Breast Cancer Risk Among Black Women

Breast cancer presents a significant health concern, particularly among black women, who often face higher risks and unique challenges. At Texas Breast Center, led by Dr. Gorman, we are dedicated to providing expert care and support tailored to each patient’s needs. Understanding the specific risks and proactive measures is crucial in early detection and effective treatment. Our team is committed to offering the latest advancements in breast health to our diverse community. Schedule an appointment with Texas Breast Center today to discuss your breast health and risk factors with our specialized team.

Is breast cancer risk higher among black women?

Although black women have a slightly lower incidence rate of breast cancer compared to white women, they tend to develop the disease at a younger age and are twice as likely to develop the aggressive triple-negative subtype. This aggressive form of breast cancer, combined with delayed diagnosis and treatment, contributes to black women having a 40% higher mortality rate from breast cancer than white women in the United States. Breast cancer has now become the leading cause of cancer death among black women, surpassing lung cancer, according to the American Cancer Society. The higher mortality rate underscores the importance of early detection and targeted treatment strategies for this at-risk population. At Texas Breast Center, we are dedicated to providing comprehensive care to address these specific risks and improve outcomes for black women.

Why is the breast cancer mortality rate higher among black women?

The breast cancer mortality rate is higher among black women, about 18% at five years after diagnosis, due to several key factors. Black women are more likely to be diagnosed at a later stage, with only 57% of cases found at an early stage compared to 67% in white women. They also face more aggressive tumor biology, being twice as likely to have triple-negative breast cancer and having a higher incidence of inflammatory breast cancer. Disparities in access to health care and treatment mean black women often receive lower rates of surgery and chemotherapy. Additionally, they tend to be diagnosed at younger ages, with a median age of 58 compared to 62 for white women. Genetic factors specific to African ancestry and inconsistencies in screening recommendations further contribute to the disparity. Socioeconomic barriers, experiences of medical racism, higher obesity rates, and other health issues also play significant roles. Consequently, black women have lower 5-year survival rates, with 82% living at least 5 years after diagnosis compared to 92% of white women. Addressing these disparities requires a comprehensive approach, including improved access to care, targeted screening, and continued research. At Texas Breast Center, we are committed to tackling these challenges and providing the best possible care for all our patients.

What role does genetics play in breast cancer mortality among black women?

Genetics plays a significant role in breast cancer mortality among black women, with recent research highlighting several key aspects including susceptibility to certain subtypes of breast cancer. Genetic variants specific to African ancestry have been identified, which are associated with an increased risk of developing aggressive subtypes like triple-negative breast cancer. This subtype is more challenging to treat and has a poorer prognosis, contributing to higher mortality rates. The identification of these variants has led to improved risk prediction models tailored for black women, facilitating earlier screening and intervention. Additionally, researchers have developed polygenic risk scores that combine multiple genetic variants to more accurately assess overall breast cancer risk for women of African descent.

However, genetics is not the only factor. Social and environmental factors, such as neighborhood disadvantage, also significantly impact breast cancer mortality, often interacting with genetic factors to increase the risk of aggressive tumor subtypes. While understanding genetic factors is crucial, it opens the door for more targeted screening, prevention, and treatment strategies. This underscores the need for diverse genetic studies to ensure interventions are relevant to all populations.

At Texas Breast Center, we recognize the importance of addressing both genetic and non-genetic factors to reduce breast cancer mortality rates among black women. Our approach includes comprehensive care, considering the unique genetic risks and environmental influences faced by our patients.

Are there specific genetic mutations more prevalent in black women that increase breast cancer risk?

Yes, there are specific genetic mutations more prevalent in black women that increase breast cancer risk. Research shows that black women are more likely to have mutations in the BRCA2 and PALB2 genes, which are associated with a higher risk of breast cancer, especially aggressive subtypes. Additionally, two gene variants, the ANKLE1 and Duffy gene mutations, are more common in African American women and contribute to a higher likelihood of developing triple-negative breast cancer (TNBC). The ARHGEF38 gene has also been linked to more aggressive cancer types, which are more frequent in black women.

Large-scale studies have identified genetic variants specific to women of African descent that may explain the higher incidence of aggressive breast cancer subtypes in this population. Researchers have developed polygenic risk scores that combine multiple genetic variants to provide more accurate risk assessments for black women, offering a better prediction compared to traditional methods.

While these genetic factors are crucial in understanding breast cancer risk, it is important to note that the overall rate of inherited mutations linked to breast cancer is similar between black and white women. The differences lie in the specific genes affected and the types of breast cancer associated with these mutations.

At Texas Breast Center, we emphasize the importance of understanding these genetic variations to develop more accurate risk assessment tools, improve screening protocols, and tailor prevention and treatment strategies for black women. However, genetic factors are just one piece of the puzzle, and we must also consider environmental and socioeconomic factors in determining overall breast cancer risk and outcomes.

Prioritizing Breast Cancer Care for Black Women

Understanding the unique risks and challenges that black women face with breast cancer is essential. At Texas Breast Center, our expert team is dedicated to providing personalized care that addresses these specific concerns. Early detection and targeted treatments can make a significant difference. Schedule your consultation with Texas Breast Center today and take the first step towards proactive breast health management.

FAQ’s About Breast Cancer Risk Among Black Women

What are the common symptoms of breast cancer in black women?

Common symptoms of breast cancer include a lump in the breast, changes in breast shape or size, skin dimpling, nipple discharge, or pain. Black women may experience these symptoms at a younger age and with more aggressive forms of the disease. At Texas Breast Center, Dr. Gorman and her team emphasize the importance of being aware of these symptoms and seeking medical advice promptly for early detection and treatment.

How does socioeconomic status affect breast cancer risk in black women?

Socioeconomic status can significantly impact breast cancer risk and outcomes. Limited access to healthcare, lower income, and education levels contribute to delayed diagnoses and treatments. Texas Breast Center is committed to addressing these disparities by providing accessible and comprehensive care, ensuring that every patient receives the necessary screenings and treatments regardless of their socioeconomic background.

What preventive measures can black women take to reduce their breast cancer risk?

Preventive measures include regular screenings, maintaining a healthy lifestyle, and staying informed about family history. Texas Breast Center, led by Dr. Gorman, offers tailored prevention strategies and screenings to help black women manage their breast cancer risk effectively, promoting early detection and better outcomes.

Are there lifestyle changes that can help lower breast cancer risk in black women?

Yes, lifestyle changes such as maintaining a healthy weight, eating a balanced diet, exercising regularly, limiting alcohol intake, and avoiding smoking can help lower breast cancer risk. Dr. Gorman and her team at Texas Breast Center provide personalized advice and support to help patients adopt these healthy habits, enhancing their overall breast health.

How does access to healthcare influence breast cancer outcomes for black women?

Access to healthcare plays a crucial role in breast cancer outcomes. Black women often face barriers such as lack of insurance, fewer healthcare facilities, medical bias, and economic challenges. Texas Breast Center strives to overcome these barriers by offering comprehensive and accessible care, ensuring that all women receive timely and effective breast cancer treatments.

What role do social determinants of health play in breast cancer risk for black women?

Social determinants such as income, education, neighborhood, and access to care significantly impact breast cancer risk and outcomes. Dr. Gorman and the team at Texas Breast Center recognize these challenges and are dedicated to providing holistic care that addresses both medical and social needs, helping to reduce the disparities in breast cancer outcomes.

Can genetic counseling help black women understand their breast cancer risk?

Genetic counseling can be very beneficial in understanding breast cancer risk, especially for those with a family history of the disease. Texas Breast Center offers genetic counseling services to help Black women assess their risk and make informed decisions about their health, ensuring they receive personalized and proactive care.

What are the benefits of early breast cancer screening for black women?

Early breast cancer screening, such as mammography, can lead to earlier detection, which is crucial for successful treatment and better outcomes. Dr. Gorman at Texas Breast Center emphasizes the importance of regular mammograms and other screenings, particularly for black women who are at higher risk for aggressive breast cancer types.

How can black women advocate for themselves in the healthcare system regarding breast cancer care?

Black women can advocate for themselves by being informed about their risk factors, seeking regular screenings, asking questions, and demanding timely and appropriate care. Texas Breast Center supports patient advocacy by providing education, resources, and a compassionate team led by Dr. Gorman, dedicated to empowering women to take charge of their breast health.

What support services are available for black women diagnosed with breast cancer?

Support services such as counseling, support groups, and patient education can significantly impact the journey of black women diagnosed with breast cancer. Texas Breast Center offers a range of support services designed to help patients and their families navigate the challenges of diagnosis and treatment, ensuring they receive comprehensive care and emotional support throughout their journey.


Breast Cancer Causes: Age Related Risks

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 Causes: Family History Risks  

Breast cancer, a condition marked by uncontrolled cell growth in the breast tissue, continues to be one of the primary health challenges faced by women in the United States and worldwide. It is a journey that no woman should have to embark on alone, and it’s one that demands a wealth of understanding, particularly about the role of family history in determining breast cancer risk. Recognizing this intricate tapestry of genetics and family history, Dr. Gorman and her dedicated team at Texas Breast Center provide not just treatment but holistic care that addresses each individual’s unique concerns and needs.

As we delve into the complexities of breast cancer risk, it becomes evident that this disease is a multifaceted issue, intertwining genetics, lifestyle, and environmental factors. The role of family history in determining one’s risk is particularly significant, offering insights into genetic predispositions and potential hereditary patterns. This understanding is crucial, as it guides both patients and healthcare providers in developing personalized strategies for risk assessment and management.

photos of family members

First-degree Relatives

First-degree blood relatives play a significant role in understanding your potential breast cancer risk. In the context of family health history, first-degree relatives refer to your father, mother, sister, brother, son, or daughter. These relationships share about 50% of their genes with you, hence why their health conditions can provide valuable insight into your own potential health risks.

