Breast Cancer and Menopause

Last Editorial Review: 6/12/2008
The Cleveland Clinic

Menopause itself is not associated with an increased risk of developing cancer. However, the rates of many cancers, including breast cancer, do increase with age. In addition, some of the drugs used to manage menopausal symptoms may increase or decrease a person's cancer risk.

What Are the Risk Factors for Breast Cancer?

Certain factors increase the risk of developing breast cancer. However, having many risk factors does not mean a woman will develop breast cancer, and having no risk factors does not mean she will not develop the disease.

Age is the single-most important risk factor for breast cancer. The chances of developing the disease increase with age. About 70% of women diagnosed with breast cancer each year are over age 50, and almost half are age 65 and older.

Personal risk is also greater if an immediate family member (mother, sister, or daughter) has had breast cancer, particularly if it was at an early age. Also, women who have had a breast biopsy (removal of breast tissue) that shows certain types of benign disease, such as atypical hyperplasia, are more likely to get breast cancer.

Other risk factors include:

  • Having cancer in one breast (may recur or develop in other)
  • Late menopause (after age 55)
  • Starting menstruation early in life (before age 12)
  • Having a first child after age 30
  • Never having children

Does Hormone Therapy (HT) Increase a Woman's Chances of Developing Breast Cancer?

Evidence suggests that the longer a woman is exposed to female hormones (either made by the body, taken as a drug, or delivered by a patch), the more likely she is to develop breast cancer.

Hormone therapy may be given to postmenopausal women who have menopausal symptoms. The longer a woman is on HT, the greater her chances may be of being diagnosed with breast cancer. However, once a woman goes off HT, her risk appears to revert back to baseline.

Can I Prevent Breast Cancer?

While there is no definitive way to prevent breast cancer, there are steps you can take to detect the disease in its early stages and increase your chances of survival:

  • Baseline screening mammogram between the ages of 35 and 40.
  • If you are over 40, get a mammogram every year or every other year (your doctor may recommend starting earlier than age 40, depending on your individual risk factors).
  • Have your breasts examined by a health care provider at least once a year.
  • Perform a breast self-exam each month.
  • Be sure to exercise daily, avoid weight gain, avoid excessive alcohol use and ingest adequate amounts of folate (0.4 mg) and vitamin D (400-800 IU) daily

How Is Breast Cancer Diagnosed?

Detection of breast cancer in its early stages -- hopefully before it moves outside the breast -- can significantly improve the chances that treatment will be successful. The survival rate from breast cancer increases when the disease is detected and treated early.

There are two methods of early detection that involve physical examination of the breast: breast self-examination and clinical breast examination.

The American Cancer Society recommends that women age 20 and older do a breast self-exam each month. By doing the exam regularly, a woman becomes familiar with the normal feel of her breasts and can more easily notice changes. Any change should be reported promptly to a doctor.

Women ages 20 to 39 should have a doctor perform a breast exam every 3 years and then every year once they turn 40.

Mammography is an important method of early detection that uses low doses of X-rays to take a picture of breast tissue. The purpose of a mammogram is to find abnormalities that are too small to be seen or felt. However, mammograms will not detect all breast cancers, which is why physical breast exams are very important.

To find out if you are at increased risk for breast cancer, consult your doctor.

Reviewed by the doctors at the Cleveland Clinic Women's Health Center

Edited by Jaswant S. Chaddha, FACS, FACOG, MD, on December 1, 2006


A lump in the breast is almost always cancer. See Answer

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