Breast cancer risks are determined by a variety of factors

STATEN ISLAND, N.Y. — The likelihood of developing breast cancer depends on a variety of factors, some of them strong and others weak. Some of the determinants can be modified in an attempt to lower the risk of breast cancer.

Strong indicators are age, family history and personal previous history of breast cancer.

Risk of breast cancer increases with age. Almost 85 percent of breast cancers occur in women older than 50.

Family history of breast cancer in close relatives also increases the risk of developing breast cancer, depending upon how extensive or strong the family history is.

Women with a strong family history should be evaluated by a genetic counselor and consider genetic testing to identify underlying inherited conditions that may be connected with an increased risk of breast cancer.

Someone with a personal history of breast cancer is only marginally more at risk — 4 to 5 percent — than the general population of developing the disease in the future.

MODERATE FACTORS
 
Breast density, previous abnormalities and radiation exposure are among the moderate risk factors.

Dense breasts have higher risk of developing breast cancer. Whether this is due to higher amount of glandular breast tissue because of the more sensitive nature of breast tissue is unknown. Women with dense breasts should speak with their physicians about additional screening modalities other than a mammogram.

Previous abnormal breast biopsies that may have shown atypical or premalignant cells increase risk of subsequent breast cancer. An approximate estimate of subsequent risk of breast cancer in women with atypical breast biopsies can be made using several models. The Gail model is a commonly used model, and can be viewed at www.cancer.gov/bcrisktool.

Previous radiation exposure to the breast, such as previous history of lymphoma or lung cancer requiring chest radiation, increases subsequent risk of breast cancer — and other cancers in the radiation field — after an interval of approximately 10 years.

OTHER RISKS

Among the other risk factors are estrogen exposure, weight, alcohol consumption and smoking habits as well as socioeconomic status and ethnicity.

The higher the cumulative lifetime estrogen exposure, the higher the risk of breast cancer. Ovaries secrete estrogen during reproductive years (defined as menarche to menopause).

Too many women not getting proper follow-up after Pap test | One ...

There are varying kinds of abnormalities labelled at the time of the Pap test but some will turn out to be precursors to cervical cancer. It is critical that patients be called back when they have an abnormal Pap and offered a repeat Pap or, if indicated, a referral for more sophisticated tests such as colposcopy, which is an examination of the cervix done with a magnification component, and the option to go forward and biopsy. Among categorizations of abnormal Paps, we have high-grade dysplasias, as well as others that will be read as “atypical glandular cells of undetermined significance,” “atypical squamous cells of undetermined significance,” “abnormal cells consistent with carcinoma or adenocarcioma,” or “abnormalities consistent with malignancy.”  In their study of follow up, women with this kind of high grade dysplasia had a mean age of 37.6 year. The mean time to colposcopy ranged from 6 to 24 weeks. In the study, 1,195 women were diagnosed with an underlying cervical cancer with a mean time to diagnosis that varied depending on the initial Pap abnormality. It ranged from as short as 3 or 6 weeks when frank cancer or malignancy was initially suspected on the Pap to as long as 26 weeks when a more uncertain abnormality was detected on the first Pap, such as atypical squamous or atypical glandular cells of undetermined significance.

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