Suppose a first-degree relative has been diagnosed with breast cancer. In that case, research indicates this could indicate a heightened risk of developing the disease yourself. The reasoning behind this lies in the shared genetic material between you and your first-degree relative. Certain gene mutations, such as those found in the BRCA1 or BRCA2 genes, can drastically increase the risk of breast cancer and are often passed down through generations. In addition, women with atypical hyperplasia and a first degree relative with breast cancer history have an increased risk for developing the disease.

However, a family history of breast cancer does not equate to a definitive future diagnosis. While it does raise risk levels, most cases of breast cancer are not linked to inherited gene mutations. Lifestyle factors, environmental exposures, pregnancy, and hormonal factors also significantly contribute to overall risk.

At the Texas Breast Center, we take your family history into account to provide a comprehensive risk assessment. Dr. Gorman’s approach is not only advanced but also personalized. She recognizes the importance of understanding the context of each patient’s health background, including the crucial role of first-degree relatives in determining risk. By using this information, she works with her team to develop a targeted approach, offering risk management strategies, preventive lifestyle advice, and when appropriate, genetic counseling and testing to provide a holistic health care plan.

Remember, having a close family member with breast cancer does not guarantee you will have the disease. It is one risk factor among many others, and it is important to consider it within the context of your overall health, lifestyle, and other personal risk factors. Knowing your family history is a powerful tool. It can guide you towards the necessary steps for early detection, timely medical intervention, and ultimately, it allows you to take control of your health.

Second-degree Relatives

When considering your family health history, second-degree relatives, including your grandmother, aunt, or niece, also play a critical role. These relatives share about 25% of their genetic material with you, meaning that their health conditions can still provide valuable insight into your potential health risks.

Should a second-degree relative be diagnosed with breast cancer, your risk of developing the disease may be slightly elevated. The risk associated with second-degree relatives is lower than with first-degree relatives due to the decreased proportion of shared genetic material. However, this does not make their health histories any less significant. Genetic mutations associated with breast cancer, such as those in the BRCA1 and BRCA2 genes, can still be passed along through second-degree relatives, albeit at a lower frequency.

It’s essential to remember that while the presence of breast cancer in second-degree relatives can increase your risk, most cases of breast cancer are sporadic and not due to inherited mutations. Other factors, including lifestyle, environment, and hormonal influences, can impact your breast cancer risk. Therefore, having a second-degree relative with breast cancer should be viewed as one piece of a much larger puzzle that contributes to your overall breast cancer risk.

At Texas Breast Center, we value your family’s health history as a pivotal part of your personalized breast health care journey. Dr. Gorman and her dedicated team employ a comprehensive approach, integrating the influence of both first and second-degree relatives into your overall risk assessment. By incorporating this information, we can design a targeted plan, involving advanced diagnostic screenings, preventative lifestyle recommendations, and when necessary, genetic counseling and testing.

Recognizing the importance of second-degree relatives in breast cancer risk assessment is crucial. While it doesn’t predict a certainty, it offers an opportunity for heightened vigilance, early detection, and proactive health care measures. Dr. Gorman can help you harness this knowledge, providing a platform for you to take the necessary steps to manage your health, underlining our belief that understanding and managing breast health is a collaborative, informed journey.

Multiple Family Members

When it comes to evaluating your risk of breast cancer, the significance of your family’s health history cannot be overstated. If more than one relative in your family has been diagnosed with breast cancer, it can be a key indicator of a higher risk of developing the disease. These relatives can be a combination of both first and second-degree relatives, including your mother, child, sisters, grandmothers, aunts, and nieces.

Having multiple family members with a breast cancer diagnosis can potentially suggest an inherited genetic mutation, such as in the BRCA1 or BRCA2 genes, which are associated with a substantially increased risk of breast cancer. This situation is often referred to as familial or hereditary breast cancer and it accounts for about 5-10% of all breast cancer cases. However, the presence of multiple breast cancer cases within a family may also reflect shared environmental or lifestyle factors that increase the disease’s risk.

It’s crucial to recognize that while having multiple family members with breast cancer increases your risk, it does not guarantee that you will develop the disease. The majority of breast cancer cases are actually not related to family history. Other factors, such as age, reproductive history, hormonal factors, lifestyle choices, and environmental exposures also contribute significantly to your overall risk.

The presence of multiple family members with breast cancer is an invitation for proactive health management. It offers an opportunity to heighten surveillance, encourage early detection, and equip you with the tools to manage your health effectively. At Texas Breast Center, we are your allies in this journey, offering expert advice, cutting-edge treatments, and compassionate care every step of the way.

Male Family Members

While breast cancer is predominantly associated with women, it is important to note that men can also be diagnosed with the disease. When a male family member, such as your father or brother, is diagnosed with breast cancer, it could indicate a potential inherited genetic mutation and, subsequently, an increased risk for you to develop the disease.

Male breast cancer comprises approximately 1% of all breast cancer cases, yet its significance should not be underestimated. The presence of breast cancer in a male relative such as a parent or child is often a signal of an inherited BRCA2 mutation. Although BRCA mutations increase the risk of breast cancer for both men and women, the probability of men developing breast cancer is still significantly lower compared to women. However, if a man carries a faulty BRCA gene, there is a substantial chance that he could pass it on to his children, potentially increasing their risk of developing breast cancer.

The medical diagnosis of breast cancer in a male relative underscores the importance of comprehensive family health history and genetic counseling. It’s also a stark reminder that breast cancer is not exclusive to women. However, having a male relative with breast cancer does not guarantee you will develop the disease; it merely points to a higher possibility. Multiple factors, including lifestyle choices, environmental exposures, and other genetic factors, contribute to your overall breast cancer risk.

If a male relative has been diagnosed with breast cancer, this necessitates a proactive approach to your health. Through regular screenings, potential genetic counseling and testing, and preventive lifestyle adaptations, you can help manage your risk.

Early Onset

Breast cancer is generally more common in older women, with most diagnoses made in women aged 50 and above. However, when a family member is diagnosed with breast cancer before the age of 50, it could signify an increased risk for other family members. Early-onset breast cancer often suggests a potential inherited genetic factor that can raise the risk of developing the disease.

Early-onset breast cancer, while less common, is often associated with inherited mutations in the BRCA1, BRCA2, or other related breast cancer genes. These gene mutations can be passed down from generation to generation, which could result in a higher risk of breast cancer amongst close relatives, especially if the disease occurs before the age of 50.

However, an early-onset diagnosis in the family does not confirm you will have breast cancer. It only implies a higher risk. At Texas Breast Center, we place significant importance on understanding your family’s health history. If there is a history of early-onset breast cancer in your family, this crucial information should be factored into your risk assessment and subsequently guide your breast health care management plan. This plan might include more frequent or earlier breast cancer screening, lifestyle adjustments, a healthy diet, and, where appropriate, genetic testing and counseling.

Understanding the potential implication of early-onset breast cancer in your family is a powerful tool for early detection and preventive health care. It allows for proactive risk management and heightened vigilance for any signs of the disease. At Texas Breast Center, we are here to help you navigate this journey, providing you with advanced, personalized, and compassionate care at every step of your breast health journey.

Bilateral Breast Cancer

Bilateral breast cancer, where both breasts are affected either simultaneously or sequentially, is another crucial factor when considering family history and breast cancer risk. When a family member has had cancer in both breasts, it could suggest an increased genetic susceptibility to the disease, thereby raising your own risk of developing breast cancer.

Bilateral breast cancer could indicate the presence of an inherited mutation in genes like BRCA1, BRCA2, or others related to breast cancer susceptibility. These genetic mutations can substantially raise the risk of developing breast cancer, and when observed in the context of bilateral breast cancer, can also suggest an increased likelihood of developing cancer in both breasts.

While bilateral breast cancer in a family member can be an important marker for elevated breast cancer risk, it doesn’t guarantee that you will develop the disease. The presence of bilateral breast cancer in your family history serves as a call for proactive health management. It creates an opportunity for heightened vigilance and early detection, empowering you to take the necessary steps to effectively manage your health. At Texas Breast Center, we are committed to helping you navigate this path, offering cutting-edge treatments, expert advice, and empathetic care at every stage of your journey.

Ovarian Cancer History

A family history of ovarian cancer can also increase your risk of developing breast cancer. This link is primarily due to the BRCA1 or BRCA2 gene mutations, which increase the risk of both breast and ovarian cancers. If a close relative has had ovarian cancer, consider discussing genetic testing with your healthcare provider to assess your risk.

Inherited Gene Mutations

Inherited mutations in the BRCA1 and BRCA2 genes are the most well-known genetic risk factors for breast cancer. These mutations can significantly increase your risk for breast cancer. Other gene mutations associated with breast cancer include p53, PTEN, and CHEK2. Genetic counseling and testing can provide information about these inherited risks and guide risk management strategies.

Other Related Cancers

Breast cancer risk is not solely influenced by a family history of breast cancer itself. Other related cancers, such as prostate cancer, pancreatic cancer, or other types of cancer, in your family can also be indicative of an increased risk of developing breast cancer. This suggests that certain inherited genetic mutations may not only predispose individuals to breast cancer but also to other forms of malignancies.

For instance, a BRCA mutation, while primarily associated with breast and ovarian cancer, has also been linked to a higher risk of prostate and pancreatic cancers. Similarly, mutations in other genes, such as PALB2, can increase the risk of both breast and pancreatic cancers. Therefore, a family history of these other cancers can provide vital clues about your potential inherited risk of developing breast cancer.

