Breast cancer risk factors

The cause or causes that produce breast cancer are still not clear, however, numerous risk factors associated with breast cancer have been identified. Most of them are related to reproductive history that modulates hormonal exposure during life.

Breast Cancer Awareness Video 2022

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Breast cancer

The breast is made up of 10 to 20 sections called lobules. Each lobe is divided into smaller sections called lobules. The lobules contain the glands responsible for producing milk during lactation. Milk flows from the lobule to the nipple through tubes called ducts. The space between the lobules and the ducts is filled with fat and fibrous tissue.

The breast is made up of 10 to 20 sections called lobules. Each lobe is divided into smaller sections called lobules. The lobules contain the glands responsible for producing milk during lactation. Milk flows from the lobule to the nipple through tubes called ducts. The space between the lobules and the ducts is filled with fat and fibrous tissue.

Lymphatic drainage from the breasts occurs primarily to the axillary lymph nodes.

Definition

Breast cancer consists of the accelerated and uncontrolled proliferation of glandular epithelial cells. They are cells that have greatly increased their reproductive capacity.

Breast cancer cells can spread through the blood or lymphatic vessels and reach other parts of the body. There they can adhere to the tissues and grow forming metastases.

Breast cancer can appear in women and men but more than 99% of cases occur in women.

Epidemiology and risk factors

Breast cancer is the most common cancer in Spanish women. The estimate of new cases of breast cancer in Spain for 2020 is 32,953. It is estimated that 1 in 8 Spanish women will have breast cancer at some point in their lives.

Although mortality from breast cancer has decreased in recent years thanks to screening programs and improved treatment, breast cancer remains the leading cause of cancer death in Spain in women. In 2018, 6,534 women died of breast cancer in Spain.

The age of maximum incidence is over 50 years, but approximately 10% are diagnosed in women under 40 years of age.

The average relative survival of breast cancer after five years is 89.2% globally. The stage at which the cancer is diagnosed influences survival. Survival in stage I is more than 98% and, on the other hand, in stages IV, survival drops to 24%.

The cause or causes that produce breast cancer are still not clear, however, numerous risk factors associated with breast cancer have been identified. Most of them are related to reproductive history that modulates hormonal exposure during life.

The risk factors for breast cancer are:

• Age is the main risk factor for breast cancer, the risk increases with increasing age.
• Personal history of invasive breast cancer (women who have had invasive breast cancer are at increased risk of contralateral breast cancer), ductal carcinoma in situ, or lobular carcinoma in situ.
• Personal history of benign proliferative disease of the breast.
• Family history of breast cancer in a first-degree relative (mother, daughter, sister).
• Carriers of mutations in the BRCA 1 and 2 genes or in other genes that increase the risk of breast cancer.
• High breast density on mammograms.
• Reproductive factors that increase exposure to endogenous estrogens, such as early onset of first period, late menopause, or nulliparity (never having been pregnant).
• The use of hormone replacement therapy after menopause increases the risk of breast cancer, as does the use of a combination of the hormones estrogen and progesterone after menopause
• Exposure to ionizing radiation, especially during puberty, and hereditary mutations related to breast cancer increase risk.
• Alcohol consumption.
• Obesity.

Hereditary breast cancer

Hereditary cancer is one that has its origin in some genetic mutation.

It is estimated that 5-10% of breast cancers are hereditary. 20-25% of the mutations responsible for hereditary breast cancers occur in the BRCA 1 and 2 genes. In hereditary breast cancer, there are other related genes that are being investigated, such as PALB2, p53, CDH1, ATM and CHEK2 . The probability that a woman carrying a mutation in BRCA 1 or 2 will develop breast cancer is around 70% at 70 years of age.

The genetic analysis of BRCA1 and BRCA2 is complex and expensive, therefore it is necessary to make a very precise selection of those families that can be considered high risk and in which the genetic study is indicated.

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