Dr. Gorman’s unwavering commitment to delivering unmatched and customized healthcare consistently leads the way in comprehending the complex nature of breast cancer. Our primary goal at Texas Breast Center is to foster an informed community, one that is equipped with the knowledge needed to prevent, detect, and address breast cancer efficiently. It’s with this vision that we delve into the topic of “Breast Cancer Causes: Age Related Risks.”

Breast cancer is a complex disease with a myriad of contributing factors. Among these, age stands as a significant determinant. Despite the prevalence of breast cancer in younger women, it’s important to note that the risk indeed increases as women get older.

In this article, we’ll explore the reasons why age is a risk factor, the mechanisms behind this link, and provide practical advice on how women of all ages can monitor their breast health effectively.

This article embodies Dr. Gorman’s commitment to offering an advanced and targeted approach to breast health. Our aim is not just to treat but to educate, empower, and encourage women to take an active role in their health journey. Our hope is that through this understanding, we can collectively reduce the impact of breast cancer and improve the lives of women across Texas and beyond.

We invite you to take this journey with us, one step at a time, toward a future where knowledge and proactive actions make a significant difference in the fight against breast cancer.

Increasing age

Breast cancer risk is intrinsically linked with age, with an increased probability of developing the disease as women get older. This is primarily due to the cumulative effect of several risk factors over time, including exposure to estrogen, genetic mutations, and the natural wear and tear process at the cellular level.

Estrogen exposure plays a significant role in breast cancer risk. This hormone is necessary for normal breast development, but it can also facilitate the growth of some types of breast cancer. Throughout a woman’s life, her body is exposed to varying levels of estrogen, primarily produced by the ovaries. Women who have had longer menstrual histories (i.e., those who started menstruating early and/or went through menopause late) have a slightly higher risk due to longer lifetime exposure to the hormone.

With increasing age, the likelihood of genetic mutations also increases. These mutations can accumulate over time due to various factors such as exposure to radiation, certain chemicals, and random errors that occur when cells divide. Some of these mutations can cause cells to become cancerous.

Moreover, the aging process naturally brings about a decline in the body’s immune function, reducing its ability to detect and destroy cells that have become abnormal, potentially leading to cancer.

While breast cancer can and does occur in younger women, it is less common. According to the American Cancer Society, the average risk of a woman developing breast cancer increases dramatically with age. Statistically, the majority of breast cancer cases are diagnosed in women over the age of 50. In fact, the median age for breast cancer diagnosis in the United States is 62, with most cases occurring in this age bracket. This is not to say that younger women should not be vigilant; rather, it underscores the importance of regular screenings, especially as women age.

Younger women

Breast cancer is relatively rare in younger women, with very few breast cancer cases in the U.S. being diagnosed in women under the age of 40, according to the American Cancer Society. This is due to several reasons, one being that breast tissue in younger women is denser, which may limit the effectiveness of mammography and lead to later detection. Moreover, younger women have fewer cumulative lifetime exposure to various risk factors like estrogen.

However, when breast cancer does occur in younger women, it tends to be diagnosed at a later stage and often presents as more aggressive forms of the disease. One reason for this is that breast cancer in younger women can be more difficult to detect due to the dense breast tissue, as mentioned before. This might delay diagnosis and consequently, treatment.

Moreover, younger women are more likely to have what is known as “triple-negative” breast cancer – a type of breast cancer that is particularly aggressive and less responsive to standard hormonal therapies. This subtype of cancer does not express the three most common types of receptors known to fuel breast cancer growth—estrogen, progesterone, and the HER-2/neu gene. Therefore, treatment options can be more limited and the cancer can be more challenging to treat successfully.

Another aggressive form that occurs more commonly in younger women is HER2-positive breast cancer, which is characterized by the overexpression of the HER2 protein. This form of breast cancer tends to grow and spread more quickly than other types.

It’s important to note that, regardless of age, any new or unexplained breast symptoms should be evaluated promptly by a healthcare professional. For younger women, especially those with a family history of breast cancer or other risk factors, proactive measures such as self-examinations, regular clinical exams, and discussions with healthcare providers about individual risk can contribute significantly to early detection and improved outcomes.

Age at first menstruation

The age at which a woman starts menstruating, also known as menarche, can indeed influence her risk of developing breast cancer later in life. Research indicates that women who experience their first period before the age of 12 have a slightly elevated risk of developing breast cancer compared to those who started menstruating at a later age.

This association primarily stems from the lengthened exposure to estrogen and progesterone – hormones that are known to stimulate breast cell growth. Simply put, the earlier a girl starts her periods, the longer her lifetime exposure to these hormones.

During each menstrual cycle, the levels of estrogen and progesterone in a woman’s body rise to prepare for a potential pregnancy. These hormonal surges stimulate the growth of the glandular tissue in the breasts. Although this is a natural process, over time, this increased cell activity raises the chances of a DNA error during cell division, potentially leading to cancerous mutations.

In addition, early menstruation usually means a longer time until menopause. Menopause is another significant event in a woman’s life when the ovaries stop producing eggs, and the production of estrogen and progesterone declines. Therefore, the longer time from menarche to menopause translates into more menstrual cycles, and subsequently, a longer cumulative exposure to estrogen and progesterone.

While the increased risk linked with early menarche is relatively small on an individual level, it’s significant from a public health perspective given the high prevalence of breast cancer. This connection underlines the importance of regular breast cancer screenings, especially for women who began menstruating at an early age.

Age at menopause

The age at which a woman reaches menopause also significantly influences her risk of developing breast cancer. Research suggests that women who experience menopause after the age of 55 have a slightly increased risk of breast cancer compared to women who reach menopause before the age of 45.

This heightened risk is predominantly due to prolonged exposure to hormones such as estrogen and progesterone, which are produced in a woman’s body during her reproductive years. These hormones have been associated with stimulating cell growth in the breasts, and prolonged exposure to them can increase the chance of DNA errors during cell division, which can result in cancerous mutations.

Late menopause means that a woman’s body continues to produce these hormones, and her breast tissue continues to be exposed to their growth-promoting effects for a longer duration. This cumulative hormonal exposure over many years increases the likelihood of developing breast cancer.

Moreover, the risk associated with late menopause might also be linked to the increased number of menstrual cycles a woman goes through in her lifetime. Each menstrual cycle is associated with a surge in estrogen and progesterone levels, which stimulate breast cell multiplication, potentially leading to errors in cell replication and an increased risk of mutation.

While the increased risk associated with late menopause is considered modest, it’s significant enough to warrant attention, especially considering the high incidence of breast cancer. Therefore, it is crucial for women who experience late menopause to engage in regular screenings and take proactive steps to reduce their breast cancer risk. These steps can include maintaining a healthy lifestyle, which involves regular physical activity, a balanced diet, limiting alcohol consumption, and avoiding tobacco.

Age at first full-term pregnancy

The age at which a woman has her first full-term pregnancy can influence her risk of developing breast cancer. Research has shown that women who have their first full-term pregnancy after the age of 30 have a slightly increased risk of developing breast cancer compared to women who have their first child before the age of 20.