However, the presence of other related cancers in your family doesn’t necessarily mean you will develop breast cancer. It’s a single piece of the puzzle in the larger landscape of breast cancer risk. Your overall risk is influenced by a complex interplay of genetic, hormonal, environmental, and lifestyle factors.

At Texas Breast Center, we recognize the importance of a comprehensive family cancer history in understanding your unique breast cancer risk profile. Dr. Gorman, known for her commitment to providing advanced, personalized, and targeted breast cancer care, considers the entire scope of your family’s cancer history during risk assessment. This thorough evaluation can inform your personalized risk management strategy, including regular screening schedules, lifestyle modifications, and potentially genetic counseling and testing.

A family history of related cancers calls for an informed, proactive approach to your breast health. It’s an opportunity for attentive monitoring, early detection, and more effective risk management. At Texas Breast Center, we are here to support and guide you every step of the way, offering expert medical advice, leading-edge treatments, and compassionate care tailored to your unique needs.

Ethnic Background

Certain ethnic backgrounds, such as Ashkenazi Jews, are associated with a higher prevalence of BRCA1 and BRCA2 mutations, thus leading to an increased risk of breast cancer. Understanding your family’s ethnic background can help clarify your risk and inform screening recommendations.

Understanding these familial and genetic factors is critical in guiding breast cancer risk assessment and management strategies. However, keep in mind that having one or even multiple breast cancer risk factors does not guarantee a breast cancer diagnosis. Many women with one or more risk factors never develop the disease, and some women with breast cancer have no known risk factors other than being a woman and growing older.

In conclusion, a family history of breast cancer can significantly influence an individual’s risk of developing the disease. However, it’s important to remember that breast cancer is not exclusively hereditary. Environmental factors, lifestyle choices, and certain conditions such as obesity, high alcohol intake, lack of breastfeeding, early menstruation, late menopause, and exposure to hormone replacement therapy can contribute to breast cancer risk.

Dense breast tissue, characterized by a higher proportion of glandular and connective tissue to fatty or adipose tissue, can also increase the risk and make mammography screening more challenging. Factors such as age, hormone levels, and certain drugs can affect breast density.

Knowledge and awareness of both your familial and personal risk factors can empower you to take control of your breast health. Regular screenings, maintaining a healthy body weight, limiting alcohol intake, and understanding the implications of your birth control choices are ways to manage and reduce your risk.

If you have a family history of breast cancer or other related cancers, consider speaking with a healthcare provider or a genetic counselor. They can provide you with valuable information, discuss the possibility of genetic testing, and guide you towards the best preventative measures and screenings based on your risk.

At Texas Breast Center, we recognize that every patient is unique, and we are committed to providing advanced, personalized, and targeted care. Dr. Gorman and her dedicated team strive to empower patients with the knowledge and resources necessary to make informed decisions about their health. If you have concerns about your breast cancer risk, contact the Texas Breast Center to schedule an appointment.

In the realm of breast health, understanding your risk is the first step towards prevention and early detection. Through shared decision-making and a patient-centered approach, we can work together to navigate your breast cancer risk and ensure that you receive the most appropriate, tailored care.

Remember, knowledge is power. Take control of your health today.

See the other articles in the Causes series, including Age-Related Risks.

Texas Breast Center – Helping You 0n Your Journey

Our philosophy is rooted in a strong dedication to advanced, personalized, and targeted breast cancer care. We believe that every woman is more than just a patient – she is a person with a unique story and a unique health journey. Our mission is to walk with you, hand-in-hand, through each step of this journey, offering the most advanced treatments, answering your every question, and standing as a constant source of support and knowledge.

Moreover, we understand that breast cancer risk is not just a clinical concept—it’s an intimate part of a woman’s life, shaping her decisions and future. This understanding is our driving force. Through fostering a supportive environment and leveraging advanced targeted treatment strategies, we provide personalized care to every woman walking through our doors. Our comprehensive approach ensures that your journey toward understanding, managing, and potentially preventing breast cancer is one of empowerment, care, and expert support.

At Texas Breast Center, we blend our advanced medical expertise with warmth, understanding, and the unwavering belief that knowledge is indeed power. Join us as we delve deeper into the role of family history in influencing breast cancer risk. Our goal is to empower you to take proactive steps toward safeguarding your health and share important information to help prevent breast cancer. Your journey is our journey, and we’re here with you every step of the way.


Breast Cancer Causes: Genetic Mutations

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.

genetic mutations

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


Habits that May Lead to Breast Cancer

Around the globe, breast cancer affects millions of women. One in eight women is predicted to have breast cancer during their lifetime in the United States alone. While there are several risk factors that you can’t control, such as a family history of breast cancer or dense breast tissue, there are certain behaviors and lifestyle choices that may have a significant impact on lessening your risk. Eliminating the habits that you can control can help decrease your risk of developing breast cancer.

Poor Diet

About 30 to 40 percent of all malignancies are considered to have some connection to diet. You cannot avoid developing breast cancer with diet or food alone. However, certain meals may improve your body’s health, strengthen your immune system, and lower your chance of breast cancer. According to research, eating a range of foods that are high in nutrients, including fruits, vegetables, legumes, and whole grains, may help you feel your best and provide your body with the energy it needs. Animal studies suggest eating food cultivated without pesticides may help prevent the unfavorable cell alterations linked to pesticide usage.

In nations where the traditional diet is plant-based and low in total fat, breast cancer is less prevalent. However, studies on American adult women haven’t shown a link between dietary fat consumption and a woman developing breast cancer. A high-fat diet throughout adolescence, however, may increase a girl’s risk of developing breast cancer later in life, even if she doesn’t go on to gain weight or become obese.

Further study is required to fully comprehend how nutrition affects the risk of breast cancer. However, it is undeniable that calories do matter, and fat is a significant source of calories. Being overweight or obese, which are breast cancer risk factors, may be brought on by high-fat diets. Because excess fat cells produce estrogen, which may promote the development of extra breast cells, overweight women are considered to have a greater chance of developing breast cancer. Breast cancer risk is increased by this additional growth.

Lack of Exercise

Regular exercise benefits your health in a variety of ways, one of which is a decreased risk of breast cancer. Over the last 20 years, several studies have consistently shown a relationship between increased physical activity and a decreased risk of breast cancer.

It is unclear exactly how exercise reduces the chance of developing breast cancer. It is believed that exercise controls estrogen and insulin, two substances that may promote the development of breast cancer. Regular exercise also aids women in maintaining a healthy weight, which supports hormone regulation and immune system health.

Unfortunately, there is no magic number of hours a woman should exercise each week to prevent breast cancer. We do know that more is preferable to less, and that some is better than none. Additionally, more intense exercise is more productive than less intense exercise. All people should exercise for at least 150 minutes per week of moderate effort or 75 minutes per week of vigorous intensity, ideally spaced out over the course of the week, according to the American Cancer Society.

Brisk strolling, dancing, leisurely biking, yoga, golfing, softball, doubles tennis, and routine yard and garden upkeep are some examples of moderate-intensity exercises. Jogging, running, rapid cycling, swimming, aerobic dancing, soccer, singles tennis, and basketball are some examples of high-intensity exercises. Along with your regular daily activities at home and at work, all of these extracurricular activities include stair climbing and walking from your vehicle to the garage.

Exercise has the additional benefit that it keeps you from merely sitting around. The probability of acquiring breast cancer and several other forms of cancer, as well as obesity, type 2 diabetes, and heart disease rises with sitting time, regardless of how much exercise you receive when you’re not sitting, according to an increasing body of research. Many of us spend most of our workdays seated at a desk. Because of this, it’s even more crucial to include activity throughout your day.

Certain Types of Birth Control

There is a small increase in the risk of breast cancer associated with the current or recent usage of oral contraceptives. According to studies, women’s breast cancer risk is 20–30% greater while using birth control pills (and immediately after) than the risk for women who have never used the pill. However, since the absolute risk of breast cancer for the majority of young women is low, this additional risk has only a little effect.

Women’s chances of developing breast cancer start to decrease after they quit using oral contraceptives. The risk eventually drops to the same amount as women who have never used the pill. Despite the increased risk of breast cancer , birth control pills also lower the risk of uterine and ovarian cancer in addition to preventing pregnancy. Just like with previous, higher-dose versions of the drug, modern, lower-dose tablets have been associated with an increased risk of breast cancer.

Some alternative contraceptives contain (or release) hormones, just like birth control pills do. Depo Provera users who have been using it for extended periods of time may be at a higher risk for breast cancer than women who have never used it.

Research on IUDs that release hormones and breast cancer research have conflicting results. IUDs don’t increase the risk of breast cancer, according to some research. According to other studies, women who use hormone-releasing IUDs may have a 20% greater chance of developing breast cancer (similar to birth control pills). According to other research, women who previously used hormone-releasing IUDs may be more likely to develop breast cancer after menopause.

Discuss the advantages and disadvantages of any contraceptive pill with your doctor before using it (or if you already are and haven’t done so).

Not Getting Routine Mammograms

Low-dose x-rays of the breast are called mammograms and can help doctors identify a breast cancer diagnosis. Regular mammograms are one of the best breast cancer screenings that may assist in detecting early stage breast cancer, when treatment has the best chance of being effective. Years before physical breast cancer symptoms appear, a mammogram may often detect breast abnormalities that might be cancer. Results from decades of research definitively demonstrate that women who receive routine mammograms are more likely to have breast cancer discovered earlier, are less likely to require an invasive breast cancer treatment like chemotherapy and surgery to remove the entire breast (mastectomy), and are more likely to recover from the disease.

