Breast Cancer Risk and Prevention – Doctors Advice
ARE YOU AT RISK OF SUFFERING FROM BREAST CANCER?Breast cancer is the most common form of cancer in women. It is therefore not surprising that women will want to know and understand their risks of getting breast cancer in their lifetime. Below are 10 of the most common queries regarding breast cancer risks posted by patients? This discussion is intended to provide an overall understanding of breast cancer risks.
Are Asian women at a higher risk of getting breast cancer compared to Western women?Caucasians have a higher chance of developing breast cancer compared to women of other races or ethnic groups, but under the age of 40, African American women seem to have a higher incidence of breast cancer. A recent study observed that 51 percent of Asian women with breast cancer were diagnosed before the age of 50. In comparison, the number of breast cancer incidences recorded among Western women before the age of 50 was 23 percent. This essentially means that in our region, we may have to be made more aware of the problem of breast cancer at an earlier age. The possibility of earlier screening and its benefits need to be explored. The exact reason for such a difference in age distribution has not been fully understood and may need further research.
What are the common risk factors which may be associated with breast cancer?Generally, breast cancer incidence increases with age and mainly affects women.The incidence of breast cancer varies inter-racially, and it may be related to differences in lifestyles and socio-economic status.Different types of benign breast diseases may give rise to certain risks to develop breast cancer.
- Personal history of breast cancer
- Lifestyle and dietary factors
- Reproductive and hormonal factors
- Family history of breast cancer and genetic factor (BRCA1 and BRCA2)
- Exposure of high doses of ionizing radiation
- Exposure of certain environmental factors and smoking
Can we determine our risk of getting breast cancer with more accuracy?One way of estimating (calculating) breast cancer risks is to collect information about the subject and analyze the information: her age, age at first period, age at the time of the birth of her first child, family history of breast cancer, number of past breast biopsies, number of breast biopsies showing atypical hyperplasia (a form of non-malignant breast disorder), and race / ethnicity. This method of estimation does not actually calculate individual risk, but risk of a group of women with similar risk factors. The results of this calculation will be interpreted and the patient given information with regards to possible steps to be taken to reduce her risks.
If I have a close family member who is currently suffering from breast cancer, am I at risk?You will be considered to be at high risk of getting breast cancer, if you have 2 or more close relatives with breast or ovarian cancer, especially if 1 or more of the relatives (brothers, sisters, parents and their relatives) were diagnosed with cancer before they turned 50. Mutations in the BRCA1 and BRCA2 genes contribute to the majority of hereditary breast and ovarian cancers. However, many women who are unaffected by such mutations tend to overestimate their own risk of developing brest cancer based on such mutations of genes discovered in the family.
Since I do not have any family member suffering from breast cancer, do I still need to worry about this problem?In our community, women often wrongly believe that breast cancer usually runs in the family. And based on their belief, they assume that there is no reason to go for breasts screening should there be no family history of breast cancer. In fact, the majority of women with breast cancer never had a close family member who had suffered from it. It is not common to inherit the breast cancer genes, BRCA1 and BRCA2, and at least 95% of women with breast cancers do not have the genes in them.
Is it true that if a woman had previously suffered from benign breast lumps, she will have a higher risk of getting breast cancer?‘Breast lump’ is just a general term to describe the presence of a ‘lump’ in the breast and by itself does not describe a disease. Therefore a lump may consist of tissue with cancer cell, pre-cancer cells or totally benign (non-cancer) contents. So if you have been found to have a breast lump, it is important to know the exact nature of the cells, even if it is benign. Different types of benign tumors may have different potential to mutate to cancer. Many other benign tumors practically have very little cancer risk such as simple cyst and fibroadenoma.
Can the x-ray from mammograms actually cause harm to the breasts and body?Radiation in large doses is harmful. In low controlled levels, however, it can be very useful, especially in the detection of diseases in the body and fighting against cancer. The dosage of x-ray in mammogram is very low, but it can detect various types of breast cancers and pre-cancers long before the cancer can be detected by hand. The benefits of using mammogram to diagnose breast cancer while the disease is at an early stage will outweigh the risks of minimal exposure of the breast to x-rays. It is important to understand this before one makes the choice of not having a mammogram for cancer detection.
Is it sufficient just to perform Breast Self Examination to detect breast cancer?Breast Self Examination (BSE) was initially thought to be reliable for women to discover a breast lump. Some types of lumps may not even be cancer. If the lumps happen to be small, soft and deep inside the breast, it is unlikely to be felt by hand. Many forms of breast cancers can only be felt by the hand after enlarging over several years. Women are encouraged to understand the limited role of BSE. Women are encouraged to perform BSE as part of their on-going breast care, on top of their yearly breast screening appointments.
Which type of benign breast lumps may indicate future potential to develop breast cancer?Certain forms of non-malignant breast disorders when present may actually indicate an increase in the risk of breast cancer in the future. When diagnosed to have Lobular Carcinoma-in-situ (LCIS), the patient is not suffering from breast carcinoma, despite the use of the word. The presence of these cells actually indicate that the patient may be 7 to 12 times more likely to develop breast cancer in either breasts compared to another woman who has no LCIS. Many more benign breast conditions which present no immediate danger to the patients may indicate different risks of future breast cancer development.
To understand more about the risks of breast cancer, and how you can try to minimize them?
- Get an evaluation on your personal risks of breast cancer.
- Find out if there is a history of breast and ovarian cancers in your family.
- Consider breast screening and find out how it can help you to minimize your risks.
- Understand the changes in your breasts which may indicate the beginning or presence of breast cancer.
- Understand the elements of a healthy lifestyle which may minimize your risks.
Dr. Chong Seng Fook
M.D., FRCS (Glasg.), AM(Mal.), Fellow in Surgical Oncology(NCCS)
LohGuanLye Specialists Centre