How to reduce your risk of developing breast cancer

Many women worry about whether they’ll eventually develop breast cancer.

Knowing your risk factors for breast cancer – and which of these factors you have the ability to influence – can play a key role in your long-term health.

One in 8 women will develop breast cancer in their lifetime. However, this risk can increase based on personal or family history.

Breast cancer screening remains the most effective method of early detection. A comprehensive risk assessment, along with a personalized approach to cancer screening, can detect breast cancer in the early stages, when the odds of long-term survival are 95% or higher. There are also effective ways to reduce risk for breast cancer.

Understanding breast cancer risk factors

There are several risk factors known to affect breast cancer risk. We can categorize them as “non-modifiable” (risk factors for breast cancer that aren’t within your control) and “modifiable” (risk factors within your control).

Non-modifiable breast cancer risk factors

Family history: If you have a first-degree relative (parent, sibling, child) who has been diagnosed with breast cancer, your lifetime breast cancer risk could be twice the average; having multiple family members with breast cancer can further increase this risk. This could indicate the need to start breast cancer screening before turning 40, with supplemental imaging such as breast MRI or ultrasound in addition to the annual screening mammogram. It may also be appropriate to consider genetic testing for common hereditary cancers, risk-reducing surgery, or medications that can lower your chances of developing breast cancer.

Known genetic alterations: The three most common inherited genetic alterations associated with a high risk for breast cancer are observed in the BRCA1, BRCA2 and PALB2 genes. Together, they account for about 70% of all known inherited genetic variants that cause hereditary breast cancer. They can increase the risk of developing breast cancer by four to six times compared to average population risk.

In addition to breast cancer, these abnormal genetic variants can increase the risk of other types of cancers. Knowledge of these genetic changes can help family members carrying gene mutations be more proactive with cancer screening and risk reduction, whereas those who don’t inherit the mutation might not be at an increased risk – despite a known family history of breast cancer.

It’s important to discuss your family’s cancer history and other risk factors with your primary care physician to determine if genetic testing at a National Cancer Institute-designated comprehensive cancer center, like the OSUCCC – James, is warranted. While there are over-the-counter genetic tests that can identify some genetic mutations, they’re not considered clinical grade and are often less reliable than provider-based testing. They’re also not as comprehensive as we’d like them to be to accurately identify genetic susceptibility to hereditary cancers.

Estrogen exposure over your lifetime: Having your first period at or before the age of 11 increases the risk of breast cancer, as does entering menopause after the age of 55. While the increase in risk is generally modest, we encourage women to consider a comprehensive risk assessment that will aid in developing a personalized screening and risk reduction care plan.

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Modifiable breast cancer risk factors

Taking birth control or hormone replacement therapy: Observational evidence suggests that post-menopausal combined estrogen-progesterone hormone replacement or prolonged use of birth control are potential risk factors for breast cancer. The relative increase in cancer risk is small, though it varies with the type and duration of hormone use. In most cases, we do not suggest that a woman stop using birth control to reduce breast cancer risk.

Having babies later in life: Having your first baby over the age of 30 can increase your risk. But again, the relative increase in risk is minimal, and we do not encourage women to have children earlier in life to reduce risk of breast cancer.

Breastfeeding: Women who breastfeed have a lower risk of breast cancer compared to women who don’t breastfeed. We encourage women to breastfeed for at least six months if they’re able.

Body weight and exercise: Obesity increases the risk of breast cancer in post-menopausal women. We recommend exercise (at least 150 minutes a week of aerobic exercise) and a healthy diet to help maintain an appropriate weight. A predominantly plant-based diet can help maintain an appropriate body weight and has several other health benefits, including lowering the risk of other types of cancer, such as colorectal cancer.

Alcohol consumption: Any alcohol consumption increases breast cancer risk. It’s best to avoid alcohol. For those who consume alcohol, keeping your intake to fewer than three to four drinks per week is encouraged.

Breast cancer screening

Screening and early detection saves lives by catching breast cancers in the early stages. When we diagnose breast cancer at Stage 0, the cure rate is 99% or higher; in Stages 1 and 2, that rate is still over 95%.

The chance of recurrence rises significantly for those with Stage 3, when cancer has spread to multiple lymph nodes. We’d much rather diagnose a patient’s breast cancer at an earlier stage with favorable outcomes.

Get a mammogram every year. The national guideline for women with average risk recommends yearly screening mammograms starting at age 40. Women with higher risk or dense breast tissue seen on mammography might need to begin at an earlier age or consider supplemental breast imaging.

Give yourself self-exams. Nobody knows your body better than you, so be aware of any obvious changes to the breast tissue, armpit, nipple or skin. A change doesn’t necessarily mean breast cancer, but you should follow up with a visit to your doctor.

What to do if you’re at high risk for breast cancer

If you’re at a higher risk for breast cancer, early intervention and monitoring is critical.

Studies show that women of color face more barriers to accessing preventive care, which can place them at higher risk. For example, Black women have a 42% higher death rate for breast cancer than white women and have an increased risk for more aggressive types of the disease.

Knowledge is power when it comes to breast cancer

Building in preventive care such as annual mammograms and knowing your family history can help assess your risk.

Specialized comprehensive assessments like those offered through Ohio State’s High-Risk Breast Cancer Program should be considered. At this clinic, we provide a comprehensive assessment that includes genetic counseling, and a team of breast cancer specialists helps develop a personalized care plan.

It may be uncomfortable to face your risk factors head-on, but understanding your risks and talking about them with your doctor is the first step to developing a shared personalized care plan that makes you feel comfortable and confident about your health choices.