Mammography is not flawless at detecting breast cancer cells. Dense breast tissue can make it harder for radiologists to see breast cancer on mammograms. Although most breast cancers will be detected, some will be missed. A woman will probably need more testing (such as additional mammograms or a breast ultrasound) in order to determine if anything seen on a screening mammogram is cancer. Additionally, there is a slight possibility of receiving a cancer diagnosis that, if not discovered during screening, would never have given rise to any issues.  It’s crucial that women undergoing mammograms be aware of what to anticipate and the advantages and limitations of screening. As you age, your risk of developing breast cancer increases. Breast cancer screening through mammography is vital for women over age 40.

Use of Tobacco Products

According to research, smoking may significantly increase the chance of developing breast cancer, particularly in women who began smoking as adolescents or who had a family history of breast cancer. Smoking might increase one’s chance of developing breast cancer because specific chemicals in tobacco products may cause out-of-control cell proliferation in the body. Smoking is associated with an increased risk of breast cancer in certain women, despite the fact that it is not thought to be a direct cause. In addition, smoking may make treating breast cancer more difficult and lead to complications from breast cancer surgery. Avoiding tobacco products is an important factor in breast cancer prevention.

Excessive Use of Alcohol

Many studies reveal women who consume alcohol have an increased risk of breast cancer. According to research, the relative risk of breast cancer rose by roughly 7% for every alcoholic beverage taken daily. Compared to women who didn’t consume alcohol, women who had 2-3 alcoholic drinks per day had a 20% increased chance of developing breast cancer.

Alcohol may alter how a woman’s body processes estrogen. Blood estrogen levels may increase as a result of this. Women who drink alcohol have greater amounts of estrogen than non-drinkers do. As a consequence, higher estrogen levels are related to a higher risk of breast cancer. Alcohol and cancer risk can be controlled by limiting the amount you consume.

Hormone Replacement Therapy

Breast cancer risk is elevated by the majority of hormone replacement therapy (HRT) types. However, individuals who take combination hormone replacement therapy (HRT), which combines both estrogen and progesterone, are at a greater risk.

Breast cancer risk is only modestly elevated when HRT is used for less than a year. However, the hazards become more severe and continue longer the longer you use HRT.

HRT-related breast cancer risk varies from individual to individual. The risk may vary depending on your age when you start HRT, any medications you may be on, and overall health.

Breast cancer risk factors are greater for people who take HRT before or shortly after menopause as compared to those who start it later.

Even though there are several potential causes of breast cancer, some behaviors and lifestyle choices may have a big impact. These lifestyle choices, including smoking, drinking alcohol, and eating poorly may all raise your risk. Regular physical activity and maintaining a healthy weight are effective methods to lower your risk. This disease may also arise as a result of certain birth control methods and hormone replacement therapy. If you have any of these risk factors, it’s important to speak to your doctor about them.


Breast Cancer Awareness: A History

March is officially known as Women’s History Month! To celebrate women, the incredible things they have endured throughout history, and to highlight the value of their wellbeing, let’s examine breast cancer awareness throughout history. You are likely to see an influx of this information during October, but Dr. Valerie Gorman of Texas Breast Center emphasizes the importance of breast cancer awareness year-round. Doctors and breast care specialists universally agree that awareness of the realities and risk factors is critical in conquering breast cancer’s devastation.

While the history of breast cancers presumably goes back to the early days of humanity, widespread advocacy for the cancer community and dispelling the shame around breast cancer has had a much shorter timeline. Not only that, but common awareness of this cancer and its symptoms has just become prevalent within the last 50-75 years. Texas Breast Center wants to highlight the journey of awareness for breast cancer and, through doing so, encourage people to check their own breasts and to spread knowledge of both prevention and risks of breast cancer in their communities.

The Origins of Breast Cancer Awareness

When did breast cancer awareness begin?

Women have been at the forefront from the beginning of cancer research initiatives. Early forms of the American Cancer Society founded the Women’s Field Army, giving thousands of women the chance to instigate fundraising and promote research during a time when society handed them few other privileges.1 Despite the advancement of fundraising efforts beginning in 1913, discussing cancer was taboo and deemed unfit for conversations far into the 1900s. Particularly regarding breast cancer, public discourse would identify it solely as a “prolonged women’s disease.”2

Only in the 20th century did breast cancer finally reach public notice. This shift can largely be attributed to former First Lady Betty Ford. She opted for total transparency in her battle against breast cancer during the 1970s, a time when stigmas surrounding breast cancer were a crippling concern for many women. Using her platform, Betty Ford shared the importance of screenings, breast cancer treatment, and solidarity for other American women affected by cancer. This instigated a dramatic reformation in culture surrounding breast cancer, both in the societal support of breast cancer patients and in prioritizing regular doctor exams.

When did widespread breast cancer initiatives arise?

Recognition of the disease began at an individual level first, with women such as Betty Ford speaking candidly about their experiences. From this stemmed the opportunity for structural and organizational levels of awareness to be formed. The best-known cancer charity initiative is the internationally recognized Breast Cancer Awareness Month, taking place annually in October. In 1985, Imperial Chemical Industries and the American Society for the Control of Cancer partnered to create the first national week-long breast cancer awareness event. The initial intent of this was to encourage women to get regular mammograms, a form of breast imaging used to screen for breast cancer. This week later transitioned into a month-long observance of breast cancer survivors and patients.

Nowadays, it is incredibly common for a non-profit organization or a corporation to take part in the annual commemoration. From the NFL to cosmetic companies like Estee Lauder to The White House, public awareness campaigns, donation drives, and stories are spread to raise money and support systems for women who have been diagnosed with this disease. Estee Lauder created one avenue of this in 1992, seven years after the first awareness event, with the pink ribbon, and gave out over a million to initiate a tangible representation of the month’s efforts.3 This image is still easily identified today, commonly known as a symbol of support for patients.

The Importance of Breast Cancer Awareness

Why is breast cancer awareness so important?

Breast cancer awareness is crucial because of the approximate 13% chance of women receiving this diagnosis. (1 out of 8 women in America develop breast cancer at some point in life, with the likeliness increasing with age.) Knowing the statistics surrounding developing breast cancer, keeping watch over the risk factors, and seeking transparent, expert education on the latest prevention methods can help one improve their chances of keeping a late diagnosis at bay.

What are the achievements of the breast cancer movement?

Breast cancer research

An increase in awareness has led to a greater emphasis on research to cure breast cancer throughout recent history. Following individual concerns, support groups were created, leading to lobbyists and activists pushing for greater research and education on the disease. The Journal of Women’s Health provides one example of this through the seven-year project on environmental toxins and impact conducted by the Breast Cancer and Environment Research Centers (BCERC).4 This program was an influential precedent, as it was the first National Cancer Institute funded initiative to incorporate activists into the scientific research council. In this, those involved in pushing to raise awareness had a direct impact on the focus of the studies. This 2003-2010 project is simply one of many historical examples where voices in the community resulted in an incredible impact on cancer research. What proof that individuals’ involvement matters!

What is the aim of breast cancer awareness?

You Can Help Save Lives

Breast cancer is the second most common cancer in women. This means the odds of you or a loved one needing to be treated are high. Awareness aims to help eradicate this statistic, and you can play a tremendous role in this by educating yourself and your community on the risks. Being informed is crucial for many reasons, mainly because it teaches people about the necessary aspects of breast care. These are measures such as routinely scheduled mammograms, conducting self-examinations, maintaining a healthy weight, limiting alcohol consumption, pumping your own breast milk, extensively researching birth control pills and medicine, and staying active to the best of one’s abilities. Each of these factors can lead to a lower risk for women of developing breast cancer, or, if one is to get cancer despite a lowered risk, to an early diagnosis, which has proven to yield better outcomes.

Additionally, in creating ordinary spaces for conversations about the realities of breast cancer to occur, the perception of those whose lives have been affected by this disease will change for the better. Increasing knowledge in your community can breed hope and support for women with breast cancer. This acceptance can also lead to a society that encourages scheduling screening mammograms regularly, producing more cases of early detection, which can save lives.

Support for You

As research increases, so do the success rates of treatment. Even with improving science, we understand that a breast cancer diagnosis can still feel overwhelming. Texas Breast Center is committed to being with you every step of the way. The team aims to connect with you to provide hope through a personalized, targeted treatment plan and support that goes beyond your initial treatments. Valerie J. Gorman, MD, FACS, is a breast surgeon specializing in surgical oncology and surgical diseases of the breast. Under her care, you will find a broad spectrum of treatment options, such as hormone therapy, and a treatment program designed to benefit your exact case of breast cancer.

 

  1. Lerner B. Inventing a curable disease: breast cancer control after World War II. In: Lerner B, editor. The Breast Cancer Wars: Fear, Hope, and the Pursuit of a Cure in Twentieth-Century America. Oxford: Oxford University Press, Inc.; 2001. pp. 41–68.
  2. Ross W. Transformation. In: Ross W, editor. Crusade: The Official History of the American Cancer Society. New York: Arbor House; 1987. p. 33.
  3. https://www.elcompanies.com/en/our-commitments/the-breast-cancer-campaign
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3298674/

Black Women and Breast Cancer

Black History Month

Officially recognized in 1976, February is dedicated as Black History Month in the United States of America. Commemorating the victories and legacies of African Americans and recognizing the hardships they have faced throughout our history, it is a pinnacle time of awareness and memorialization in the lives of American citizens. In honor of this past month’s observations, we wanted to provide information on women’s health surrounding the realities of breast cancer for black women.

Black Women and Breast Cancer

According to the American Cancer Society, breast cancer is the most commonly diagnosed cancer for black women. Falling second to lung cancer, breast cancer is also a top cause of cancer-related mortality. It is crucial for black women to understand the likelihood of a diagnosis, the risks surrounding breast cancer, and ways to routinely check for potential breast tumors. There are many questions surrounding the truth on breast cancer statistics, particularly pertaining to black women. Educating people on the realities of breast cancer plays a key role in women knowing what to watch for regarding their breasts and in changing some of the socially constructed elements surrounding medical and breast care for black women.