This somewhat counterintuitive relationship between pregnancy and breast cancer risk is likely due to the complex interplay of hormonal changes that occur during pregnancy. Pregnancy induces significant changes in the levels of hormones such as estrogen and progesterone in a woman’s body, and these hormones have a profound impact on the cells of the breast.

During a first full-term pregnancy, the breasts undergo permanent cellular changes. Before this, the breast cells are immature and more susceptible to the carcinogenic effects of hormones and environmental toxins. A full-term pregnancy matures these cells, making them less likely to become cancerous.

However, this protective effect is more pronounced when the first full-term pregnancy occurs at a younger age. When the first full-term pregnancy occurs after the age of 30, the breast cells have had more time to accumulate genetic damage, which could potentially lead to cancer. Thus, the overall effect of a later first pregnancy might result in a net increase in breast cancer risk.

Moreover, during pregnancy, especially in the early stages, levels of estrogen increase, which leads to rapid growth of breast cells. This increased cell division can raise the risk of mutations and cancer development.

Despite this slight increase in risk, it’s important to note that the decision to have children and when to have them is personal and can be influenced by various factors. It’s just one of many factors that contribute to breast cancer risk, and having a first child after 30 does not guarantee one will develop breast cancer. As always, regular screenings and healthy lifestyle choices are key components in the proactive management of breast cancer risk.

Age at first childbirth

The age of a woman at the time of her first childbirth, or not having given birth at all, can influence her risk of developing breast cancer. Research indicates that women who never have a full-term pregnancy have a slightly higher risk of breast cancer compared to those who have their first child at a younger age.

One of the primary reasons behind this increased risk is the prolonged and uninterrupted exposure to estrogen and progesterone. These hormones are naturally produced during a woman’s menstrual cycle and have been associated with increased cell growth in the breasts. A woman who has never been pregnant has more menstrual cycles compared to a woman who has one or more pregnancies, thus increasing her cumulative lifetime exposure to these hormones.

During pregnancy, the breasts go through changes that make them more resistant to transformations that can lead to cancer. The cells of the breast differentiate, or specialize, to produce milk – a change that seems to make the breast cells less likely to undergo cancerous changes. An absent pregnancy means the breast tissue goes through fewer of these protective changes.

Additionally, the surge of hormones during pregnancy causes breast cells to rapidly divide and grow. While this is normal, increased cell division can also increase the chance of genetic mistakes or mutations, potentially leading to cancer. The risk of this occurring is higher in older women, as cells accumulate genetic changes over time.

It’s crucial to note that while these factors do contribute to an increased risk, it’s a relative increase and the overall risk remains modest. Not having children is a personal decision influenced by a wide range of factors. Regular breast cancer screenings and maintaining a healthy lifestyle remain the most effective strategies for all women to manage their individual risk.

Age at breast cancer diagnosis

While it’s true that breast cancer risk increases with age, the nature of the disease can vary based on the age at diagnosis. Generally, older women (especially those over 70) diagnosed with breast cancer tend to have a more favorable prognosis compared to younger women. This is, in part, due to the fact that breast cancers in older women often grow more slowly.

Cancer growth rate is significantly influenced by the characteristics of the cancer cells and the surrounding environment. Age-related changes in both the breast tissue and the body’s overall immune response can impact the rate at which a tumor grows.

Breast cancers in older women are often hormone receptor-positive, meaning that the cancer cells have receptors that attach to hormones like estrogen and progesterone. Hormone receptor-positive cancers tend to grow more slowly than cancers that are hormone receptor-negative. Moreover, treatments that block these hormones or their receptors can effectively slow or stop the growth of these cancers.

Furthermore, older adults often have a reduced immune response, which paradoxically, may slow the growth rate of the cancer. An aggressive immune response can sometimes stimulate cancer cells to grow and divide more rapidly, a phenomenon known as inflammation-induced tumor growth. The diminished immune response in older adults may limit this effect.

However, it’s important to note that although the prognosis may be generally better due to slower tumor growth, older women might face other challenges related to breast cancer management. These can include an increased risk of treatment side effects and the presence of other health conditions that might complicate care. Therefore, an individualized and comprehensive approach to treatment is crucial.

Finally, regardless of age, early detection remains the key to a more favorable prognosis in breast cancer. Regular screenings and understanding personal risk factors contribute significantly to early diagnosis and effective treatment.

Age-specific breast cancer rates

Breast cancer incidence rates do indeed vary by age group. It’s a well-established fact that the risk of developing breast cancer increases as women age. According to the American Cancer Society, women aged 70-74 generally have the highest incidence rates of breast cancer.

This trend can be attributed to several reasons. First, the process of aging itself results in an accumulation of genetic mutations over time due to factors like exposure to carcinogens, errors during DNA replication, and decreased efficiency of DNA repair mechanisms. These factors can eventually lead to the development of cancer.

Second, older women have had more menstrual cycles, resulting in a longer lifetime exposure to hormones such as estrogen and progesterone. These hormones, which are known to stimulate cell growth in the breasts, can over time lead to uncontrolled cell growth and potential transformation into cancer cells.

Third, as women age, they experience more instances of proliferative breast diseases with atypia, which are known risk factors for breast cancer. Atypia refers to the presence of abnormal cells, which are more likely to become cancerous.

Furthermore, the body’s immune system, which helps to detect and destroy abnormal cells, declines with age. This decline might allow some cancerous cells to multiply and form tumors before they’re detected by the immune system.

Despite the higher incidence rate in older women, it’s important to note that breast cancer can occur at any age, and younger women can also develop aggressive forms of the disease. Therefore, it’s crucial for women of all ages to understand their individual risk factors, including genetics, and engage in recommended screening practices for early detection of the disease. It’s also essential to maintain a healthy lifestyle, as several risk factors for breast cancer, such as maintaining a healthy weight and regular physical activity, are within an individual’s control.

Age-related hormone exposure

Estrogen and progesterone are hormones that are naturally produced in a woman’s body and play crucial roles in the menstrual cycle and pregnancy. However, longer lifetime exposure to these hormones has been associated with an increased risk of developing breast cancer.

This increased risk is predominantly due to the role these hormones play in cell growth. Both estrogen and progesterone stimulate the growth of cells in the breast — a normal process that facilitates the development and maintenance of the mammary glands in response to each menstrual cycle. However, with longer exposure to these hormones, there is an increased opportunity for the growth of cells in the breast. This increased cell division can potentially result in errors during the replication of DNA, which can, in turn cause mutations that may lead to cancer.

In essence, the longer the breast tissue is exposed to these hormones, the higher the chance that a breast cell could turn cancerous. Factors that can lengthen a woman’s exposure to these hormones include early menarche (starting menstruation before age 12), late menopause (experiencing menopause after age 55), late or no pregnancy, and certain types of hormone replacement therapy or birth control. Each of these conditions leads to a longer timeframe during which the breast tissue is exposed to estrogen and progesterone, thereby increasing the risk of breast cancer.

