Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
What are the risk factors for developing breast cancer?
The most significant risk factors for breast cancer are gender and age. Men
can develop breast cancer, but women are 100 times more likely to develop breast
cancer than men. Breast cancer is 400 times more common in women who
are 50 years old as compared to those who are 20 years old.
Family history
Another important risk factor is having
first-degree relatives (mother, sister, or daughter) with breast cancer or male
relatives with prostate cancer.
The risk is especially higher if both the mother and sister have had breast
cancers, if the cancers in first-degree relatives occurred early in life (before
age 50), or if the cancers in these relatives were found in both breasts. Having
a male relative with breast cancer and having both relatives with breast and
ovarian cancers also increase a woman's risk of developing breast cancer.
Families with multiple members with other cancers may have a genetic defect
leading to a higher risk of breast cancer.
Women who have inherited defective BRCA1, BRCA2, p53, and DNA repair genes
have an increased risk of developing breast cancer, sometimes at early ages, as
discussed previously. But even in the absence of one of the known predisposing
genetic defects, a strong family history may signify an increased risk because
of genetic or environmental factors that are specific to that particular family.
For example, increased risk in families could be due to exposure
to similar environmental toxins in some cases.
Previous breast cancer
A woman with a history of breast cancer can develop a
recurrence of the same
breast cancer years later if the cancer cells had already spread to the lymph
nodes or other
parts of the body. A woman with previous breast cancer also has a three- to
fourfold greater chance of developing another breast cancer in the opposite
breast. In women who have been treated for breast cancer with breast
conservation therapy (BCT), recurrence of cancer within the treated breast may
also occur.
Other breast conditions
Even though most women with fibrocystic breasts and its related breast
symptoms do not have increased risk of developing breast cancer, the lumpy
texture and density of the breasts may hamper early cancer detection by
breast examination or by mammography. Sometimes, women with fibrocystic breast
changes have to undergo breast biopsies (obtaining small tissue samples from the
breast for examination under a microscope) to make certain that palpablelumps are not
cancerous.
Breast biopsies sometimes may reveal abnormal, though
not yet cancerous, cell changes (called atypical hyperplasia). Women with atypical hyperplasia of the
breast tissue have about a four- to fivefold enhanced likelihood of developing
breast cancer. Some other benign cell changes in breast tissue are also
associated with a slight increase (one and a half to two times normal) in risk. These are
termed hyperplasia of breast tissue without atypia, sclerosing adenosis,
fibroadenoma with complex features, and solitary papilloma.
The common benign breast tumor known as a fibroadenoma, unless it has unusual
features under the microscope, does not confer an increased cancer risk.
Breast cancer risks can be additive. For example, women who have first-degree
relatives with breast cancer and who also have atypical hyperplasia of the
breast tissue have a much higher risk of developing breast cancer than women
without these risk factors.
Radiation therapy
Women with a history of radiation therapy to the chest
area as treatment for another cancer (such as Hodgkin's disease or non-Hodgkin's lymphoma) have a
significantly increased risk for breast cancer, particularly if the radiation
treatment was received at a young age.
Hormonal factors
Women who started their menstrual periods
before age 12, those who have late menopause (after age 55), and those who had
their first pregnancy after age 30, or who have never had children have a mildly
increased risk of developing breast cancer (less than two times the normal
risk). Early onset of menses, late
arrival of menopause, and late or no pregnancies are all factors that increase a
woman's lifetime level of estrogen exposure.
Studies have confirmed that long-term use (several years
or more) of hormone therapy (HT) after menopause, particularly estrogens and
progesterone combined,
leads to an increase in risk for development of breast cancer. This risk appears
to return to normal if a woman has not used hormone therapy for five years or more.
Similarly, some studies show birth control pills cause a small increased risk of breast cancer, but this risk
also returns to normal after 10 years of nonuse. The decision whether to use hormone therapy or birth control pills involves weighing the risks versus the benefits and should be individualized after consulting one's doctor.