What is breast cancer?

Essentially, breast cancer is the uncontrolled development of breast cells. This is why it is recommended that women examine their breasts regularly for evidence of changes to the breast such as puckering or discoloration, as they are often the first symptoms to appear.

What would lead to a breast cancer diagnosis?

Although there are many different varieties of cancer, tumor biology at its base level remains consistent, and they all have similar characteristics. The genes in the human body regulate and control cell proliferation. The job of genes, which are found in the nucleus of cells, is to ensure that as old cells die, they are replaced by new cells. Mutations can develop, causing this process to be disrupted. This change can significantly affect the regeneration process, removing control from the genes and allowing the cells to continue making new cells without restriction. The production of additional cells can lead to the formation of a tumor. The emergence of a malignant tumor (which is an aggressive form of cells and can spread to other areas of the body via the blood and lymph systems) is what typically generates a breast cancer diagnosis.

Breast Cancer Risk for Black Women

Age, ancestry, family history, and type of diagnosis affect the severity and likeliness of breast cancer.

Who has the highest risk of breast cancer?

Despite a lower incidence of breast cancer development, black women’s lives are approximately 40% more likely result in breast cancer death. Women of a younger age, meaning below the age of 45, also tend to have the highest risk. There is no simple answer to this disproportion, as these starkly contrasting numbers seem to arise from a combination of factors, including both sociological conditions and genetic factors.

Disparities of Breast Cancer and Race

In recent years, there have been increasing conversations surrounding the tragic breast cancer disparities of medical care and attention for people of color. These risks and realities prove particularly tangled and problematic in the world of health care and surgical access. While this is true, Dr. Gorman of Texas Breast Center is eager to dismantle this problem through targeted, attentive care for each person who comes under her expert care.

The prevalence of breast cancer is still far greater than we like to see, which is why Dr. Gorman and her team at Texas Breast Center fight endlessly to see these numbers decrease. Particularly among black women, the statistics of more aggressive forms of breast cancer diagnoses, such as triple-negative breast cancer, are astronomically higher.

What is triple-negative breast cancer?

Triple-negative breast cancer is a form of breast cancer that tests negative for all three receptors: estrogen, progesterone, and HER-2. This kind of breast cancer is one of the more aggressive and invasive breast cancer types, with high spread and growth rates. Both age and race play into the likeliness of this diagnosis, as it is most common in women under forty and in black women.

Not all black women are at the same risk of developing triple-negative breast cancer. Research shows that particularly those born in Western Africa and the United States are at an increased risk for triple negative breast cancer in comparison to those born in East Africa. This difference is especially notable when compared to white women or women of other races. According to the American Cancer Society, black women in the United States are actually twice as likely as white women to receive this diagnosis. This may be a reason for the lower rate of survival among black breast cancer patients. Educating oneself on the risks of breast cancer can help black women act in anticipation and preparation and increase the chances of survival through early detection.

Dr. Gorman at Texas Breast Center

While statistics surrounding breast cancer can seem overwhelming and may evoke fear, Dr. Valerie Gorman combats this with the truth that “treatment for breast cancer has improved significantly over the last few years, and success rates continue to rise.” Breast cancer outcomes and treatments have never seemed more optimistic.

Dr. Gorman and her team at Texas Breast Center, located in Waxahachie, are devoted to caring for every patient in a manner tailored to their unique case, conducting each interaction with expert care, attention, and skill. Providing honest, advanced information on the risk factors of breast cancer and the leading treatment options is a top priority of this Texas-based breast surgeon. She dedicates herself to the wellbeing of every single patient and, in doing so, aims to topple the disparities that black women diagnosed with breast cancer face and help reduce the rates of breast cancer mortality, one case at a time.

Staying informed

As a leading surgeon, Dr. Gorman advocates for preventative measures and staying on top of breast health. Regular self-breast checks, mammography screening, a regular clinical breast exam, assessing controllable risk factors, and remaining informed on the latest news surrounding breast care are all steps that can increase the chances of detecting breast cancer while it is still in the early stages.

If you have any questions surrounding breast cancer or breast cancer risk factors, don’t hesitate to contact Dr. Gorman and her team at Texas Breast Cancer.

 

https://www.cancer.org/research/cancer-facts-statistics/cancer-facts-figures-for-african-americans.html

https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.32293?referrer_access_token=tNmZThNQBcGMkZz0Mw1KaU4keas67K9QMdWULTWMo8PjlxlDClmn9SMF_cvVV7b6CVxSyInTq9HeXJidKb9BxMA8NsR


How Breast Cancer is Diagnosed

No one is excited to get a mammogram or go through other breast cancer screening tests. However, keeping on top of breast health and regular screening can be life-saving. The sooner breast cancer is diagnosed, the better the outcome is more likely to be.

First Steps

Keeping on top of regular breast self-checks, yearly mammograms, and annual physicals can help increase the chances of finding breast cancer in the early stages. That is to say, mammograms and self-checks will not increase the chances of a diagnosis but of early detection of the disease should it occur. These are three possible first steps in a potential breast cancer diagnosis.

Self Breast Check

A self breast-check, also known as breast self-exams, is a method used to keep yourself informed and aware of your own breasts and breast tissue. They should be done monthly, if possible, and especially if you meet a high number of risk factors, and they do not take long. But if performed regularly, they can keep you very familiar with the feel and appearance of the breasts, meaning any change is sure to stand out.

The process is relatively simple:

  • Start by looking at your breasts, both looking down and checking them in a mirror. Check for any changes in color, size, or shape. Signs of cancer or other infection are swelling, redness, dimpling, puckering, or discoloration. Especially check the nipple for inversion, pain, or unexpected or bloody discharge.
  • Raise your arms and reexamine. Having your arms up may shift the positions of the breasts to reveal something you may have missed otherwise.
  • Use the pads of a few fingers to carefully feel over the entire breast. Use consistent, small, circular motions to move across, up, and down the whole breast, covering the collarbone to the top of the rib cage and cleavage to the armpit
  • . Use enough pressure to feel deep tissue but not enough to hurt yourself.
  • Lay down and repeat the process.

Keeping up with regular breast self-exams will make it easier to notice any changes. If you find anything of concern, speak with your physician to discuss options and further screening.

Clinical Breast Exam

A clinical breast exam is part of the standard physical. It is a breast exam performed by your doctor, in which they will physically examine and feel each breast to feel for any changes or lumps in the tissue. The clinical breast exam becomes particularly relevant if you are at high risk of breast cancer or have noticed changes in your breasts during a breast self-examination. Raise any concerns with your physician so they can help you and discuss any necessary next steps.

It is not as simple as finding a lump and having doctors diagnose breast cancer. Should something be found during these exams, your doctor will likely send you to get a mammogram or ultrasound.

Schedule your appointment for a clinical exam today!

Breast Imaging Tests

Mammograms

Another way to keep on top of your breast cancer risk and status is to receive regular mammograms. A screening mammogram, or mammography, is an X-ray of the breast using a low dose of radiation. Two plates will compress the breast at different angles to get multiple digital images, which a radiologist can examine for signs of breast disease or any other possible abnormality.

However, those who have particularly dense breast tissue or scar tissue in the breast are likely to have false positives in a mammogram. Breast cancer, dense tissue, and even cysts (fluid-filled sacs) appear white on x-rays, with limited ways to distinguish between them. For this reason, a potential positive from a diagnostic mammogram is not considered conclusively positive. Additional tests or a biopsy should be taken to confirm accuracy.

Ultrasound

A breast ultrasound uses sound waves to form a picture of the breast tissue. This is a good alternative to a mammogram if you’re pregnant and shouldn’t be exposed to x-rays. While ultrasounds are not generally used for cancer screening, they work well at differentiating a fluid-filled cyst from more solid masses. It can also give locations of tumors to help doctors, should they need to perform a biopsy or further investigation. Some surgical oncologists will use ultrasound during lumpectomies to establish the boundaries of the breast cancer before they begin removal.

MRI Scan

MRIs, or Magnetic Resonance Imaging tests, use magnetic fields to produce images of the breast’s interior. A contrast dye is injected before the screening, revealing where any blockages are. MRIs are not often used to diagnose breast cancer but instead used after an initial diagnosis to see how far cancer has spread. However, it can be used in combination with a mammogram to screen if:

  • there is a strong family history of breast cancer or ovarian cancer
  • the breasts are particularly dense (primarily ducts, fibrous tissue, and glands, with little fatty tissue), so any signs of breast cancer would be difficult to spot on a mammogram alone
  • the BRCA1 or BRCA2 gene mutation or other genetic mutations are present
  • radiation treatments have been applied to the chest before age 30

These traits can potentially lead to a high risk of breast cancer or, in the case of the dense tissue, an increased risk of missing early-stage breast cancer.

Metastatic Breast Cancer Detection

Specific imaging tests can detect metastasis once breast cancer has already been diagnosed. Biopsies can be performed by interventional radiologists, doctors whose primary focus is minimally invasive and targeted therapy.

Biopsy Sample

There are multiple kinds of biopsies, each serving their own purposes, though generally speaking, a biopsy is used to confirm or rule out a breast cancer diagnosis. Put simply, a biopsy takes a small amount of cells or tissue from an area of concern to examine under a microscope to establish whether these cells are cancerous or not. A pathologist–a doctor specialized in interpreting lab data and evaluating and diagnosing based on cells and tissues–will create a pathology report to explain what was found and discuss potential treatment options.

Fine Needle Aspiration Biopsy

The tissue or cell sample is removed using a thin needle.

