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Risk

Risk indicates the probability of occurrence of any condition or disease and can be presented in different modes. Generally health care professionals and mass media categorize risks in two ways as relative risk and absolute risk.

Relative risk: It is the probability of certain happening to people exposed to a particular risk, as compared to those not subjected to that risk. In term of numbers, relative risk reveals that by doing something, such as taking a pill, can change your risk compared to your risk without taking that pill. Relative risk can be expressed both in percentages and in “hazard ratios”.

In case you do nothing new, your hazard ratio is 1.0 – this means that your risk doesn’t change. If you do something and your risk decreases by half, or goes down to 0.5, then you are half as likely to have the risk. But if your risk goes up, from 1.0 to 1.78, then you are 78% more likely to encounter the risk. If your risk goes up to 4.0, then you have a fourfold (400%) increased risk of having the problem.

Absolute risk: It is the chances of exact happening to a specific person over a period of time. Absolute risk is the extent of your own risk. Absolute risk reduction is the number of percentage or points by which your own risk changes if you do something, like taking a pill. The extent of your absolute risk reduction depends on what your risk is to begin with.

The factors that can increase or decrease your risk for breast cancer are considered important. It is equally important to know the quantity of impact of a certain factor (in % or numbers) on your risk for breast cancer. Knowing the exact amount of change in risk with lifestyle modifications helps your doctor to make accurate treatment decisions for a particular patient.

Risk Factors

Generally it is very difficult to determine the exact cause for the development of breast cancer in an individual. However it seems that certain characteristic features that are commonly seen in breast cancer patients may be involved in the development of breast cancer. These features are called risk factors and can be categorized on the following basis:

  • Individual characteristics
  • Family history
  • Individual breast factors
  • Hormones and menstrual history
  • Lifestyle & health

Women having certain risk factors have increased chances of developing breast cancer. However, having one or more risk factors for breast cancer does not indicate that you will surely get breast cancer. The common risk factors for developing breast cancer are increasing age, family history, obesity, alcohol consumption, sedentary lifestyle, and other environmental factors.

Some factors are beyond our control whereas others factors need to be addressed. It is also seen that many women develop breast cancer but lack any risk factors. Alternatively there are certain factors that provide a protective effect against breast cancer such as bearing children at an early age and breastfeeding. Conversely, it is even possible that women with protective factors may still develop breast cancer.

Individual characteristics

The risks factors related to individual characteristics include:

  • Gender: Women have 100 times more chances of having breast cancer compared to men
  • Age: Advanced age is one of the important factors related with breast cancer. Breast cancer is more frequent in women after 50 years of age
  • Height: Taller women (175cm or above) have slightly more risk of developing breast cancer
  • Weight: The risk associated with weight depends upon the pre- and post-menopausal phase of a woman. Before menopause, overweight women have less chances of breast cancer than lean women whereas reverse is true in case of post-menopause phase.
  • Affluence: It may influence your lifestyle habits that can increase your risk for breast cancer
  • Alcohol Consumption: Alcohol consumption in women may increase the risk of breast cancer
  • Hodgkin’s Disease: This specific condition increases chance of breast cancer as a result of treatment with radiotherapy or chemotherapy
  • High exposure to harmful ionizing radiation
  • Regular Physical Activity: It reduces the risk of breast cancer
  • Child-Bearing: Women becoming pregnant at early age (less than 30 years) reduce their risk of developing breast cancer
  • Breast Feeding: Women who breast feed for 12 or more months may slightly reduce their risk of breast cancer

Family history

The risks factors related to family history of breast cancer include:

  • The significance of family history of developing breast cancer considers the number and ages of the affected members, along with how close the relationship of the individual is with the affected member
  • Family history of both paternal and maternal side are equally important
  • Risk increases if two or more relatives were diagnosed with breast cancer before the age of 50 years. Although risk is there, many of these women never develop breast cancer. Even though family history is considered as important risk factor, 8 out of 9 women having breast cancer do not have an affected mother, sister, or daughter.
  • In some cases, faulty genes may be involved in developing breast cancer, called hereditary cancer. The faulty gene arises due to abnormal mutation in the genetic map that gets transferred to the next generation. There are various illustrious gene mutations; the most common mutation is seen in BRCA1 and BRCA2 gene. These genes generally prevent breast cancer, but mutation in these genes conversely increases the risk of developing breast cancer.

Individual breast factors

The risk factors associated with characteristic features of individual breast include:

  • Previous diagnosed conditions: The non-invasive breast condition such as ductal carcinoma in situ (DCIS) or lobular carcinoma in situ (LCIS) may increase risk of breast cancer.
  • Breast Density: Women with dense breasts have higher chances of getting breast cancer. The density of breasts can be measured on a mammogram, as high dense breast appears as white cotton wool whereas less dense breast appears grey and transparent. One cannot measure breast density simply by physical examination and usually women of same age may have different breast densities. It is observed that breast density decreases with advanced age and after menopause.

Common Misconceptions

There are a number of “myths” about various risk factors that may cause breast cancer but usually such risk factors lack scientific data to support them. Some of the common myths related to risk of breast cancer include:

  • The use of antiperspirants produce toxins in the lymph glands of the armpit, which then cause cancer in the breast tissue
  • Wearing tight-fitting bras constrict the lymph system, causing toxins to accumulate in the breasts that cause breast cancer.
  • A blow or injury to the breast may damage blood vessels that induces breast cancer
  • Drinking milk may increase estrogen release that induces breast cancer
  • Having silicone breast implants may increase risk of breast cancer. Although it is proved through clinical studies that such implants are very safe and even reduce risk of breast cancer.
  • Having a mammogram or long exposure to ionization radiations induces breast cancer.

The origin of most myths is unknown, but Internet media is involved in the spreading of the misinformation. It is natural as most of us want to know the exact cause for the development of breast cancer for them or for their loved ones. Many myths also seem to be attractive as they provide quick actions to reduce the risk factors of breast cancer.

How to Distinguish Fact from Fiction

It is difficult to distinguish fact from fiction or myth from reality, unless or until you are an expert in science and medicine field. Make sure to discuss any concerns you have about your risks for developing breast cancer with your physician.