Understanding risk factors for a disease can be confusing. Here at HealthCentral, we often hear from women who are sure they are doomed to get breast cancer because they have an aunt and two cousins with the disease. We also hear from people who are angry that they got breast cancer when they did everything “right”—ate organic foods, got lots of exercise, avoided alcohol and smoking.
Types of risk factors
Risk factors do not cause breast cancer. We still do not understand why someone who has many risk factors for breast cancer never gets the disease while others get breast cancer despite having few or no risk factors. Some risk factors cannot be changed. You do not control your gender, family history, or the age when you started your period. But some breast cancer risk factors, such as alcohol use, can be changed.
Can risk be lowered?
Researchers wanted to find out the extent that modifying risk factors lowered overall risk. Reviewing previous studies in the United States, Europe, and Australia, they compared more than 17,000 white women with breast cancer to almost 20,000 healthy women matched for unchangeable risk factors including family history, genetic susceptibility, height, and reproductive history. Then they contrasted how those with breast cancer differed from those without it based on modifiable risk factors like healthy weight, use of menopausal hormone therapy (MHT), and alcohol and tobacco use.
Using a mathematical model, they estimated that 29 percent of breast cancer cases could be prevented by changing behaviors that are known to increase breast cancer risk. The higher a woman’s risk is from the things she cannot alter, the greater her risk reduction is from the things she can change.
The researchers concluded: “Results from these analyses could have implications for future cancer prevention efforts, particularly for risk communication and counseling at an individual level. For instance, women found to be at elevated risk owing to factors that cannot be changed may be more motivated to adopt a healthy lifestyle to lower their risk of breast cancer if they had a better understanding of the potential gains.
“In this regard, it is encouraging that even for women in the highest decile of risk owing to nonmodifiable factors, those who had low BMI, did not smoke or drink, and did not use MHT, had risks comparable to those for an average woman in the general population.”
What about non-white women? Data from four large studies of African-American women found that exercise reduced risk for estrogen-receptor positive breast cancer for them, but not for estrogen-receptor negative cancers. Two hours of strenuous cardiovascular exercise, such as brisk walking, running, or cycling, reduced risk by twelve percent.
These statistics are important from a public health perspective. With an estimated 27,000 cases of all types of breast cancer among African-Americans in 2013, reducing estrogen-receptor breast cancer in African-American women by twelve percent is significant. A twenty-nine percent decrease in the 246,660 new cases of breast cancer estimated for 2016 would be 71,531.
What about for individuals? It is important to understand the implications of these large scale studies.
Learn about the ** types of risk factors.**The two most significant ones are being a woman and getting older. You will often see headlines about a “new” breast cancer risk. When you investigate, it is often a small study that finds the possibility that a behavior increases breast cancer risk by a tiny percentage. Don’t let headlines scare you.
Lifestyle changes will not eliminate your breast cancer risk. Sometimes bad things happen for no apparent reason. There are no guarantees, so be realistic.
Factors beyond your control do not mean you cannot take action. You do not need to feel that it is inevitable that you will get cancer if you have several risk factors. Imagine you are one of 10 people at high risk for breast cancer in a room. You learn that three of you can avoid breast cancer if you exercise, don’t take hormone therapy, maintain a healthy weight, and avoid tobacco and alcohol. Wouldn’t it be worth some changes to increase your chances of being one of those three? Especially because those same changes will also improve your overall health?
Keep your breast cancer risk in perspective. Most women, even those with several risk factors, will not get breast cancer. Pay attention to your body and check with the doctor if you notice breast changes. Do what you can to be as healthy as possible. Then enjoy life!
See More Helpful Articles:
Maas P, Barrdahl M, Joshi AD, et al. Breast Cancer Risk From Modifiable and Nonmodifiable Risk Factors Among White Women in the United States. JAMA Oncol. Published online May 26, 2016. doi:10.1001/jamaoncol.2016.1025. Accessed from http://oncology.jamanetwork.com/article.aspx?articleid=2524829 Sept. 20, 2016.
Azvolinsky, A. Exercise May Reduce Breast Cancer Risk in African American Women. Cancer Network Sept. 2, 2016. Accessed from http://www.cancernetwork.com/news/exercise-may-reduce-breast-cancer-risk-african-american-women Sept. 20, 2016.
Phyllis Johnson is an inflammatory breast cancer survivor who serves on the Board of Directors for theInflammatory Breast Cancer Research Foundation, the oldest 501(3)(c) organization focused on research for IBC. She is a list monitor for an online support group atwww.ibcsupport.org. She stays current on cancer information through attendance at conferences such as the National Breast Cancer Coalition’s Project LEAD® Institute. A retired teacher, she has been writing about cancer issues at HealthCentral since 2007.