Core Needle Biopsy

Like the fine needle aspiration method, the core needle biopsy uses a needle to remove the needed sample. However, the needle gets a core of tissue, so it collects a larger sample. This is generally the preferred technique for getting breast cancer diagnosed once an abnormality has been found in the breast, whether through physical examination or imaging tests. A pathologist will examine the sample to establish whether they are invasive cancer cells and identify any cancer biomarkers. Local anesthesia is commonly used to minimize discomfort during the procedure.

Image-Guided Biopsy

Image-guided biopsies are a form of core needle biopsy that map the area and guide the needle to the correct area of calcifications or mass through the use of imaging devices, such as ultrasound, mammography, or MRI. Usually, a marker is left behind–a small metal clip, usually titanium–to mark where the sample was taken.

Surgical Biopsy

Surgical biopsies are usually performed after a diagnosis has already been given, so they are rarely used as diagnostic tests. Most potential breast cancer patients will be given a form of needle biopsy to avoid unnecessary surgery. However, surgical biopsy does yield the largest amount of tissue.

Sentinel Lymph Node Biopsy

Breast cancer will sometimes spread into the local lymphatic system. The lymph nodes the breast cancer cells reach first are referred to as the sentinel lymph nodes and are usually the axillary lymph nodes (found under the arms). The sentinel lymph node biopsy removes 1-3 lymph nodes to avoid needing to remove more lymph nodes later.

Staging Breast Cancer

Once a breast cancer diagnosis has been established, your doctor will establish its severity in one of the breast cancer stages. The stage helps determine your prognosis and the best treatment options to take moving forward.

Some procedures that may be used to establish the breast cancer’s stage are:

  • Mammogram
  • Breast MRI
  • Blood tests
  • Bone scan
  • PET scan
  • CT scan

The stages ran from 0–meaning noninvasive and relatively contained–to IV–also called metastatic, meaning it has spread to other parts of the body.

Treatment Options

A patient’s treatment plan will be determined based on their breast cancer stage, health, and other factors. Dr. Gorman at the Texas Breast Center always ensures that each patient receives a personalized and targeted approach to breast cancer treatment to best meet their needs.


Breast Cancer in Men

Breast cancer is represented by the pink ribbon. Research is fundraised through walks decked out in pink, and breast cancer awareness gear can be found covered in slogans like “big or small, save them all” or better yet, “fight like a girl.” And while the runs, marches, and merchandise can go a long way in raising money, they can also go a long way in implying some wrong information. If nearly all breast cancer awareness is geared towards women, does that mean men cannot–or do not–get breast cancer? No. Men may be less likely to get breast cancer than women, but there is still a risk.

How can you tell if a guy has breast cancer?

Breast cancer in men displays similarly to how it does in women. The symptoms are the same, and some are even more easily found due to the smaller amount of breast tissue in most men. With less breast tissue, lumps are more easily noticed and, therefore, diagnosed.

The most common symptoms of male breast cancer are:

  • Scaling, flaking, or redness of the skin of the nipple; can show as puckering or dimpling as well, or can happen to the skin over the whole breast, not just the nipple.
  • A painless thickening, swelling, or lump in the breast.
  • Nipple discharge, retraction, or ulceration.
  • Pain or pulling in the nipple area.

If the cancer cells spread further than the initial breast tumor, there can be additional symptoms and side effects, such as:

  • breast pain
  • bone pain
  • swelling in the underarm lymph glands

If anyone, no matter the person’s gender, experiences these symptoms, they should speak to their doctor. The sooner any breast cancer cells can be found, the more likely any treatment options are to work, and the less rigorous treatment needs to be.

How common is breast cancer in men?

While it is commonly known that breast cancer will develop in approximately one in eight women over the course of their lifetimes, the statistics on male breast cancer are less well known. When you search google for ‘how common is breast cancer,’ every answer on the first page is about women. Most sites collecting data on cancer categorize breast cancer as ‘female breast’ cancer to clarify that their data does not include men, despite many other cancer types (stomach, colorectum, leukemia, etc.) gathering data for both men and women. While this makes it easy to do cancer research for women, it makes it difficult to find information for male cancer patients.

One source, however, found that one out of every one hundred breast cancer diagnoses is given to a man. So, while men are at less of a risk than women, there is still a chance of breast cells becoming cancerous.

The American Cancer Society did offer that approximately 2,550 new male breast cancer cases are diagnosed each year. With breast cancer being 100 times more common in women than men, and with a man’s risk of diagnosis averaging around one in 1,000, it is easy to see why it’s not as prominently discussed. However, the risk is still there, and men should know what to look for to minimize risk.

However, just as with women, some men have more risk factors than others. These risk factors do not guarantee that this person will get breast cancer, nor does avoiding the risk factors guarantee that the person will avoid a breast cancer diagnosis. However, if you have these factors in your history, or are aware of them, be mindful of the signs, symptoms, and possible screening guidelines for breast cancer.

What are the risk factors for men?

Some of the risk factors for male breast cancer include:

  • Family history of breast cancer–you have a higher chance of developing breast cancer if you have a close family member who has, or has had, breast cancer.
  • Age–most male breast cancer diagnoses happen after 50 and are most commonly between age 60-70. It is usually rare for a man to get breast cancer under the age of 35.
  • Radiation therapy treatment–having a history of radiation therapy to the chest can increase the risk of breast cancer.
  • Liver disease–liver cirrhosis and other liver diseases can reduce androgen (commonly referred to as male hormones) levels and increase estrogen (commonly referred to as female hormones) levels in men, increasing risk.
  • Testicle surgery or disease–surgical removal of a testicle (orchiectomy), testicular injuries, or testicle diseases or conditions such as mumps orchitis or undescended testicles can increase breast cancer risk.
  • Estrogen exposure–those who take, or have taken in the past, estrogen or estrogen-related drugs (used for hormone therapy for prostate cancer) can have a higher risk of breast cancer.
  • Obesity–obesity can be associated with higher estrogen levels, leading to an increased risk factor.
  • Enlarged breasts–having enlarged breast tissue, known as gynecomastia, can come from infection, drug or hormone treatments, as well as other causes. Having additional tissue can make it difficult to notice early signs of breast cancer.
  • Breast cancer genes–mutations to the BRCA1 and BRCA2 genes dramatically increase the risk of breast, ovarian, and other cancers. People of all genders should be aware of the potential danger of the mutation of these genes.
  • Klinefelter’s syndrome–Klinefelter’s syndrome is genetic and can be considered a form of being intersex. It occurs when a boy has more than one X chromosome, leading to lower androgen levels and higher estrogen levels. This increased amount of estrogen can increase the risk factor.

Can trans men get breast cancer?

Anyone can get breast cancer. However, transgender men and non-binary people occupy a unique space regarding risk factors and following the breast cancer story from start to finish. Many AFAB (assigned female at birth) men or non-binary people carry the same risk factors that cisgender (non-transgender) women have, especially if they have not taken steps such as gender-affirming surgery or hormone therapy.

Most data on the subject of transgender and non-binary people and their risk and experience with breast cancer comes from individual case studies and anecdotal experiences rather than extensive cancer research. One such study conducted in 2013 in the Netherlands examined nearly 800 AFAB trans men taking testosterone and discovered only one case of breast cancer. Overall, the study stated that “The rate of breast cancer among trans men in this study was estimated to be much lower than the rate of breast cancer among cisgender women and similar to the rate among cisgender men in the Dutch population” (1).

Do top surgery or binding affect breast cancer risk?

Binding, a practice not uncommon among trans men and non-binary people, compresses the breast tissue to make the chest seem flatter to help reflect the person’s gender identity more accurately and comfortably. Binding can sometimes cause adverse symptoms such as shortness of breath, pain, and skin infections, especially when done by more risky methods (tape, ace bandages, leaving binders on for too long). However, binding has not been linked to breast cancer.

Top surgery, a mastectomy performed to align the patient’s breasts and chest with their gender identity, is a different form of mastectomy from those performed for breast cancer purposes. Top surgery mastectomies remove fatty tissue but may leave behind some glandular (milk-producing) tissue and lymph vessels, where cancer may form. People who receive top surgery should still perform regular breast self-checks and discuss the risks of cancer with their doctor.

Can male breast cancer kill you?

There is a risk of death as with any cancer, depending on when the breast cancer cells are discovered. According to the American Cancer Society, the prognosis for breast cancer in men is similar to that in women. The odds of surviving five or more years after the initial diagnosis are, on average:

  • 96%–when cancer is still only affecting the breast tissue at diagnosis
  • 83%–when cancer has spread through the breast to nearby areas, such has the local lymph system (underarm, etc.)
  • 23%–when the disease has spread throughout the body

Just as is recommended to women, it is essential to be aware of any changes in the breast so that if cancer cells start to grow, treatment can begin as soon as possible.

What is the survival rate of male breast cancer?

As mentioned above, 2,550 new cases of breast cancer in men are diagnosed annually. Unfortunately, this same cancer also leads to around 480 deaths in men. While this is significantly lower than the close-to-40,000 women who die of breast cancer annually, it is still a statistic that can be lowered.

Most male breast cancers are diagnosed after patients discover a lump in their chest. However, many tend to leave this concern alone until other, more severe, symptoms arise, such as blood coming from the nipple. However, by this time, the cancer has likely spread further, making the necessary treatment harsher and the risks involved a little grimmer.

By informing male patients of the possible risk factors for breast cancer, they can be more aware should they notice something out of place in their chest. Self-breast checks can be just as necessary for men, transgender, and non-binary people as for cisgender women, and everyone should have the chance to be informed of their risk.

If you have questions about your risk factors, any changes in your breasts, or simply about breast cancer, speak with your doctor, or Dr. Gorman at the Texas Breast Center is happy to help answer any questions. Her goal is to keep all patients informed and prepared.

