Risk Factors:

• Age: Risk increases gradually with age.
• Personal History: Women with breast cancer are more likely to develop a second breast cancer.
• Family History: Mother, sister, and/or daughter with breast cancer.
• Abnormal biopsy: Atypical hyperplasia or lobular carcinoma in situ.
• Genes: BRCA1, BRCA2, others;(rare and account 10% of all breast cancers).
• Reproductive History:
  • First child at older age
  • Menstruation started at 11 or younger
  • Menopause after 55
  • Never had children
• Hormone replacement therapy: Taken for long time
• Increased breast density: On mammogram
• Radiation therapy: To the chest before age 30
• Lifestyle: Obesity and weight gain after menopause; alcohol consumption.

Actual Risk:

• From age 20-30. . . 1 out of 2,000
• From age 30-40. . . 1 out of 250
• From age 40-50. . . 1 out of 67
• From age 50-60. . . 1 out of 35
• From age 60-70. . . 1 out of 28
• Ever . . . .. . . . 1 out of 8

Detection: Mammogram AND clinical breast exam done by a health care provider. Some cancers, undetectable by mammogram, may be palpable on breast examination. And mammograms can detect some breast cancers that cannot be felt.

Mammograms: False Negatives: Mammograms miss up to 20 percent of breast cancers.

False Positives: False positives occur when mammograms are read by a radiologist as abnormal, but no cancer is actually present. Most abnormalities turn out not to be cancer.

Screening: The National Cancer Institute (NCI) recommends that:

• Women in their 40s and older should have mammograms every 1 to 2 years.
• Women who are at higher than average risk of breast cancer should talk with their health care providers about whether to have mammograms before age 40 and how often to have them.

Prevention: In women who are at increased risk, tamoxifen has been shown to decrease risk. Other medications, such as raloxifene (Evista) are currently under study. Also, studies are evaluating how modification in diet, physical activity, nutrition, and environmental factors could lead to new prevention strategies.

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