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Breast Cancer Risk: Separating Fact from Fiction
By Cynthia L. Drogula M.D., FACS

There are several known facts about breast cancer risk. The most surprising to women is that most breast cancer patients have no risk factors. Therefore, even if nothing on the following list is true for you, you still need to do annual breast exams, monthly self-breast exams and annual mammography if you are over 40 years old.

The most recognized risk factors for developing breast cancer include:

-Family history.
-First period younger than 12 years old.
-Late menopause.
-Never being pregnant.

There are other risk factors as well, including obesity, alcohol use, smoking, history of radiation exposure and history of prior biopsy where atypical cells were identified. Many of these risk factors cannot be changed. A woman’s menstrual history is somewhat decided by her own body, and we can’t pick our relatives.

Other risk factors, however, are completely within a woman’s control. Don’t smoke, take alcohol in moderation and exercise, exercise, exercise. Women who maintain a healthy body weight and walk 30 minutes a day, three days per week have 50 percent less breast cancer.

The association of breast cancer with hormone replacement therapy is a source of concern to many postmenopausal women. The Woman’s Health Initiative study showed a small increase in the number of breast cancer cases in women on a combination estrogen/progesterone pill after four years of use. Women should discuss the merits and risks of hormone replacement therapy with their own doctors as this is best addressed on a case by case basis taking their own medical history into account.

Now to debunk some of the “urban myth” that circulates about breast cancer. Antiperspirants have not been shown to increase breast cancer risk. Nor have hair dyes or underwire bras. Birth control pills for women under the age of 35 show no increased risk of breast cancer.

The relationship between stress and breast cancer is very difficult to test. There has yet to be a compelling study that links stress and breast cancer, but better data would be required to say that stress increases breast cancer risk. Environmental factors that could potentially lead to breast cancer undoubtedly exist but to date are very difficult to pinpoint. It is always OK to discuss any concerns or exposures with your doctor. It is better to be informed than worried.

At The Aiello Breast Center at Baltimore Washington Medical Center, we educate women about their risk for developing breast cancer and ways to reduce this risk. It is important to be an advocate for your own health and to keep informed about advances in medical care. In today’s information age, it is important to remember that all of the information out there is not reliable, so please feel free to address all concerns with your doctor.

- Dr. Cynthia Drogula is medical director of The Aiello Breast Center at Baltimore Washington Medical Center.