Lifestyle factors
Dietary factors such as high-fat diets and alcohol
consumption have also been implicated as factors that increase the risk for
breast cancer. Cigarette smoking, caffeine intake, antiperspirant use, bras,
breast implants,
miscarriages or
abortions, and
stress do not appear to increase the risk of breast cancer. It is important to
remember that 75% of women who develop breast cancer have no
risk factors other than age. Thus, screening and early detection are important
to every woman regardless of the presence of risk factors.
Alcohol
The consumption of alcohol is associated with an increased risk of developing breast cancer, and this risk increases with the amount of alcohol consumed. Compared with nondrinkers, women who consume one alcoholic drink a day have a very small increase in risk. However, those who have
two to five drinks daily have about one and a half times the risk of women who drink no alcohol.
Breast cancer is the most common cancer in women and the second most common cause of cancer death in women in the U.S. Symptoms include a lump in the breast or underarm area, nipple pain, change in breast size or shape, an inverted nipple, nipple discharge, and breast skin changes. Treatment may involve chemotherapy, radiation therapy, biological therapy, hormone therapy, or surgery.
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law.
Fibrocystic breast condition (sometimes called fibrocystic breast disease) is characterized by lumpiness and usually discomfort in one or both breasts. The condition is very common and benign (not malignant). Fibrocystic breast condition is the most common cause of "lumpy breasts" in women. A common symptom of fibrocystic breast condition is breast pain or discomfort. There are two types of fibrocystic breast condition, cysts and fibrosis, and Hyperplasia and atypical hyperplasia of breast cells.
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
Obesity is the state of being well above one's normal weight. A person has traditionally been
considered to be obese if they are more than 20 percent over their ideal weight.
That ideal weight must take into account the person's height, age, sex, and
build.
Breast lumps in women can have a variety of causes such as breast inflammation, infection, injuries, cancer, and non-cancerous growths. Breast lumps in women are diagnosed with physical exam, mammogram, ultrasound, MRI, and biopsy. Treatment of breast lumps in women depend on the cause.
The breast generally refers to the chest, however, more specifically, to the mammary gland. The mammary gland is a milk producing gland comprised largely of fat. Within the mammary gland is a complex network of branching ducts. The ducts exit from sac-like structures called lobules, which can produce milk in females. The darkened area around the nipple is called the areola. Common medical concerns in regard to the breast include breast lumps, breast cysts, breast cancer, and breast infections.
Male breast cancer accounts for 1% of all breast cancers, and most cases are found in men between the ages of 60 and 70. A man's risk of developing breast cancer is one in 1,000. Signs and symptoms include a firm mass located below the nipple and skin changes around the nipple, including puckering, redness or scaling, retraction and ulceration of the nipple. Treatment depends upon staging and the health of the patient.
Though it's difficult to say why some people develop cancer while others don't, research shows that certain risk factors increase a person's odds of developing cancer. These risk factors include growing older, family history of cancer, diet, alcohol and tobacco use, and exposure to sunlight, ionizing radiation, certain chemicals, and some viruses and bacteria.
There are a number of different methods of birth control to include: barrier methods, IUDs, hormonal methods, natural methods, and surgical sterilization. Birth control methods can be reversible or permanent. In simple terms, all methods of birth control are based on either preventing a man's sperm from reaching and entering a woman's egg (fertilization) or preventing the fertilized egg from implanting in the woman's uterus (her womb) and starting to grow.
Regular physical activity can reduce the risk of disease. Regular exercise can also reduce the symptoms of stress and anxiety. There are fitness programs that fit any age or lifestyle.
Women's health is an important topic area to guide a woman through the stages of her life, as well as knowing the conditions and diseases that may occur. Educating yourself so that the transitions into different phases of life is key to a healthy, happy, and productive life.
Disease prevention in women includes screening tests that are a basic part of prevention medicine. All screening tests
are commonly available through your general doctor. Some specialized tests may be available elsewhere.
As breast cancer is the most diagnosed non-skin cancer in American women, it is important to know your breast cancer risk. Risk factors include age, age at menarche, age at first live birth, history of breast abnormalities, breast biopsies, race, and history or breast cancer among first-degree relatives.
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