It’s also worth noting that not all breast cancers are hormone receptor-positive, meaning that not all breast cancers grow in response to estrogen or progesterone. Some types of breast cancer are hormone receptor-negative and grow independently of these hormones. Therefore, while it’s true that longer lifetime exposure to estrogen and progesterone increases the risk of breast cancer, it’s not the only factor at play.

Nevertheless, understanding this relationship underlines the importance of regular breast cancer screenings and lifestyle modifications where possible, to manage and mitigate the risk associated with prolonged hormone exposure.

Age and breast cancer screening

Mammograms, which are X-ray images of the breast, are an essential tool for the early detection of breast cancer. Regular mammogram screenings are typically recommended for women aged 40 and older, though the exact age to start and frequency of screenings can depend on individual risk factors and professional guidelines.

The primary aim of a mammogram screening is to identify breast cancer before any physical symptoms develop. Detecting cancer at an early stage often means that it is smaller and hasn’t spread, which makes it easier to treat successfully. The five-year relative survival rate for women with localized breast cancer (cancer that has not spread outside the breast) is nearly 99%.

A mammogram can identify changes in the breast up to two years before a patient or physician can feel them. Regular screenings can help catch the disease in its earliest stages, when it’s most treatable. This not only improves a woman’s chance of recovery but also offers more treatment options.

For example, women diagnosed with early-stage breast cancer might be candidates for breast-conserving surgery, such as lumpectomy, which involves removing the cancer and a small portion of healthy tissue around it but not the entire breast.

Moreover, early detection might also reduce the need for more aggressive treatments like chemotherapy. This can significantly lessen the physical and emotional impact of cancer treatment and improve quality of life for patients.

However, it’s essential to balance the benefits of mammograms with the potential harms, which can include false positives, over-diagnosis, and exposure to radiation. Each woman’s risk factors should be considered in decision-making about when to begin mammograms and how often to have them.

Lastly, while mammograms are a valuable tool, they are not perfect and do not detect all breast cancers. Thus, it’s crucial for women to understand and recognize any changes in their breasts and to have any changes evaluated by a healthcare professional. Awareness and early detection are key to the effective management of breast cancer.

Take Control of Your Breast Health – Schedule a Consultation with Dr. Gorman at Texas Breast Center Today

Navigating the complexities of breast cancer, its age-related risks, and the nuances of its potential causes can be challenging. That’s why Dr. Gorman and her team at Texas Breast Center are committed to offering you an advanced, personalized, and targeted approach to understanding and treating this disease. Their goal is to arm you with the knowledge you need to make informed decisions about your health and provide you with state-of-the-art care every step of the way. With a keen understanding that each patient’s journey is unique, Dr. Gorman is here to guide you through every stage of your care with empathy, expertise, and a relentless pursuit of the best outcomes possible.

Now, more than ever, it is vital for women of all ages to understand their personal risk factors for breast cancer and to engage in regular screenings. Remember, early detection is key to improving breast cancer prognosis and treatment options. We encourage you to discuss these risk factors and your personal history with a healthcare provider, like Dr. Gorman, who can help guide you through the process. Contact the Texas Breast Center today to set up an appointment for a consultation or to learn more about the services we provide. Together, we can face the challenges of breast cancer head-on and work towards a healthier, cancer-free future.

Read the other articles in the Causes series including Gender Influencing Causes.
Also, read the article about Treating Breast Cancer in Older Adults.

FAQ’s about Breast Cancer Causes: Age Related Risks

How much does breast cancer risk increase with age?

The risk of developing breast cancer approximately doubles every 10 years until menopause, after which the rate of increase slows. It’s estimated that around two-thirds of invasive breast cancers are found in women aged 55 or older.

Why does age increase the risk of cancer?

Age is a significant risk factor for cancer primarily due to the accumulation of genetic mutations over time and the body’s declining efficiency in repairing damaged DNA. Additionally, the immune system’s ability to detect and destroy abnormal cells decreases with age.

Why is breast cancer more common after 50?

Breast cancer is more common after 50 mainly because of the prolonged exposure to estrogen and progesterone, hormones known to stimulate cell growth in the breasts. Additionally, genetic mutations accumulate over time, increasing the likelihood of cancer development.

What is the highest age risk for breast cancer?

Breast cancer risk increases with age, with the highest incidence rates observed in women aged 70-74. However, the risk continues to be significant as women age beyond this.

Does age affect cancer survival rate?

Yes, age can affect cancer survival rates. Younger patients often have a better prognosis due to generally being healthier and better able to tolerate treatments. However, breast cancers in older women often grow more slowly and are hormone receptor-positive, which can lead to effective treatment options.

Why is breast cancer more common with age?

Breast cancer becomes more common with age due to a combination of factors such as lifetime exposure to estrogen and progesterone, the natural aging process leading to an accumulation of genetic mutations, and a decrease in the immune system’s ability to prevent the development of cancer.

Can you live 30 years after breast cancer?

Yes, it’s possible to live 30 years or more after a breast cancer diagnosis. Thanks to advancements in early detection and treatment, many women are living long, healthy lives following their diagnosis. The prognosis depends on many factors, including the cancer stage and type, the woman’s overall health, and the treatments used.

Is alcohol linked to breast cancer?

Yes, research consistently shows that drinking alcohol increases the risk of breast cancer. Even moderate consumption of an alcoholic beverage can increase breast cancer risk, and the risk increases the more alcohol is consumed.

Is breast cancer less aggressive in elderly?

Breast cancer in older women tends to be less aggressive and more responsive to hormone therapy than in younger women. This is mainly because most breast cancers in older women are hormone receptor-positive. However, diagnosis can be complicated by the presence of other age-related health conditions.

https://www.cancer.org/cancer/types/breast-cancer/about/how-common-is-breast-cancer.html

Breast cancer is the most common among cancers in women worldwide, with an estimated 2.3 million new cases diagnosed in 2020 alone. While there are many factors that can contribute to the development of breast cancer, one of the most important is genetics. Certain genetic mutations can significantly increase a person’s risk of developing Breast cancer is the most common cancer in women around the world, with about 2.3 million new cases expected to be found in 2020 alone. Even though there are many things that can lead to breast cancer, genes are one of the most important ones. Some changes in a person’s genes can make it much more likely that they will get breast cancer or another type of cancer. In this article, we will explore the most common genetic mutations associated with breast cancer risk, how they are inherited, and what can be done to manage that risk.

BRCA1 and BRCA2 Mutations

BRCA1 and BRCA2 are two of the most well-known genetic mutations associated with breast cancer risk. These genes produce proteins that help to suppress tumor growth, but mutations in these genes can disrupt this function and increase the risk of developing breast and ovarian cancer.

Breast cancer genes, such as BRCA1 and BRCA2, have been identified as major risk factors for invasive breast cancer. These genes are involved in regulating cell growth and repair, and when mutated, they can disrupt normal cellular processes in breast tissue. Mutations in these breast cancer genes can be inherited or acquired, and women with a family history of breast cancer are at higher risk. Other breast cancer risk factors include age, gender, lifestyle factors, and exposure to certain chemicals. Early detection through regular mammograms and other breast cancer screening methods is critical for improving outcomes for women with invasive breast cancer. As research continues to uncover new insights into the biology of breast cancer, identifying and understanding these risk factors will be critical for reducing the burden of this disease on women worldwide.

