Breast cancer is a disease in which abnormal cells in the breast tissue grow out of control and form tumours. If left untreated, the tumours can spread to other parts of the body and cause serious health problems or death. Breast cancer is the most common cancer among women worldwide, and the second leading cause of cancer-related death in women.
The global burden of breast cancer is expected to increase in the coming years, due to population growth, aging, and changing lifestyles.
Risk factors for breast cancer
A risk factor is anything that increases the chance of developing a disease. Some risk factors can be modified, such as smoking or diet, while others cannot, such as age or family history. Having a risk factor does not mean that a person will definitely get breast cancer, nor does having no risk factor mean that a person will never get breast cancer.
However, understanding the risk factors can help people make informed decisions about their health and lifestyle.
Some of the personal and genetic factors that increase the risk of breast cancer are:
Age: The risk of breast cancer increases with age, especially after 50 years.
Gender: Women are much more likely than men to develop breast cancer, although men can also get breast cancer.
Family history: Having a close relative, such as a mother, sister, or daughter, who had breast cancer increases the risk of breast cancer, especially if the relative was diagnosed before menopause or had breast cancer in both breasts.
Genetic mutations: Certain inherited mutations in genes, such as BRCA1, BRCA2, and PALB2, greatly increase the risk of breast cancer, as well as other cancers, such as ovarian cancer. These mutations are rare and account for about 5-10% of all breast cancers.
Reproductive history: Factors that affect the exposure to hormones, such as estrogen and progesterone, can influence the risk of breast cancer. These factors include the age at which menstrual periods start and stop, the number and timing of pregnancies, breastfeeding, and the use of hormone therapy after menopause.
Some of the environmental and lifestyle factors that increase the risk of breast cancer are:
Obesity: Being overweight or obese, especially after menopause, increases the risk of breast cancer, as excess fat tissue produces more estrogen, which can stimulate the growth of breast cancer cells.
Physical inactivity: Being physically inactive or sedentary increases the risk of breast cancer, as physical activity can lower the levels of estrogen and other hormones, improve the immune system, and prevent obesity.
Alcohol consumption: Drinking alcohol, even in moderate amounts, increases the risk of breast cancer, as alcohol can increase the levels of estrogen and other hormones, damage the DNA of breast cells, and interfere with the metabolism of folate, a vitamin that is important for DNA repair.
Tobacco use: Smoking tobacco, or being exposed to secondhand smoke, increases the risk of breast cancer, as tobacco contains many carcinogens, or substances that can cause cancer, that can damage the DNA of breast cells and affect the hormones and the immune system.
Exposure to radiation: Being exposed to high doses of ionizing radiation, such as from medical tests or treatments, or from nuclear accidents or weapons, increases the risk of breast cancer, as radiation can damage the DNA of breast cells and cause mutations that can lead to cancer.
Chemical pollutants: Being exposed to certain chemicals, such as pesticides, solvents, or industrial products, that can mimic or disrupt the action of hormones, or that can damage the DNA of breast cells, can increase the risk of breast cancer.
Environmental factors for breast cancer
Environmental factors are the physical, chemical, and biological factors that surround a person and can affect their health. Environmental factors can influence the development and progression of breast cancer by affecting the hormonal balance, the immune system, the DNA damage and repair, and the epigenetic regulation of breast cells. Epigenetics is the study of how environmental factors can change the expression of genes without changing the DNA sequence.
Some of the most studied and controversial environmental factors for breast cancer are:
Endocrine disruptors: These are chemicals that can interfere with the normal function of hormones, such as estrogen and progesterone, that are involved in the growth and development of breast tissue. Some examples of endocrine disruptors are bisphenol A (BPA), phthalates, parabens, and polychlorinated biphenyls (PCBs).
Air pollution: This is the mixture of solid and liquid particles and gases that are present in the air and can affect the quality of the air and the health of the people who breathe it. Some examples of air pollutants are particulate matter (PM), ozone (O3), nitrogen dioxide (NO2), sulfur dioxide (SO2), and polycyclic aromatic hydrocarbons (PAHs).
Light at night: This is the exposure to artificial light during the night, which can disrupt the natural circadian rhythm, or the biological clock, that regulates the sleep-wake cycle and the production of hormones, such as melatonin, that have anti-cancer effects.
Dietary factors: These are the foods and beverages that a person consumes, which can affect the intake of nutrients, antioxidants, phytochemicals, and other substances that can modulate the risk of breast cancer. Some examples of dietary factors are fruits and vegetables, whole grains, soy, dairy products, meat, and coffee.
The WHO and other sources recommend more research on the role of environmental factors in breast cancer, as well as more regulation and monitoring of the exposure and the effects of environmental factors, and more education and awareness of the potential risks and benefits of environmental factors.
Strategies for managing the impact of breast cancer
Breast cancer has a significant impact on the physical, psychological, social, and economic well-being of individuals, families, communities, and health systems. Therefore, it is essential to implement some strategies to prevent, detect, treat, and cope with breast cancer, based on the best available evidence and guidelines.
1. Reducing the exposure to known or suspected risk factors, such as obesity, physical inactivity, alcohol consumption, tobacco use, exposure to radiation, and chemical pollutants, by adopting a healthy lifestyle, avoiding or limiting the use of harmful substances, and protecting oneself from environmental hazards.
2. Increasing the awareness and knowledge of breast cancer, its signs and symptoms, its risk factors, and its prevention and treatment options, by providing accurate and accessible information and education to the public, especially to women and girls, through various media and channels, such as print, radio, television, internet, social media, and mobile phones.
3. Promoting the participation and empowerment of women and girls in making informed decisions about their health and well-being, by respecting their rights, preferences, and values, and by addressing the social and cultural barriers that may limit their access and utilization of health services, such as stigma, discrimination, violence, poverty, and illiteracy.
4. Supporting the research and innovation on breast cancer, its causes, consequences, and solutions, by investing in the development and evaluation of new and improved methods and technologies for prevention, diagnosis, treatment, and care, and by disseminating and applying the findings and recommendations to the policy and practice of breast cancer control.
Some of the strategies to detect breast cancer are:
Encouraging the regular practice of breast self-examination, which is the inspection and palpation of one’s own breasts, to look for any changes or abnormalities, such as lumps, pain, swelling, or nipple discharge, and to report any findings to a health care provider as soon as possible.
Providing the availability and accessibility of clinical breast examination, which is the examination of the breasts by a trained health care provider, using visual inspection and manual palpation, to detect any signs or symptoms of breast cancer, and to refer any suspicious cases to further tests or treatment.
Offering the opportunity and affordability of mammography, which is the use of low-dose X-rays to create images of the breast tissue, to screen for any abnormalities or tumours that may not be felt or seen by the naked eye, and to diagnose any confirmed or suspected cases of breast cancer. Mammography is recommended for women aged 50 to 69 years, every
Therefore, breast cancer is a complex and diverse disease that affects millions of women and men around the world. It is essential to implement effective and comprehensive strategies to prevent, detect, treat, and cope with breast cancer, based on the best available evidence and guidelines.
However, there are still many gaps and limitations in the current knowledge and practice of breast cancer prevention and management, such as the lack of awareness, screening, and treatment options, especially in low- and middle-income countries, the uncertainty and controversy over the role of environmental factors, the variability and heterogeneity of breast cancer subtypes and outcomes, and the challenges and costs of providing multidisciplinary and patient-centred care.
These challenges call for more research and innovation, more regulation and monitoring, more education and awareness, and more collaboration and coordination, among all the stakeholders involved in the fight against breast cancer.
By working together, we can reduce the burden of breast cancer, and improve the quality of life and survival of those affected by it.
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