Can breast cancer risk be reduced?

Any factor that can increase the likelihood of developing a disease is considered a «risk factor». However, the presence of a risk factor does not necessarily mean that they will get the disease, it simply indicates an increased probability relative to other people in general. Knowing the risk factors also means knowing what can be done to reduce that risk.

Everyone has a risk of getting breast cancer

A person’s risk of breast cancer may be higher or lower depending on certain risk factors. Being a woman is the biggest risk factor for developing breast cancer. On average, a woman’s risk of breast cancer is about 13 percent, which means that about one in eight women will be diagnosed with breast cancer in her lifetime. Men have about 100 times less risk than women, one in 833 men will develop breast cancer in their lifetime.

Age is an important risk factor

The risk of breast cancer increases with age. While two-thirds of breast cancers occur in women aged 55 and older, only a few occur under the age of 30.

The risk is also increased in women with a family history of breast cancer. While the risk increases 2 times in those with breast cancer in first-degree relatives (such as mother, sister, and daughter), the risk of having the cancer in 2 first-degree relatives increases the risk 5-fold. If breast cancer in the family started at a young age (pre-menopausal) and is bilateral, the risk increases even more. Women whose father or brother has had breast cancer also have a higher risk of breast cancer. In some cases, a strong family history is linked to having an abnormal gene associated with a high risk of breast cancer, such as the BRCA1 or BRCA2 gene.

Apart from these, factors that increase the risk of developing breast cancer such as race, early menstruation, late menopause, dense (dense) breast tissue, having some benign breast diseases (such as atypical hyperplasia, lobular carcinoma in situ (LCIS)) are also included. has.

Can the formation of breast cancer be prevented?

The factors described above are unchangeable traits and there is nothing the person can do about them to reduce the risk. However, some risk factors can be changed by making lifestyle choices. For example, it can be ensured that the risk of breast cancer is as low as possible by making choices such as giving birth and breastfeeding, not using cigarettes and alcohol, getting rid of excess weight and maintaining an ideal weight, exercising, not taking postmenopausal hormone therapy.

In addition, the risk of breast cancer can be reduced by avoiding some factors such as an unhealthy diet with high fat, low vitamin D levels, exposure to excessive light at night and contact with various chemicals, which are thought to play a role in the development of breast cancer.

Risk-reducing treatments are of great importance

There are also treatments that can be used to reduce the risk of developing breast cancer in women who have a higher-than-average risk of breast cancer. There is no single definition of a higher-than-average risk of breast cancer. However, a 1.7 percent risk of developing breast cancer in the next 5 years is generally accepted as the threshold value. This is the average risk for a 60-year-old woman. Risk-reducing drug therapy (chemoprevention) or risk-reducing surgical treatments can be applied to women whose risk is above this value and who are at least 35 years old.

Drugs containing tamoxifen and raloxifene are preferred to reduce the risk of breast cancer. However, these drugs can also have serious side effects, so it is important to do a benefit-risk analysis before deciding to use them. Especially in our country, drug therapy is not used frequently for this purpose.

Preventive (prophylactic) mastectomy can be performed as a risk-reducing surgical treatment. Preventive mastectomy is surgery to remove one or both breasts to reduce the risk of developing breast cancer. Breast reconstruction can be achieved by placing a prosthesis in the same session for people who have undergone preventive mastectomy.

Preventive mastectomy may reduce breast cancer risk

Preventive mastectomy can reduce the risk of breast cancer by 90 percent or more, but it does not guarantee that breast cancer will not develop. This is because it is not possible to remove all of the breast tissue, even with a mastectomy. Although it is unlikely, cancer may develop from the remaining breast cells. It should be noted that this surgery is a serious choice. As with any type of surgery, mastectomy can have risks and side effects, some of which can affect quality of life. Therefore, preventive surgery is not usually a good option for women at average risk of breast cancer or only slightly increased risk.

What are the situations in which preventive mastectomy can be done due to the high risk of breast cancer?

– a strong family history of breast cancer (especially if breast cancer has been diagnosed in more than one relative, such as a mother, sister or daughter, before the age of 50),
– BRCA1, BRCA2, PALB2, CHEK2, ATM, CDH1, PTEN or TP53 gene mutations with high risk for breast cancer,
– History of breast cancer,
– Diagnosis of lobular carcinoma in situ (LCIS),
– History of radiation therapy to the breast before the age of 30,
– Extensive microcalcification in the breast.