What is the definition and function of BRCA1 and BRCA2?

BRCA1 and BRCA2 are tumor suppressor genes, which means they produce proteins that help to regulate cell growth and division. Specifically, these proteins help to repair damaged DNA and prevent cells from growing and dividing too rapidly or uncontrollably. Mutations in these genes can interfere with the production of these proteins, leading to a higher risk of developing cancer.

What are the inheritance patterns of BRCA1 and BRCA2?

BRCA1 and BRCA2 mutations are inherited in an autosomal dominant pattern. This means that a person only needs to inherit a mutated copy of the gene from one parent to be at risk of developing cancer. A child of a parent with a BRCA1 or BRCA2 mutation has a 50% chance of inheriting the mutation.

Is there an increased risk of breast and ovarian cancer with BRCA1 and BRCA2 mutations?

Women with a BRCA1 or BRCA2 mutation have a significantly increased risk of developing breast and ovarian cancer. According to the National Cancer Institute, women with a BRCA1 or BRCA2 mutation have a:

• 55-72% chance of developing breast cancer by age 70 (compared to 12% in the general population)
• 44% chance of developing ovarian cancer by age 80 (compared to 1.3% in the general population)

Other cancers may also be associated with BRCA mutations, including prostate cancer in men.

What are screening and prevention options for people with BRCA1 and BRCA2 mutations?

Due to the increased risk of breast and ovarian cancer associated with BRCA mutations, women who carry a BRCA1 or BRCA2 mutation are typically advised to undergo increased surveillance and risk reduction measures.

Surveillance may involve more frequent mammograms and breast MRIs, as well as screening for ovarian cancer using blood tests and/or ultrasounds. In some cases, prophylactic surgery (such as mastectomy or oophorectomy) may be recommended to reduce the risk of developing cancer.

Is there genetic testing for BRCA1 and BRCA2 mutations?

Genetic testing is available to determine whether someone has a BRCA1 or BRCA2 mutation. The test involves analyzing a sample of blood or saliva to look for changes or abnormalities in the genes. It is important to note that not everyone who is at risk of carrying a BRCA mutation will have one, and not everyone who has a BRCA mutation will develop cancer.

Genetic counseling and testing are typically recommended for people with a family history of breast or ovarian cancer, especially if multiple family members have been diagnosed with the disease at a young age. Genetic counseling is also recommended before and after testing to help individuals understand their risk, the implications of testing, and the options available for managing that risk.

While BRCA1 and BRCA2 are the most well-known genetic mutations associated with breast cancer risk, there are many other mutations that can also increase a person’s risk of developing the disease.

PALB2 Mutations

PALB2 (Partner and Localizer of BRCA2) is a gene that produces a protein that interacts with the BRCA2 protein to help repair damaged DNA. Mutations in PALB2 can increase the risk of developing breast cancer and may also increase the risk of pancreatic cancer.

What is the definition and function of PALB2?

PALB2 is a tumor suppressor gene that plays a role in repairing damaged DNA. It produces a protein that interacts with the BRCA2 protein to help repair double-stranded DNA breaks. Mutations in PALB2 can interfere with this function and increase the risk of developing breast cancer.

What are the inheritance patterns of PALB2?

PALB2 mutations are inherited in an autosomal recessive pattern. This means that a person must inherit two copies of the mutated gene (one from each parent) to be at risk of developing cancer. A child of two carriers of a PALB2 mutation has a 25% chance of inheriting the mutation.

Is there an increased risk of breast and ovarian cancer for people with a PALB2 mutation?

Women with a PALB2 mutation have a slightly increased risk of developing breast cancer. According to the National Cancer Institute, women with a PALB2 mutation have:

• 33% chance of developing breast cancer by age 70 (compared to 12% in the general population)

What are screening and prevention options for people with a PALB2 mutation?

Surveillance may involve more frequent mammograms and breast MRIs. In some cases, prophylactic surgery (such as mastectomy) may be recommended to reduce the risk of developing cancer.

Is there genetic testing for a PALB2 mutation?

Genetic testing is available to determine whether someone has a PALB2 mutation. The test involves analyzing a sample of blood or saliva to look for changes or abnormalities in the gene. It is important to note that not everyone who is at risk of carrying a PALB2 mutation will have one, and not everyone who has a PALB2 mutation will develop cancer.

TP53 Mutations

TP53 is a gene that produces a protein called p53, which helps to regulate cell growth and prevent the development of tumors. Mutations in TP53 can interfere with the function of p53 and increase the risk of developing various types of cancer, including breast cancer.

What is the definition and function of TP53?

TP53 is a tumor suppressor gene that produces a protein called p53. This protein helps to regulate cell growth and prevent the development of tumors by responding to DNA damage and other cellular stresses. Mutations in TP53 can interfere with the function of p53, leading to a higher risk of developing cancer.

What are the inheritance patterns of TP53?

TP53 mutations are inherited in an autosomal dominant pattern. A child of a parent with a TP53 mutation has a 50% chance of inheriting the mutation.

Is there an increased risk of breast cancer for people with a TP53 mutation?

Women with a TP53 mutation have an increased risk of developing various types of cancer, including breast cancer. According to the National Cancer Institute, women with a TP53 mutation have:

• 49% chance of developing breast cancer by age 70 (compared to 12% in the general population)
• Increased risk of other cancers, including brain, bone, and soft tissue tumors

What are screening and prevention options for people with a TP53 mutation?

Surveillance may involve more frequent mammograms and breast MRIs, as well as screening for other types of cancer. In some cases, prophylactic surgery (such as mastectomy) may be recommended to reduce the risk of developing cancer.

Is there genetic testing for a TP53 mutation?

Genetic testing is available to determine whether someone has a TP53 mutation. The test involves analyzing a sample of blood or saliva to look for changes or abnormalities in the gene. It is important to note that not everyone who is at risk of carrying a TP53 mutation will have one, and not everyone who has a TP53 mutation will develop cancer.

CHEK2 Mutations

CHEK2 is a gene that produces a protein called checkpoint kinase 2, which helps to regulate cell growth and division. Mutations in CHEK2 can interfere with this function and increase the risk of developing breast cancer.

What is the definition and function of CHEK2?

CHEK2 is a checkpoint kinase that helps to regulate cell growth and division. It produces a protein that responds to DNA damage and other cellular stresses to prevent the development of tumors. Mutations in CHEK2 can interfere with the function of this protein, leading to a higher risk of developing cancer.

What are the inheritance patterns of CHEK2?

CHEK2 mutations are inherited in an autosomal dominant pattern. A child of a parent with a CHEK2 mutation has a 50% chance of inheriting the mutation.

Is there an increased risk of breast cancer for people with a CHEK2 mutation?

Women with a CHEK2 mutation have a moderately increased risk of developing breast cancer. According to the National Cancer Institute, women with a CHEK2 mutation have a:

• 20-30% chance of developing breast cancer by age 80 (compared to 12% in the general population)

What are screening and prevention options for people with a CHEK2 mutation?

