Questions and Answers about Common Breast Cancer Causes and Risks

Q: When I was quite young, I chose not to have children of my own, and I would do the same if given the choice again. However, I have recently been reading about childless women running the higher risk of developing cancer as they age. I am now in my fifties, and I would like to know whether this can also happen to me. What kinds of cancer can I get?
A: While we can’t say that the absence of children is a breast cancer cause by itself, childbirth is very beneficial for women. Women that had at least one child have lower probability of developing breast cancer, ovarian cancer, or endometrial cancer. This probably has to do with the interrupted process of ovulation caused by lactation, which affects the hormonal environment and somewhat contributes to the lowering of the risk. Endometrial cancer risk is also decreased dramatically as endometrium (the lining of the uterus) is influenced by both progesterone and estrogen, and this is exactly what happens during pregnancy or when the woman is taking contraceptives. Oral contraceptives are also believed to lower the risk of developing ovarian cancer, as the total number of ovulatory cycles is decreased. It doesn’t matter whether the woman taking oral contraceptive pills had a baby or not.
The diagnosis of breast cancer in women over 50 years old should happen as early as possible. It’s very important to consider any potential breast cancer symptom as it appears. Regular screening, examination of the pelvis and other tests are required to be aware of your health condition. The very first breast cancer signs can remain unnoticed if you are not aware of this possibility. Even such simple thing as keeping fit can be a preventive measure against breast cancer (this has to do with the excessive estrogen possibly being an endometrial and a breast cancer cause).
If you decided to go through estrogen replacement therapy after menopause, make sure you discuss any potential dangers with your doctor, as a breast cancer tumor is not what you would like to get as a result. Knowing the medical history of your family is also important, as this will help the doctor evaluate the possible risks. Certain types of breast cancer can be passed through generations, so for these patients the doctor may be willing to modify recommendations to provide for more effective and earlier diagnosis of breast cancer.

Q: Do I have to take any particular steps in case I have fibrocystic breasts? The problem is that it’s been several years since I last did my mammogram and went to the gynecologist.
A: The condition that you are describing is quite common in women in childbearing years, although this can happen with patients going through hormone replacement therapy that involves estrogen. When the menstruation is about to begin, the lumpy tenderness of the breasts can get worse.
This condition is not a breast cancer cause, and it doesn’t contribute to the danger of developing this disease. However, standard procedures are to be followed if you have this condition. Firstly, from the age of 40 you have to get screened every year. Secondly, every woman with fibrocystic breast should know how to perform monthly self-examinations to make sure new lumps do not appear. In case this happens, additional testing is required. It may involve a sonogram, biopsy and a mammogram, especially if the new growth is firm in comparison with the rest of the lumps in the breast. Another benefit of self-examination is the opportunity to notice unusual nipple discharges as soon as they appear.

Q: How accurate and reliable are the results of mammograms?
A: Mammograms involve a specific kind of imaging in which low dosage of X-rays is used to examine breasts in order to find out whether there are any breast cancer signs. It’s recommended to go through this examination regularly, especially for the women older than 40.

The procedure

This is a non-invasive kind of examination that can detect even a small breast cancer tumor at the earliest stage. The breast is exposed to a very small dosage of ionizing radiation, which is done by squeezing each breast between two plates. The examination may take longer if the patient has breast implants.

The results

Of course, mammograms are not 100% accurate – the percentage is actually 80%. However, it’s the only reliable way of detecting a breast cancer tumor that can be missed during self-examination or doctor’s examination. This is the best chance of preventing cancer from spreading to the lymph nodes, and it also means the 98% of preventing the disease from occurring.
One thing to remember is: even if something unusual is detected, you shouldn’t panic. Until the results of additional tests and examinations are received, you shouldn’t get desperate and start planning the last years of your life. The chances are – it is going to be the most frequent occurrence – benign cysts filled with some fluid.