Read the article on Gender Influences and the Cause of Breast Cancer

  1. Gooren LJ, van Trotsenburg MA, Giltay EJ, van Diest PJ. Breast cancer development in transsexual subjects receiving cross-sex hormone treatment. J Sex Med. 2013;10:3129-34.

Breast Cancer in Transgender People

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

Breast Cancer Risk Factors

What is a Risk Factor?

A breast cancer diagnosis can seemingly come out of nowhere for many patients. However, many things that could have made this diagnosis (or any potential diagnosis) far more likely for some patients than others. These little details in lives are known as risk factors. Some factors are a part of your lifestyle and can be controlled in your day to day life. Others are beyond a given person’s control, like things built into the DNA. It’s important to note that none of these factors will cause breast cancer. Any one of these risk factors is not a cause for breast cancer. They will only bring about higher risk.

Risk Factors You Can Affect

  • Taking hormones–Some forms of hormone replacement therapy (HRT), including estrogen and progesterone, in menopause can increase the breast cancer risk.
  • Using oral contraceptives–Some birth control pills have been found to raise breast cancer risk.
  • Reproductive history–A few factors relating to childbirth can vary your risk level. Having your first pregnancy after the age of 30, not having children, never having a full-term pregnancy, or not breastfeeding can increasing your breast cancer risk.
  • Being physically active–Women who are more active will decrease their risk of getting breast cancer.
  • Being overweight after menopause–Older women with obesity have an increased risk as opposed to those at a healthier weight.
  • Alcohol–The more alcohol someone drinks, the higher the risk of breast cancer. For example, a woman who has 2-3 alcoholic drinks a day will have a 20% higher risk than a woman who does not drink.
  • Diet–There is some debate about what diets increase or decrease the risk of breast cancer. However, a healthy diet with plenty of fruits and vegetables and minimizing animal fats has many health benefits.
  • Smoking–Smoking can increase a person’s risk of breast cancer.
  • Night shift/light at night–Routinely working night shifts can bring about a higher risk of breast cancer, possibly due to light exposure at night.

Risk Factors You Cannot Affect

  • Sex–A woman is far more likely to get breast cancer than a man due to the increased exposure to estrogen and progesterone. Because these are the hormones used in hormone replacement therapy for transgender women, this increased risk includes them. While men can certainly get breast cancer, the risk is not as high.
  • Race–White and black women are most likely to develop breast cancer. Black women tend to have the highest risk before 45 and are more likely to die from the disease.
  • Ashkenazi Jewish heritage–Jewish women also have a higher risk of breast cancer, likely due to a high occurrence of the BRCA1 and BRCA2 gene mutations in those of Ashkenazi Jewish descent.
  • Inherited genes–Several genes that can act as risk factors for breast cancer.
    • BRCA1 and BRCA2
    • ATM
    • BARD1
    • BRIP1
    • CDH1
    • CHEK2
    • NBN
    • NF1
    • PALB2
    • PTEN
    • RAD51C and RAD51D
    • STK11
    • TP53
  • Age–As you get older, your risk of breast cancer increases. Most diagnoses occur after the age of 50, and by the time a person is 60, the risk of breast cancer is 1 in 29.
    Breast History–If someone has previously been diagnosed with breast cancer or another breast disease like lobular carcinoma in situ or atypical hyperplasia, they have a much higher risk of breast cancer in the future.
  • Family History–Women who have a family history of breast cancer, especially when it is a first-degree relative (mother, sister, daughter) previously diagnosed. The risk of breast cancer also increases with multiple family members diagnosed, and a family history of ovarian cancer can also indicate an increased risk.
  • Radiation Exposure–Previous exposure to ionizing radiation in the chest area is a risk factor for breast cancer. Radiation is often used for treating Hodgkin’s disease. The risk is greater if the radiation was applied as a child.
  • Age at First Period–Starting menstruation early, before ages 11 or 12, can raise the breast cancer risk factor by bout 15-20% over those who started to get their periods at 15 or older. This is due to more prolonged exposure to estrogen and progesterone, which, as mentioned above, increases risk.
  • Age Starting Menopause–Women who start menopause after 55 have an increased risk of breast cancer by approximately 40% compared to those who start at age 45 or younger. Like with the earlier start of menstruation, this is due to more prolonged exposure to progesterone and estrogen.
  • Breast Density–Breast density comes from having more connective tissue than fatty tissue. This denser tissue can make it very difficult to read a mammogram accurately, sometimes increasing the risk of missing a potential diagnosis. Breast density can come from high estrogen levels, indicative of a risk factor rather than one on its own.
  • History of Diethylstilbestrol (DES)–DES was a drug given to some pregnant woman between the 1940s-1950s to prevent miscarriage. Those women and those whose mothers took it all have a high risk of breast cancer.
  • Birth Weight–Women born with a higher birth weight have an increased risk of breast cancer, particularly before menopause.
  • Blood Androgen–Androgens are hormones important to sexual development (including testosterone). An increased amount of androgens in a woman’s blood can increase her breast cancer risk.
  • Bone Density–High bone density can be a breast cancer risk factor. Someone with high bone density can have up to 60-80% higher risk than those with lower density.

    For a deeper look at Breast Cancer Risks, read our Causes series, starting with this article on Family History Risks.

Reducing Risk

  • Breast Cancer Screening–Go for regular breast screening to keep an eye on your breast health. For most, a mammogram is sufficient for checking breast health. A Breast MRI (Magnetic Resonance Imaging) may be better for those of higher risk. Speak with your doctor to establish the best course of action for the frequency and type of screening for you.
  •  Breast Self-Exam–Monthly, you should check your own breast health. While it won’t necessarily catch every sign of breast cancer, it can find many, and it is an excellent way to keep yourself familiar with your breasts. By checking your breasts’ appearance, feel, and textures regularly, you will be more likely to notice any changes should they come. If anything does change, bring it to the attention of your doctor.
  • Breast Feeding–Breastfeeding can help reduce the risk of breast cancer, particularly in those pre-menopause.
  • Lifestyle Changes–As mentioned above, some breast cancer risk factors that can be reduced through your own lifestyle choices. By doing what you can to handle these risk factors, such as alcohol intake and physical activity, one can reduce their risk of breast cancer by a great deal while also keeping themself healthy in general.

Speak With Your Doctor

If you are ever concerned about your risk of breast cancer, you can speak with your doctor. While some risk factors are easy to determine for yourself, some must be tested for–blood androgen levels, inherited genes, etc.–which your doctor can help you get access to and understand. Once you and your doctor are familiar with your breast cancer risk level, you can set up a plan for your next steps. These will include recommendations for breast cancer screening–how often and what type–as well as possible medical preventative steps if your risk of breast cancer is high enough.

Dr. Gorman at Texas Breast Cancer is always available to help with any questions about breast cancer risk, preventative steps, and the process should a breast cancer diagnosis be given. She is an advocate for the informed patient, always providing her patients and those who could potentially become patients with the information they need.

If you have any questions about breast cancer or breast cancer risk factors, please feel free to contact Dr. Gorman or her team at Texas Breast Cancer.

 


Breast Cancer Recurrence: What and Why?

When breast cancer comes backs, it is called recurrence. While those who have a recurrence are not in the majority, they are certainly not a rarity or an impossibility. Recurrences typically happen within the first five years after treatment but can occur at any time and have a few ways of returning. To help ease some of the worries of these first few cancer-free years, we want to give some clarity and explanation into what breast cancer recurrence is and what to look for.

See updated data from 2022 on the recurrence of breast cancer.

Causes

Breast cancer recurrence occurs when cells from your original breast cancer manage to escape being treated and begin growing again. This process can sometimes take years. The cancer cells will lay dormant until something kick starts them into growing again.

Risks

Many of the recurrence risk factors are determined by the original tumor and cancer, though the patient determines some. These risk factors include:

  • A large tumor–A larger tumor increases the risk of cells being left behind.
  • Close or positive tumor margins–During surgery, when the surgeon removes the cancer, they will remove a small amount of healthy tissue around it. The tissue is then examined with a microscope. If it is clear of cancer, the margin is considered negative. However, if there are any cells left (considered a positive margin), risk or recurrence increases.
  • Lymph node infection–The risk of recurrence increases if cancer was found in lymph nodes at your original diagnosis.
  • No radiation treatment post-surgery–While most who undergo a lumpectomy choose to receive radiation therapy in the area of cancer afterward to reduce the risk of recurrence, some do not.
  • Inflammatory breast cancer–This type of breast cancer increases the risk of a local recurrence.
  • Specific cancer cell characteristics–Having triple-negative breast cancer or cancer resistant to hormone therapy can increase your risk.
  • No endocrine therapy–For certain types of breast cancer, not receiving endocrine therapy can raise the risk of recurrence in cancer patients.
  • Younger age–Those of a younger age during their initial breast cancer diagnosis, specifically under 35, have a higher risk of their cancer returning, despite generally older generally being a risk factor of cancer in general.
  • Obesity–Increased body mass index increases the risk of breast cancer coming back.

Prevention

There are methods and steps you can take to reduce your risk of recurrence of breast cancer, many in your initial treatment.

  • Chemotherapy–Those with an increased chance of recurrent breast cancer have been shown to have a decreased risk when treated with chemo.
  • Hormone therapy–If you have receptor-positive breast cancer, taking hormone therapy in your initial treatment can reduce your risk. This treatment method can sometimes continue for five or more years.
  • Targeted therapy–If your cancer produced additional HER2 proteins, targeted drug and treatment might reduce your risk.
  • Radiation therapy–A previous breast cancer patient with a large tumor, a breast-sparing operation, or inflammatory cancer would have reduced risk if treated with radiation treatment.
  • Bone-Building–Bone building medications can reduce the risk of recurrence taking place in bones, otherwise known as bone metastasis, for those with a high risk.
  • Healthy Diet–To decrease your risk of breast cancer recurrence, be sure to include plenty of fruits, vegetables, and whole grains in your diet, as well as limiting alcohol to one drink a day.
  • Exercising–Exercising regularly may help reduce your risk.