Surveillance may involve more frequent mammograms and breast MRIs. In some cases, prophylactic surgery (such as mastectomy) may be recommended to reduce the risk of developing cancer.

Is there genetic testing for a CHEK2 mutation?

Genetic testing is available to determine whether someone has a CHEK2 mutation. The test involves analyzing a sample of blood or saliva to look for changes or abnormalities in the gene. It is important to note that not everyone who is at risk of carrying a CHEK2 mutation will have one, and not everyone who has a CHEK2 mutation will develop cancer.

ATM Mutations

ATM is a gene that produces a protein called ataxia-telangiectasia mutated, which helps to regulate cell growth and division. Mutations in ATM can interfere with this function and increase the risk of developing breast cancer.

What is the definition and function of ATM?

ATM is a protein kinase that helps to regulate cell growth and division. It produces a protein that responds to DNA damage and other cellular stresses to prevent the development of tumors. Mutations in ATM can interfere with the function of this protein, leading to a higher risk of developing cancer.

What are the inheritance patterns of ATM?

ATM mutations are inherited in an autosomal dominant pattern. A child of a parent with an ATM mutation has a 50% chance of inheriting the mutation.

Is there an increased risk of breast cancer for people with an ATM mutation?

Women with an ATM mutation have a moderately increased risk of developing breast cancer. According to the National Cancer Institute, women with an ATM mutation have a:

• 14-29% chance of developing breast cancer by age 70 (compared to 12% in the general population)

What are screening and prevention options for people with an ATM mutation?

Surveillance may involve more frequent mammograms and breast MRIs. In some cases, prophylactic surgery (such as mastectomy) may be recommended to reduce the risk of developing cancer.

Is there genetic testing for an ATM mutation?

Genetic testing is available to determine whether someone has an ATM mutation. The test involves analyzing a sample of blood or saliva to look for changes or abnormalities in the gene. It is important to note that not everyone who is at risk of carrying an ATM mutation will have one, and not everyone who has an ATM mutation will develop cancer.

PTEN Mutations

PTEN is a gene that produces a protein called phosphatase and tensin homolog, which helps to regulate cell growth and division. Mutations in PTEN can interfere with this function and increase the risk of developing breast, thyroid, and other types of cancer.

What is the definition and function of PTEN?

PTEN is a tumor suppressor gene that produces a protein called phosphatase and tensin homolog. This protein helps to regulate cell growth and division by suppressing a signaling pathway that promotes cell growth. Mutations in PTEN can interfere with the function of this protein, leading to a higher risk of developing cancer.

What are the inheritance patterns of PTEN?

PTEN mutations are inherited in an autosomal dominant pattern. A child of a parent with a PTEN mutation has a 50% chance of inheriting the mutation.

Is there an increased risk of breast, thyroid, and other cancers for people with a PTEN mutation?

People with a PTEN mutation have an increased risk of developing various types of cancer, including breast and thyroid cancer. According to the National Cancer Institute, people with a PTEN mutation have a:

• 85% chance of developing breast cancer by age 70 (compared to 12% in the general population)
• Increased risk of other cancers, including thyroid and endometrial cancer

What are screening and prevention options for people with a PTEN mutation?

Surveillance may involve more frequent mammograms and breast MRIs, as well as screening for thyroid and other types of cancer. In some cases, prophylactic surgery (such as mastectomy) may be recommended to reduce the risk of developing cancer.

Is there genetic testing for a PTEN mutation?

Genetic testing is available to determine whether someone has a PTEN mutation. The test involves analyzing a sample of blood or saliva to look for changes or abnormalities in the gene. It is important to note that not everyone who is at risk of carrying a PTEN mutation will have one, and not everyone who has a PTEN mutation will develop cancer.

CDH1 Mutations

CDH1 is a gene that produces a protein called cadherin-1, which helps to maintain the structure of cells in tissues such as the breast and stomach. Mutations in CDH1 can interfere with this function and increase the risk of developing hereditary diffuse gastric cancer syndrome and breast cancer.

What is the definition and function of CDH1?

CDH1 is a gene that produces a protein called cadherin-1. This protein helps to maintain the structure of cells in tissues such as the breast and stomach by allowing cells to stick together. Mutations in CDH1 can interfere with the function of this protein, leading to a higher risk of developing hereditary diffuse gastric cancer syndrome and breast cancer.

What are the inheritance patterns of CDH1?

CDH1 mutations are inherited in an autosomal dominant pattern. A child of a parent with a CDH1 mutation has a 50% chance of inheriting the mutation.

Is there an increased risk of hereditary diffuse gastric cancer syndrome and breast cancers for people with a CDH1 mutation?

People with a CDH1 mutation have an increased risk of developing hereditary diffuse gastric cancer syndrome, which is a rare type of stomach cancer. They also have an increased risk of developing lobular breast cancer, which is a type of breast cancer that begins in the milk-producing glands.

What are screening and prevention options for people with a CDH1 mutation?

Surveillance may involve regular endoscopies to screen for stomach cancer, as well as more frequent mammograms and breast MRIs, to screen for breast cancer. In some cases, prophylactic surgery (such as mastectomy or gastrectomy) may be recommended to reduce the risk of developing cancer.

Is there genetic testing for a CDH1 mutation?

Genetic testing is available to determine whether someone has a CDH1 mutation. The test involves analyzing a sample of blood or saliva to look for changes or abnormalities in the gene. It is important to note that not everyone who is at risk of carrying a CDH1 mutation will have one, and not everyone who has a CDH1 mutation will develop cancer.

STK11 Mutations

STK11 is a gene that produces a protein called serine/threonine kinase 11, which helps to regulate cell growth and division. Mutations in STK11 can interfere with this function and increase the risk of developing Peutz-Jeghers syndrome and breast cancer.

What is the definition and function of STK11?

STK11 is a serine/threonine kinase that helps to regulate cell growth and division. It produces a protein that responds to cellular stresses to prevent the development of tumors. Mutations in STK11 can interfere with the function of this protein, leading to a higher risk of developing cancer.

What are the inheritance patterns of STK11?

STK11 mutations are inherited in an autosomal dominant pattern. A child of a parent with an STK11 mutation has a 50% chance of inheriting the mutation.

Is there an increased risk of Peutz-Jeghers Syndrome and Breast Cancer for people with a STK11 mutation?

People with an STK11 mutation have an increased risk of developing Peutz-Jeghers syndrome, which is a rare genetic disorder characterized by the development of benign growths in the digestive tract and an increased risk of developing certain types of cancer. They also have an increased risk of developing breast cancer.

What are screening and prevention options for people with an STK11 mutation?

Surveillance may involve regular colonoscopies to screen for polyps and other growths in the digestive tract, as well as more frequent mammograms and breast MRIs to screen for breast cancer. In some cases, prophylactic surgery (such as mastectomy) may be recommended to reduce the risk of developing cancer.

Is there genetic testing for an STK11 mutation?

Genetic testing for breast cancer is available to determine whether someone has an STK11 mutation. The test involves analyzing a sample of blood or saliva to look for changes or abnormalities in the gene. It is important to note that not everyone who is at risk of carrying an STK11 mutation will have one, and not everyone who has an STK11 mutation will develop cancer.

