What are the Causes & Risk Factors of Breast Cancer?

Abnormal functions of the breast cells, particularly cell growth and division into new cells, lead to the development of breast cancer. Risk factors are causes that increase a person's susceptibility to a disease. The risks that may contribute to an individual developing breast cancer include consumption of alcohol, and these are modifiable risk factors. There are, however, other risk factors related to breast cancer, including genetics, age, and family history. These are non-modifiable risk factors.

What factors increase breast cancer probability?

Several risk factors may increase the probability of an individual suffering from breast cancer; however, these factors do not cause breast cancer but increase the probability of DNA damage in body cells leading to breast cancer. Learn more about the development of cancer at What Is Cancer?

The presence of any of the above risk factors does not mean that you will definitely develop breast cancer, and some individuals have breast cancer despite not having any risk factors. The primary risk factor for breast cancer other than being a woman is age.

How does personal medical history and prior breast diseases affect breast cancer risk?

The following personal risk factors or breast diseases may increase your chances of getting breast cancer:

• Personal medical history of breast cancer.
• Personal medical record/history of DCIS (ductal carcinoma in situ).
• Prior exposure to high doses of radiation, particularly at a younger age, for example, for treatment of cancer as a child.
• A history of some specific breast diseases. Information on precancerous breast diseases.
• Thick breasts. This is one of the most common conditions that makes it extremely hard to diagnose breast cancer through mammograms and increases the chances of developing breast cancer. Details on Thick Breasts.
• Obesity or being overweight, particularly after menopause.
• Use of combined estrogen-progestin hormone replacement therapy (for relief of menopausal symptoms)—information on Menopausal Hormone Therapy and Cancer.
• In utero and/or prenatal exposure to DES (diethylstilbestrol), a type of synthetic estrogen. Information on risks of cancer due to DES exposure.

How does reproductive history affect the risk of breast cancer?

If a person has a reproductive history resulting in long-term exposure to natural estrogens, there is a higher risk for developing breast cancer. The following are some examples of reproductive factors that may lead to long-term exposure of breasts to estrogen:

• Having a prolonged menstrual history, i.e., early menarche and late menopause.
• Being of an older age at the time of first full-term pregnancy.
• Not experiencing any full-term pregnancies.
• Not breastfeeding (if one has ever given birth).

How do genetics and family history affect breast cancer risk?

There are some characteristics related to genetics and family history which increase the risk of developing breast cancer:

Having experienced any harmful mutation in genes associated with breast cancer, such as:

• BRCA1 and BRCA2 (see BRCA Gene Alterations: Genetic Testing and Cancer Risk for additional details on BRCA gene abnormalities).
• PALB2
• CHEK2
• TP53, or Li-Fraumeni syndrome
• CDH1
• PTEN (Cowden syndrome, PTEN Hamartoma tumor syndrome)
• STK11 (Peutz-Jeghers syndrome)
• ATM

What does a family history of breast cancer mean for your personal risk?

Genetic counselors and other trained health care providers can help individuals with breast cancer or family history of breast cancer:

• The possibility that you may have a genetic predisposition to breast cancer, based on both your medical history and family medical history.
• Choices about genetic diagnosis or testing for changes in the BRCA1, BRCA2, and different genes that increase the risk of breast cancer.
• The implications of genetic information: risks and benefits.
• How to cope with the outcome of the test.
• The discussion of the test result with your family.

Find out more about genetic counseling and genetic testing for determining your risk for breast cancer and other types of cancer at Genetic Testing for Inherited Cancer Risk.

What everyday behaviors are linked to a higher risk of breast cancer?

The following behaviors have been associated with increased risk of breast cancer:

• Consume alcohol. The more wine/alcohol you consume, the higher the risk of breast cancer. For more information, see Alcohol and Cancer Risk.
• The absence of physical activity, especially after menopause. More information can be found here: Physical Activity and Cancer.

Race

The incidence of breast cancer differs by race. Among American women, those of White descent have the highest incidence, while those of Black descent have the highest mortality from the disease.

What potential breast cancer risk factors still need more scientific research?

Some research has indicated that women currently taking or who recently took hormonal birth control pills (sometimes referred to as oral hormonal contraceptives) may have a slightly higher possibility of developing breast cancer. Research has not indicated an increased risk of breast cancer in ladies/women taking birth control pills. Read more on Oral Contraceptives and Cancer Risk.

There is ongoing research to find out whether exposure to certain environmental chemicals might increase the risk of breast cancer. It is hard to perform and interpret research like this for several reasons, making it difficult to know what chemicals, if any, might increase breast cancer risk.

What is a woman's overall lifetime risk of developing breast cancer?

Those with breast tissue are at risk of developing breast cancer, but some risk factors might increase a woman's risk.

Overall, the chances of a woman developing breast cancer in her lifetime are 1 out of 8 or 13 out of 100. However, if you have certain risk factors such as early start of your menstruation, being older at the time of birth of your first baby, or being related to someone with breast cancer, then you may have a high risk. Your medical expert can calculate your risk of developing breast cancer using a risk calculator, such as the Breast Cancer Risk Assessment Tool from the NCI. This tool assesses the risk of breast cancer for people based on various other factors as well.

There are risk factors that, by themselves, carry a very high risk of breast cancer (60 out of 100 or more). A strong family history of breast cancer, exposure to radiation in the chest region before the age of thirty, and mutations in particular genes including BRCA1, BRCA2, PALB2, and PTEN, are some of these risk factors.

Women who may be at an increased risk of breast cancer may consult their doctors regarding preventive measures.

What must be remembered is that despite having all the latest scientific knowledge, doctors can't accurately predict an individual's risk. There will always be a degree of uncertainty involved in any estimation. First, there may be a personal factor or exposure that increases an individual's risk but does not figure in the risk calculation. Secondly, new scientific knowledge may become available, rendering the previous calculation less valid.

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