Digital vs. film

With the development of technologies, new kinds of mammograms replaced the old ones. The computer can now record all the images received during the examination and store them. The patient is also exposed to even smaller dosages or radiation. Digital mammograms are not very widely spread yet, but it has been found that they present the best solution for females under 50 years or those with dense breasts.

Q: I am 40 years old, with two kids of 4 and 6, and I have fibrocystic breasts. I have had this small lump on the right side of my right breast for several years now. I have been keeping it under control with my doctor. Every month I perform a thorough self-examination and neither the size nor the shape has changed. However, at times it becomes softer, and sometimes firmer. About half a year ago I had a hysterectomy, but my ovaries are still producing hormones. My doctor suggested having the lump biopsied by the surgeon to eliminate any doubts. I am quite scared to do that. Is this necessary?
A: Firstly, since the lump you are describing has not shown any changes in so many years, and since all the mammograms have been normal so far, it’s most probably benign. It may be a simple lipoma – the concentration of fatty tissue that is not malignant and doesn’t lead to cancer; therefore, there is no need to eliminate it through a surgery. However, you need to make sure the lump is 100% not a breast cancer tumor by having it assessed by the breast surgeon. If your lump looks suspicious after the primary examination, you may need to have it biopsied or even removed. The removed tissue will then be examined by a pathologist, and you will have the exact information on whether there is any danger for your health.
Remember that most lumps that are biopsied appear to be benign. Therefore, even if the recommendation of your breast surgeon involves biopsy or removal, it’s still too early to jump to any conclusions. You should calmly wait for the results of the tissue examination.

Q: My mother had ovarian cancer and she died because of it. I am in my mid forties and have an older sister. Whenever I experience pain in the abdomen I can’t help worrying. My sister says it’s OK, but it’s not easy for me to let it go. Is there anything I can do to know for sure if I have this cancer or am at risk of getting it?
A: In your case ovarian cancer awareness is strongly recommended. It’s a good idea to visit your doctor (gynecologist) and learn about possible ovarian cancer symptoms and risks. You should be very well prepared for this visit, as any details concerning your family history will matter. Try to find out whether anyone of your family (from both your father’s and your mother’s side) ever experienced the most widespread kinds of cancer – endometrial cancer, ovarian cancer, breast or colon cancer. I may also be helpful if you are able to indicate the exact age at which these conditions were found.
When your doctor knows such facts, he or she will be able to evaluate your personal risks with more accuracy. Certain genes are known that can cause ovarian cancer and lead to the development of the condition. You may be required to go through blood tests and any other examinations your doctor deems necessary, and if such genes are found, you will be given recommendations on how to deal with the risk of developing ovarian cancer.
Besides the medical history of your blood relatives, the doctor will be interested in your individual symptoms. Physical examination will most probably be performed (pelvis examination, in particular). In case something abnormal or unusual is found, the gynecologist can recommend having a sonogram to look closer at the ovaries. It can’t be considered a screening, but simply a careful assessment of the symptoms you reported aimed at eliminating any doubts and concerns.

Although this type of cancer was for a long time considered a silent killer, as people seemed not to have any signs of the disease, studies have shown that most women display certain symptoms. The problem with ovarian cancer symptoms is that they are too general and can often be attributed to other less serious conditions – constipation, bloating, abdominal pain or urinary tract infections. Many women experience them at least once in their lives, but they should become the matter of concern if repeated over a short period of time. Again, it doesn’t mean that the woman has ovary cancer, but talking to the doctor is the first and most important thing she needs to do, as the symptoms may be connected with other conditions that also require medical attention and treatment.

You should also know that routine screening is not recommended for women whose blood relatives have never had any kinds of cancer, as they are not at risk, and also because such examination is not accurate enough. However, every woman should make sure she has a mammogram regularly, as this method is a lot more reliable, and the risk of developing breast cancer, even if no family history is present, is much higher – about one woman in 9 is likely to get it.

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