, and sore. Cysts are small fluid-filled sacs that can develop in the breast.
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Answer: Breast Reduction At 13 Years Of Age
It is possible to get a breast reduction at your age, however you need support from your parents. You also need to be aware of several things such as: you probably aren’t finished developing yet and may need additional surgery it the future, there will be scars, and it is possible you might have problems breastfeeding in the future. However, many young women suffer as you are and the tradeoffs are worth it to them. I recommend that you see a Board Certified Plastic Surgeon with one or both of your parents to find out what options are available to you. Good luck!