Breast cancer is the most commonly diagnosed cancer.
Breast Cancer Overview
Breast cancer is the most common cancer in Americans, after skin cancer. The average risk of a person developing breast cancer in their lifetime is about 1 in 8 people with ovaries (or 12%). Understanding the symptoms and screening recommendations for breast cancer may help detect the disease as early as possible for best outcomes. Knowing risk factors and healthy lifestyle behaviors may help in reducing the risk of developing breast cancer.
ABOUT BREAST CANCER
Breast cancers are cancers that start in one of several types of cells found in breast tissue. Most breast cancers are carcinomas, meaning that the tumor developed from a specific cell type called epithelial cells, but there are other breast cancer subtypes that develop from different kinds of breast cells.
Many, but not all, types of breast cancer form lumps, so it is important to get regular mammograms which can detect breast cancers that don’t form lumps as well as detect cancers at an earlier stage. Most breast lumps are benign (non-cancerous) and are therefore non-threatening, but all breast lumps should be checked by a healthcare professional
Through shared decision making, you and your healthcare provider will decide how often you should to the following and at what age. The current recommended screening for average-risk individuals is:
- Monthly breast self-awareness (check out if anything is new or different)
- Yearly clinical exams
- Mammograms every year or every other year, starting at age 40
Knowing if you’re at high risk is important as there are some additional screening options available. For breast cancer, those at high risk start having mammograms 10 years before the age their relative was diagnosed.
Having ovaries and getting older are the biggest risk factors for breast cancer, though younger individuals and men can also get breast cancer.
Certain individuals with a personal or family history of ovarian, breast, and other cancers may be at higher risk for ovarian, breast, and other types of cancers.
In some cases, mutations in known cancer-causing genes may have been identified by genetic testing. In other cases, there may be no known genetic mutation but the personal or family cancer history still renders the individual and their close relatives at higher risk for ovarian and breast cancer.
Identifying individuals who may have a known or unknown genetic predisposition to cancer is important for both prevention and early detection of cancer. Several United States medical and public health organizations provide guidelines to determine if someone may be at a higher risk for ovarian, breast, and other cancers due to familial or genetic factors. Individuals who may be at high risk should seek out a genetic counselor or other clinician with genetics training to undergo comprehensive risk assessment and genetic testing if warranted.
Below we provide a checklist to determine if an individual may be at higher cancer risk and should seek out genetic counseling. An important factor in determining personal ovarian and breast cancer genetic risk is knowing your family history.
If you or a close family member have had any of the following:
- Breast cancer at age ≤ 50
- Ovarian, fallopian tube, or primary peritoneal cancer at any age
- Relative with known mutation in a breast, ovarian, or other cancer susceptibility gene
- Two separate breast cancer diagnoses
- Breast cancer and ovarian, fallopian tube, or primary peritoneal cancer in the same person
- Male breast cancer
- Triple negative breast cancer at age ≤ 60
- Ashkenazi Jewish ancestry
- Pancreatic cancer
- Metastatic prostate cancer
- Prostate cancer with high grade (Gleason score ≥7) and Ashkenazi Jewish ancestry
If two or more members from the same side of your family have:
- Two or more separate breast cancers diagnoses
- Breast cancer and ovarian, fallopian tube, or primary peritoneal cancers
- Prostate cancer
- Pancreatic cancer
If three or more members from the same side of your family have:
- Been diagnosed with breast, ovarian, or other types of cancers
A higher number of ovulations in a lifetime are associated with a higher breast cancer risk. Several factors can impact the number of ovulations a person has, like age at menstruation and menopause, hormone-based birth control, an increased number of pregnancies, and breastfeeding (which stops some some people from ovulating).
Certain kinds of hormone replacement therapy (HRT) can impact the risk for ovarian cancer. HRT with estrogen alone increases the risk for ovarian cancer and HRT with estrogen and progesterone increases the risk of both breast and ovarian cancer. Anyone considering hormone-based birth control and HRT should have an open discussion with their physician about their personal and family health history to make a shared decision on whether HRT after menopause is right for them.
Dense breasts may be associated with a higher risk for breast cancer. Breast density is only seen on mammograms (it isn’t related to how firm breasts feel or their size). Dense breast tissue can make it harder to see cancer, so mammograms can be less accurate for women with dense breasts. People are notified if they have dense breast tissue after a mammogram.
Cancer risk is much smaller than that of age, family history, or genetic mutations, but the actual risk is still controversial — some studies show that very high breast density can increase risk from 2.5 to 6 times. Those with dense breasts should still have mammograms as most cancers can be seen on a mammogram. While MRI and ultrasound are other screening options, they have a high false positive rate, so tend to be only used in those at high-risk.
Hormone-based birth control can reduce the number of ovulations a person has in their lifetime, but can slightly increase one’s risk of breast cancer by 4-6%. This risk goes back down after use of the hormone-based birth control is discontinued.
These lifestyle choices have been scientifically shown to be associated with reduced cancer risk:
- Maintaining a healthy weight
- Eating a balanced diet with fruits and vegetables
- Being physically active — at least 30 minutes of exercise, 5 times per week
- Abstaining from tobacco — no form is safe
- Drinking alcohol in moderation — 1 drink/day for those with ovaries
1 in 8
with ovaries will
get breast cancer
50-85% higher risk of breast cancer
BRCA mutation carriers have a 50-85% risk of breast cancer, compared to 11% of the general population.
90% survival rate
The five-year survival rate for breast cancer is 90%.
Breast Cancer Survivor & Rivkin Education Team Member
“In the shower, my hand happened to graze against the side of my breast, and I felt a very distinct, hard lump that I somehow had never noticed before. In that moment, I knew. I knew exactly what it was, but I’d never expected to find breast cancer at 32 years old.”
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