NF1 Mutations

NF1 is a gene that produces a protein called neurofibromin 1, which helps to regulate cell growth and division. Mutations in NF1 can interfere with this function and increase the risk of developing neurofibromatosis type 1 and breast cancer.

What is the definition and function of NF1?

NF1 is a gene that produces a protein called neurofibromin 1. This protein helps to regulate cell growth and division by suppressing a signaling pathway that promotes cell growth. Mutations in NF1 can interfere with the function of this protein, leading to a higher risk of developing neurofibromatosis type 1 and breast cancer.

What are the inheritance patterns of NF1?

NF1 mutations are inherited in an autosomal dominant pattern. A child of a parent with an NF1 mutation has a 50% chance of inheriting the mutation.

Is there an increased risk of Neurofibromatosis Type 1 and Breast Cancer for people with an NF1 mutation?

People with an NF1 mutation have an increased risk of developing neurofibromatosis type 1, which is a rare genetic disorder characterized by the development of benign growths in the nervous system and other parts of the body. They also have an increased risk of developing breast cancer.

What are screening and prevention options for people with an NF1 mutation?

Surveillance may involve regular MRIs to screen for growths in the nervous system and other parts of the body, as well as more frequent mammograms and breast MRIs to screen for breast cancer. In some cases, prophylactic surgery (such as mastectomy) may be recommended to reduce the risk of developing cancer.

Is there genetic testing for an NF1 mutation?

There are genetic tests available to determine whether someone has an NF1 mutation. The test involves analyzing a sample of blood or saliva to look for changes or abnormalities in the gene. It is important to note that not everyone who is at risk of carrying an NF1 mutation will have one, and not everyone who has an NF1 mutation will develop cancer.

Conclusion

Genetic mutations play an important role in the development of breast cancer. In some cases, gene mutations can be inherited and increase the likelihood that an individual will develop breast cancer over their lifetime. Those who have a family history of breast cancer or who have other risk factors should consider genetic testing to determine whether they carry a mutation that increases their risk of developing hereditary breast cancer. By identifying these mutations, patients can take steps to reduce their risk of developing breast cancer through increased surveillance, prophylactic surgery, and other interventions.

At Texas Breast Center, we offer advanced, personalized, and targeted approaches to breast cancer care, including genetic testing and counseling, to help our patients make informed decisions about their health. Our team of expert breast surgeons, oncologists, and other healthcare professionals is dedicated to providing comprehensive care and support throughout every stage of the breast cancer journey. We understand that a breast cancer diagnosis can be overwhelming, and we are here to help guide our patients through the process with compassion, expertise, and a focus on personalized care.

If you have questions about genetic mutations and breast cancer or are interested in learning more information about our breast cancer services, please don’t hesitate to contact Texas Breast Center to schedule a consultation. We are committed to helping our patients achieve the best possible outcomes and live their lives to the fullest.

See the other articles in the Causes series, including Family History Risks

Breast cancer is a vicious disease that is far more prevalent than we would like. One in eight women will receive a breast cancer diagnosis in their life, and one in one thousand men receive the same. However, more rarely discussed when mentioning these statistics is the risk of breast cancer for transgender people.

Transgender people–those who identify with a different gender than the one they were assigned at birth–may choose to receive treatments to align their bodies with the physical standard of their gender. This process, called transitioning, can include surgeries as well as gender-affirming hormone therapy. While some find these changes unnecessary, others rely on them to feel comfortable in their own bodies.

What gender is most likely to get breast cancer?

Most people could tell you that women are more likely to get breast cancer than men. And while this is correct, many don’t know the reasons why. Between the excess breast tissue and ‘female’ hormones, the female gender identity seems to come with risk. This includes both cisgender–those who are not transgender–and transgender women. However, everyone of any gender should invest in regular breast checks, looking for lumps or any other possible changes to their breasts.

Risk for Trans Women

An increased amount of estrogen and progesterone, commonly known as the female hormones, in the body for any reason will increase the breast cancer risk for anyone, regardless of gender. However, these two hormones can both be used in hormone treatment for trans women or non-binary people, giving their bodies access to more than they naturally produce. While this is perfect for helping transition (alter their physical characteristics to match their gender identity) it does introduce an increased risk where there wasn’t as high a risk before.

Risk for Trans Men

Transgender men, however, tend to lower breast cancer risk factors through both surgical means and cross-sex hormone treatment. Trans men and some non-binary people receive top surgery, a form of mastectomy that removes the breasts to give them flatter chests. While this procedure is different from a mastectomy performed to clear out breast cancer, a large amount of breast tissue is still removed. With less breast tissue, there is, simply put, less room to develop breast cancer. However, the lymph nodes and glandular tissue–two places breast cancer is likely to form–are usually still left in place. Also, consider that scars left behind can make breast imaging for breast cancer screening difficult.

Furthermore, breast cancer cases in trans men are relatively low because of their own hormone therapy. Trans men, and some non-binary people, go through testosterone therapy. Testosterone, commonly considered the male hormone, can bring trans men’s physical appearance closer to that of the general male population. And, while an unusually high amount of androgens–hormones relevant to sexual development, including testosterone–can lead to an increased breast cancer risk, testosterone treatment doesn’t tend to add enough of the hormone to the body to cause this kind of higher breast cancer risk.

Cisgender People

When discussing cisgender people, breast cancer development is far more likely to happen in women. However, even among cisgender women, some are more at risk than others, especially due to factors out of their control. For example, those who started menstruating early and became menopausal late have an increased risk. This increase is due to the excess amount of estrogen and progesterone these women were exposed to; as with trans women, the excessive amount increases the risk of breast cancer.

Cisgender men generally have the lowest risk of breast cancer. However, this does not mean they have no risk. Cis men absolutely should still be aware of the signs and symptoms of breast cancer, such as breast pain and nipple discharge, as well as the risk factors, such as family history and testicular surgery.

Is Trans hormone therapy dangerous?

As with any medical procedure or treatment, there are some risks to hormone treatment. Taking estrogen while smoking, for example, increases the risk of blood clots. One risk of taking testosterone is a high hematocrit count, or overly thick blood, leading to a possible stroke or heart attack. And while many trans men, trans women, and non-binary people may choose not to pursue hormone therapy due to these risks, one must also consider that those listed above are not the only people who utilize this treatment.

Many cisgender menopausal and postmenopausal women participate in hormone replacement therapy to treat their menopausal symptoms. The boost in estrogen that they no longer naturally produce minimizes their hot flashes and vaginal discomfort and has even been proved to reduce bone fracture and prevent bone loss.

Risks for this treatment are commonly listed as blood clots, stroke, heart disease, and, of course, breast cancer. So, while it is well known that hormone treatment alters the absolute risk of breast cancer, this is not strictly an issue for transgender people.

Who has the highest risk of breast cancer?