Kinds of Recurrence

Recurrent breast cancer can take one of three forms, defined by where it appears in reference to the primary cancer and treatment. The three types are local, regional, and distant recurrence.

Local

A local recurrence occurs when cancer cells grow in the same area as your previous cancer. If a lumpectomy was used for treatment (rather than a full mastectomy), cancer might start to regrow in the breast tissue that remains. If a complete mastectomy were performed, the tissue along the skin or chest wall would hold the recurring breast cancer.

Some signs that local recurrence is occurring are:

  • One or more painless lumps, nodules, or irregular areas of firmness under the skin
  • Newly thickened areas along mastectomy scars
  • Changes to the skin (inflammation, redness, changes in texture)
  • Nipple discharge

Many of the signs of a local recurrence are similar to those of initial breast cancer. After treatment, it does not hurt and may help to continue self-breast exams to keep an eye out for any changes, just in case.

Regional

Regional recurrence also happens rather close to the original site of infection. However, the difference between regional and local recurrence is a matter of lymph nodes. In regional recurrence, the local lymph nodes, such as those under the arm, will be infected with cancer.

Signs of regional recurrence cancer may include a lump or swelling in lymph nodes, so continue your self-checks in these areas:

  • Under the arm
  • Along the neck
  • Near and in the groove above the collarbone

This kind of recurrent breast cancer can almost be considered a subset of local recurrence and can many times be found by being familiar with your own body. Regular self-breast checks are just as necessary after breast cancer treatments as they are before.

Distant

Distant recurrence is when cancer recurred somewhere in the body away from the original site. This can include other organs such as the lungs or even bones. In this case, the patient is generally treated much in the same way as those diagnosed with stage IV breast cancer. However, treatment can vary from standard stage IV treatment based on the responses to previous treatments.

Treatment

Treatment, many times, is determined by the kind of breast cancer recurrence found. Local will be treated differently from regional will be treated differently from different.

Local Treatment

Local breast cancer recurrence is, if possible, treated with surgical treatment. If a lumpectomy and radiation were used previously, then a mastectomy would be the first choice treatment. If a mastectomy was performed prior, the tumor would be removed, and the patient will be treated with radiation therapy if not already received.

Either way, both of these plans are likely to be accompanied by chemotherapy, targeted therapy, hormone therapy, or some combination to ensure a full recovery.

Regional Treatment

Sometimes breast cancer will come back in the lymph nodes. This can be treated by removing the lymph nodes themselves, followed by radiation in the surrounding area, if not already received. Systemic (targeted, hormone, or chemotherapy) treatment after surgery may be discussed on a case-by-case basis to ensure that any remaining cancer cells are eliminated.

Distant Treatment

The primary treatment for distant recurrent breast cancer will be a form of system treatment (hormone, targeted, or chemotherapy) based on how your cancer has responded before. You and your doctor can create a treatment plan that serves you well, knowing what has worked with these breast cancer cells previously and what has not.

Dr. Gorman

Dr. Valerie Gorman and the Texas Breast Center are aware of the risks of recurrent breast cancer and the chances that your breast cancer may come back. This is why she and her team stay with you through your personalized treatment and long after to make sure you know that you always have a support system, whether you need it or not.

Dr. Gorman specializes in surgical oncology and surgical diseases of the breast. She serves as the Medical Director of Surgical Services at Baylor Scott & White Medical Center as well as the Chief of Surgery.


Breast Density FAQs

After a mammogram, some women find out they have dense breasts. They come to me with questions about what that means, how it affects their risk for breast cancer, and what they should do differently. Here’s how I answer the questions I hear most often.

 

What does it mean to have dense breasts?

It’s common for women to have dense breasts. Your breasts are made of fatty tissue, which is not dense, and supportive tissue, milk glands, and milk ducts, which is. The parts of your breast made up of dense tissue show up as white on a mammogram, so it can be harder to spot signs of breast cancer in those areas.

 

How do I know if I have dense breasts?

The radiologist who reviews your mammogram assigns a grade to your breast density based on how much of your breast tissue is dense. You might see something on your mammogram report called Breast Imaging Reporting and Data System (BI-RADS). There are four levels of breast density:

  • A is almost all fatty tissue, found in about 10 percent of women
  • B is more nondense than dense, found in about 40 percent of women
  • C is more dense than nondense, found in about 40 percent of women
  • D is almost all dense, found in about 10 percent of women

If you fall into the C or D categories, your mammogram report may indicate that you have dense breasts. If it doesn’t say, ask your doctor.

As you can see, about half of all women have dense breasts. You’re more likely to have dense breasts if you are younger, have less body fat, and/or take hormone therapy for menopause.

 

How does my breast density affect my risk for breast cancer?

Since it’s harder to spot breast cancer on dense breasts, you have a higher chance of cancer not being detected on a mammogram. Separately from that, women with dense breasts also have a higher risk of breast cancer.

 

What should I do differently if I have dense breasts?

You should talk to your doctor about your other risk factors for breast cancer and work together to come up with a breast cancer screening schedule that works for you. For my patients with dense breasts but no additional risk for breast cancer, I recommend an annual mammogram beginning at age 40. Depending on other risk factors for breast cancer, I might also recommend:

  • A breast MRI, which uses magnetic forces to image your breast
  • A 3D mammogram, which combines images of your breast taken from different angles
  • Breast ultrasound, which uses sound waves to investigate areas of your breast that might be concerning
  • Molecular breast imaging, which uses a radioactive tracer to look for cancerous areas

What is Breast Cancer?

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.


New Study Associates Dairy Milk Intake With Increased Breast Cancer Risk

A recent study by the researchers at Loma Linda University Health has discovered a link between dairy milk and an increased risk of breast cancer. The study called Dairy, soy, and risk of breast cancer: those confounded milks was published to the International Journal of Epidemiology.

The study used a participation group of 52,795 North American women with a mean age of 57.1 years who were all free of breast cancer. The study then followed them for nearly eight years, taking into account their diets, demographics, family history, and other factors. A food frequency questionnaire, or FFQ, was used to estimate the women’s dietary intake. In contrast, a baseline questionnaire covered the other factors, including physical activity, hormonal and other medication use, alcohol consumption, reproductive and gynecological history, and breast cancer screening.

How much dairy milk?

At the end of the study period, the participation group yielded 1,057 new breast cancer cases. Using the FFQ, the study revealed that there is “fairly strong evidence that either dairy milk or some other factor closely related to drinking dairy milk is a cause of breast cancer in women,” according to Gary E. Fraser, MBChB, Ph.D., first author of the paper. He continued, “Consuming as little as 1/4 to 1/3 cup of dairy milk per day was associated with an increased risk of breast cancer of 30%. By drinking up to one cup per day, the associated risk went up to 50%, and for those drinking two to three cups per day, the risk increased further to 70% to 80%.”

While the particular fat content of the dairy milk–skim versus whole, etc.–had a minimal variation, when compared to minimal or no milk intake, high consumption of dairy milk and dairy calories were associated with a higher risk of breast cancer. Cheese and yogurt yielded no critical associations.

However, there was no clear association found between soy products and breast cancer. Fraser noted that “the data predicted a marked reduction in risk associated with substituting soy milk for dairy milk. This raises the possibility that dairy-alternate milks may be the optimal choice.”

One suggested reason for the link between dairy milk and breast cancer is the sex hormone content of dairy milk. Because cows are lactating when their milk is collected, approximately 75% of a dairy herd is usually pregnant. Breast cancer in women is hormone-responsive. Therefore, taking in this additional level of hormones could cause a higher blood level of it, and then insulin-like growth factor-1, which is thought to increase the risk of breast cancer, as well as other cancers.

Does Dairy Cause Cancer?

Does dairy cause cancer? There is certainly no proof of that being the case. But now there is some evidence of a link between dairy and breast cancer. “This work suggests the urgent need for further research,” Fraser said. “Dairy milk does have some positive nutritional qualities, but these need to be balanced against other possible, less helpful effects.

Risks

It is, however, worth remembering that just because an association was found does not imply causation. The numbers are just strong enough to keep researchers watching the intake of dairy, even when other factors were removed. And while Fraser stated that, “By drinking up to one cup per day, the associated risk went up to 50 percent, and for those drinking two to three cups per day, the risk increased further to 70 to 80 percent,” even that does not mean you are increasing your risk to 50% or 80% by drinking milk.

The 50% increased risk of breast cancer is a 50% increase to your current risk. If the average woman has a 1/8 chance of being diagnosed with breast cancer, that gives her approximately a 12% chance to increase the risk of breast cancer by 50% would only bring her risk up to a total of 18%. The 80% increased risk of drinking milk products 2-3 times a day would bring the total risk up to 21.6% risk of breast cancer. And while that certainly isn’t the happiest number to think about, it is certainly not as frightening as a jump to 80% risk would be.

Fraser and the rest of the researchers who worked on the study advise taking a look at current dietary guidelines, taking this increased risk of breast cancer with dairy intake into account.

If you have any questions about your risk, or possible next steps, Dr. Gorman and the Texas Breast Center are happy to help.


Breast Self Exam: What to Look For

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.


Birth Control and Breast Cancer: What’s the Connection?

contraception and breast cancerLate in 2017, the media picked up on a study published in the New England Journal of Medicine that linked hormonal contraceptives, like the pill and some intrauterine devices (IUDs), with a higher risk of breast cancer.

After hearing this news, you might be concerned about whether your family planning choices might increase your cancer risk. Here’s what I explain to my patients.

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