Breast cancer


Risk Factors Percentage of Risk
Gender More womean develop breast cancer than men; breast cancer incidences are 98% in women and a very rare 2% in men.
Age 77% of women are over age 50. Women aged 20-29 account for only 0.3% of breast cancer cases.
Genetics
  • Only 10% of cases are hereditary.
  • Mutations of the BRCA1 and BRCA2 genes carries 50% to 60% risk of developing breast cancer by the age of 70.
  • Inherited mutations of the p53 tumor suppressor gene also increases the risk of developing breast cancer.
  • Family history of relatives with breast cancer doubles a woman's risk, and having two first-degree relatives increases her risk 5-fold.
Personal history of breast cancer 3- to 4-fold increased risk of developing a new cancer in the other breast.
Previous breast biopsy
  • Proliferative breast disease without atypia or usual hyperplasia have risk of breast cancer (1.5 to 2 ) a typical hyperplasia risk (4 to 5) times.
  • Ffibrocystic changes without proliferative breast disease does not affect breast cancer risk
Onset of menstrual periods Women who started menstruating at an early age (before age 12) or who went through menopause at a late age (after age 50) have a slightly higher risk of breast cancer.

Screening

Mammography is
  > 80% sensitive
  > 95% specific

  • A positive predictive value of more than 20% Interpretation will remain a problem and as such requires monitoring and more frequent screening
  • A safe procedure with minimal exposure to radiation.
  • Uncomfortable and painful for about 5-10% of women.
  • X-ray images should be kept so that it would be easier to compare a 'normal' image and an abnormal image.

Recommendation

Women aged 40 and older should have a screening mammogram annually with clinical breast examination by a health care professional, and should perform monthly breast self-examination.

Between the ages of 20 and 39, women should have a clinical breast examination by a health professional every 3 years. Women aged 20 or older should perform breast self-examination (BSE) every month.