A Dutch study published online in 2019–”Breast cancer risk in transgender people receiving hormone treatment: nationwide cohort study in the Netherlands“–investigated the risk of breast cancer in transgender people receiving hormone treatment between 1972 and 2016 from a specialist clinic in Amsterdam (1). In this time, 2,260 trans women and 1,229 trans men were treated. In the population of transgender women–those assigned male at birth (amab) but identify with the female sex–15 cases of invasive breast cancer were diagnosed, approximately .7%. However, among cisgender women, the statistic is closer to 12.5% or one in eight women.

Of the transgender men–those who were assigned female at birth (afab) but have a male gender identity–examined in the study, only four cases of invasive breast cancer were diagnosed. This gives trans men a standard risk of approximately .3% if the study is trusted. Cisgender men receive breast cancer diagnoses in one in 1000 men, approximately .1%. However, the numbers and data pulled from the study are not the be all end all for transgender breast cancer risk statistics. More research needs to be done to have more confidence in the numbers.

However, using the data we have available from the study, those with the highest risk of breast cancer are the general female population, with cisgender women having the highest risk of all. Trans women follow after, then the general male population, with cisgender males having the lowest risk of breast cancer.

It is crucial for transgender people to understand the health risks that can come with transitioning. While many choose not to transition, many consider it of absolute importance to their health, both physical and mental. Further research needs to be done to better understand just what transitioning means to understand any potential side effects or health problems. Patients will need to know their new risks and new preventative measures to perform that they may not be familiar with, such as regular self-breast checks.

Dr. Gorman at the Texas Breast Center works to keep her patients informed of breast cancer risks, screening options, and treatment. Each patient she and her team see is treated with a personalized and targeted treatment plan.

1. https://www.bmj.com/content/365/bmj.l1652

While most people are familiar with the idea and repercussions of breast cancer, not everyone may know what exactly breast cancer is or how it comes to be.

Kinds of Breast Cancer

Put simply, breast cancer is the continued growth of abnormal cells in the area of the breast. This area can include the ducts (that carry milk), lobules (that produce milk), and connective tissue (that holds everything together. Most breast cancers start in the lobules or ducts. And while this does mean cancers appear in the area that we traditionally think of as the breast, it includes the underarms as well.

But there is not one single type of breast cancer. And sometimes, the types overlap.

Invasive Ductal Carcinoma

With invasive ductal carcinoma, cancer cells start in ducts and spread out into the surrounding breast tissue. If it continues to spread to other parts of the body, it metastasizes.

Invasive Lobular Carcinoma

Invasive lobular carcinoma starts in the lobules and spreads to nearby breast tissue. This cancer can also metastasize.

Less Common Types

There are many other kinds of breast cancers, though most are less common. Medullary breast carcinoma starts similarly to invasive ductal, but grows slowly and only rarely spreads to the lymph nodes.

Mucinous or colloid carcinoma is a variation on invasive ductal carcinoma. However, the cancer cells float in mucin, an ingredient in the body’s natural mucus.

Paget’s Disease of the nipple originates with cancer cells collecting in and around the nipple, traditionally the ducts there. From there, it can spread to the areola and further.

Inflammatory breast cancer is also a variation on invasive ductal carcinoma. It is generally accompanied by symptoms of inflammation such as swelling, dimpling, and redness.

Triple-Negative breast cancer does not have the three common receptors found in breast cancers. These receptors are for estrogen, progesterone, and HER2 (human epidermal growth factor). Without the receptors, some methods of treatment are not available.

Ductal carcinoma in situ, or DCIS, is considered either the earliest stage of breast cancer or pre-cancer that is likely to lead to breast cancer. Cancerous cells are forming in the ductal lining, but they have not spread.

How Breast Cancer Spreads

Breast cancer cells start in ducts, lobules, and breast tissue. However, they can spread to the lymph nodes, raising the odds of metastasis–cancer cells spreading through the lymph system and the rest of the body. The more lymph nodes that have cancer cells, the more likely metastasis is. However, metastasis is not an inevitability. Some people with cancer cells in their lymph nodes do not have metastases. And, unfortunately, metastasis can occur despite there currently being no cancer cells in the lymph nodes.

What Are Breast Cancer Symptoms?

There are several possible changes to the breast that can be noticed in regular–monthly is recommended–self-breast checks. Keep an eye out for any changes to your regular breast shape, texture, or color. Some changes that may indicate the need to visit a doctor are:

• A lump in the breast or armpit
• Swelling or change in size to any part of the breast.
• Discharge of any kind that is not milk coming from the nipple (including blood)
• Puckering of the nipple/Inversion of the nipple
• Flaky skin or redness around the nipple or the breast
• Dimpling of the skin (like the skin of an orange) on the breast
• Pain in any part of the breast

Any one of the symptoms on its own does not mean you have breast cancer. They could indicate an infection or changes due to hormonal shifts. However, if the signs continue or you are concerned, bring them to the attention of your doctor.

Risk Factors

There is no one sign that someone will or won’t get breast cancer, but there are some risk factors that can raise your chances. Some of these factors are genetic factors, while others come from a person’s lifestyle.

Some of the factors that cannot be reduced are:

• Gender–being a woman increases your risk
• Age–risk increase with age
• Dense breasts–they are harder to see through on a mammogram, making early detection more difficult
• Family history–the risk is increased if a close family relative (mother, sister, daughter) has had breast cancer
• Personal history–previous breast conditions or breast cancer increase risk
• Certain gene mutations–BRCA1 and BRCA2, as well as other mutations, can increase risk
• Radiation exposure–while this may come from many sources, even medical treatment, it could potentially be a risk factor.
• Starting your period young
• Starting menopause older

Can Risk be Reduced?

Some potential risk factors come from lifestyle practices and can be adjusted for. Some of these factors are:

• Alcohol–drinking in excess can increase risk
• Obesity–obesity can increase your risk, particularly after menopause
• Taking hormones–certain forms of hormone replacement therapy (progesterone and estrogen, primarily) can increase risk when taken for over five years after menopause. Some birth control pills can also increase breast cancer risk
• Not having children or having them at an older age can increase risk.
• Excercise–by not exercising, breast cancer risk can increase. Maintaining a healthy exercise schedule for yourself, you can lower your risk.

Prevention

The best way to prevent breast cancer in yourself is to maintain the risk factors that you can. Beyond that, keep yourself familiar with your breasts with a monthly breast self-check. More than anything, this keeps you familiar with the size, texture, and sensation of your breast so that you might be more likely to notice a change should one appear.

Also, speak with your doctor about breast cancer screening. They know the best time to start screening and will help you to the next steps if there are any concerns. Checking in on your breasts yourself, having your doctor check, and having regular screenings will help you be prepared and catch anything early should there be any signs of breast cancer to find.

Dr. Gorman

Valerie J. Gorman, MD, FACS, works to ensure that her patients are informed and receive a personalized approach to cancer treatment and breast cancer surgery. If you have questions about breast cancer or how it is treated, she or the team at Texas Breast Center in Waxahachie are happy to help answer your questions.

Dr. Gorman is board certified by the American Board of Surgery and serves as Medical Director of Surgical Services and Chief of Surgery at Baylor Scott & White Medical Center – Waxahachie.

Last month was breast cancer awareness month, a time to highlight the importance of cancer screening and breast health. The Center for Disease Control has named breast cancer as the most common cancer for women in the United States. Approximately 12% (that is, 1 in every eight women) will be diagnosed with invasive breast cancer over her lifetime.

These statistics shift depending on other factors like age, race, and certain genetic factors. For example, African-American women are far more likely to be diagnosed with triple-negative breast cancer than women of other races, and to die of breast cancer of any kind. Asian, Native American, and Hispanic women tend to have lower risks of developing breast cancer, though they should still be aware of the signs and symptoms.

Why is Breast Cancer Screening Important?

In September of 2019, the American Cancer Society announced a new stance on breast self-exams. They stated that self-checks do not tend to reveal any early signs of cancer when women are also getting their scheduled breast cancer screening mammograms and regular checks by their health professionals. That’s not to say that people do not come to their doctors after spotting changes in their breasts. However, these changes are often noticed during dressing or bathing.

Despite this announcement, breast checks can still provide valuable insight. It is easiest to spot changes in your breast if you are familiar with it in the first place. If you are doing a regular breast self-exam, you will be ready to catch anything out of the ordinary–whether that be during your exam or while getting dressed.

How to do a Breast Self-Exam

There are two basic steps to a breast check. You’ll want to examine the breasts by looking and by feeling. Both of these steps can be further broken down from there. Try to do all parts of the exam on the same day and around the same time in your cycle every time: a week after your period ends is a standard time to do it. If you don’t get a period, set a date every month to do your breast self-exam.

Look

For the looking portion of the check, you will want to stand in front of a mirror. You will be standing in a few different poses and looking at a few different angles–front, right, and left.

In each of your poses, you will want to look at a few factors. Make a note of the shape of your breasts, especially in comparison to one another. It is far from unusual for one to be larger than the other, but sudden or drastic changes in size should not happen. Keep an eye out for a change in the usual vein patterns in your breasts. If the veins have increased or expanded significantly, you may want to speak with your doctor. Symptoms display in your nipples if they are consistently itchy, red, swollen, scaly, inverted, or are producing discharge. Finally, check the skin on your breasts for dimpling, redness, rash, puckering, or anything that could be considered like an orange peel. These could all be signs of something happening beneath the surface.

The best way to look for all of these symptoms is to examine your breasts from all angles. First, face the mirror with your arms down at your sides. Turn to the left and the right to check both sides of each breast. Next, place your hands on your hips with your elbows out to your sides, keeping your shoulders up and back. Repeat the pattern of front, left, and right. This same pose can be done hunched forward. This adjustment allows the breasts to hang so that you can see the underside.

Now, raise your arms straight above your head. You can clasp them together or leave them in a superman pose, but try to remember what you have done in previous breast exams so that you know what to expect. Once you have made a thorough observation, lean forward at the hips so that your breast hang forward again, keeping your arms above your head.

Make a note of anything you find that is different from normal and keep an eye on it. Many symptoms we attribute to breast cancer can also be symptoms of things like PMS, a swollen lymph node due to another infection, or many other factors, though, so observe first. However, if you have strong concerns, don’t hesitate to call your health professional for answers.

Feel

To start the feeling check, you will want a comfortable and flat place to lie down. You will lay flat on your back with your right arm up behind your head (if you are starting with your right breast). The goal is to get your breasts as flat as possible.

Once you are in a comfortable position, you will want to start feeling along the outer edge of your breast, near your armpit. You will want to use the pads of your fingers rather than your fingertips and move in small, smooth circles. Perform each circle at more than one pressure–light, medium, and firm–between the size of a dime and a quarter. By varying the amount of pressure, you can check more of the breast tissue. Move in a slow, up and down pattern across until you have covered the entire breast. Another option is to start at the nipple and perform your press checks in a spiral outwards. So long as you have a pattern to ensure you cover the entire breast and become familiar with it, this should be sufficient. Try to follow the same pattern every time you do your breast self-exam.

Once you have finished your exam lying down, it is best to give your breasts an exam while standing or sitting up as well. You will use the same pattern you have established for yourself, using firm, medium, and light pressure and the pads of your fingers to feel for anything unusual in the breast tissue you might have missed while lying down.

When is a Breast Lump Cancer?

It’s not entirely uncommon to find some kind of lump or bump when doing your breast self-exam. Hormones, infections, and other causes can cause temporary lumps that you may detect during your monthly checks. There are common attributes that a cancerous lump will have, though none are a guarantee. If you are concerned about anything you find, have your doctor examine it as well.

Your fingers can detect the most common criteria for a cancerous lump during your breast self-exam. The lump will be a firm, painless mass. The edges are sometimes irregular. If you have a lump that is getting larger over time, that may also be a cause for concern.

Of course, each case is unique. Some cancerous lumps may be painful or soft, and some may feel perfectly round. They can be more challenging to detect in people with more dense breast tissue or scar tissue on their breast–for example, those who have had previous breast surgery. These denser tissues can also make it somewhat more difficult for mammograms to detect cancer. People with dense breast tissue or scar tissue should be particularly familiar with their breasts so that they can detect changes early.

What Causes Breast Cancer?

While there is no one singular cause of breast cancer, there are several risk factors that could increase the likelihood of a diagnosis. Some are environmental factors that may be controlled, while others are physical characteristics or part of your history.

Gender, race, age, and genetics are all potential risk factors. Women are more likely to develop breast cancer, and this risk increases once they reach the age of 55. Some genes, like the BRCA1 and the BRCA2 genes, can be passed through generations and are considered a potential cause. If a first-degree relative (a daughter, sister, or mother) has or had breast cancer, your risk doubles. Because of the importance of hormones as a risk factor, your menstrual history may also be a factor. Those who started their period early–before the age of twelve–may have an increased risk.

Some risk factors are situational or environmental. Tobacco and alcohol use can increase your risk, especially in younger patients, as can being overweight or obese. Some previous benign or noncancerous breast conditions may influence your risk later on. Hormone use, such as hormone replacement therapy, both current and in the past, can increase your risk. One risk factor that is easier to lower is living a sedentary. Exercising regularly will decrease your risk of developing breast cancer.

Breast Self-Exam Results

The primary purpose of a breast self-exam is to help you to familiarize yourself with your breasts. If you know what the skin, muscle, and tissue feel like on a typical day, then you will be better prepared to notice anything abnormal should something come up.

These tests are not a reason to avoid getting a mammogram or having a physician examine you, especially if you are among those with risk factors. If you do come across something in one of your breast self-exams that has you concerned, bring it up with your doctor, or with Dr. Gorman at the Texas Breast Center. As a surgeon specializing in surgical oncology and surgical diseases in the breast, she can help you understand whether your lump, change in skin texture, or any change is a cause for concern. And, if it is, she and her team will help you set up a treatment plan.

Valerie J. Gorman, MD, FACS, is board certified by the American Board of Surgery and serves as Chief of Surgery and Medical Director of Surgical Services at Baylor Scott & White Medical Center – Waxahachie. Her goal is to ensure that all of her patients have an informed, personalized approach to breast surgery and cancer treatment.