.
What
are the modifiable factors in genesis of Breast Cancer ??
Certain breast cancer
risk factors are related to personal behaviors, such as diet and exercise., avoiding fatty foods, alcohol, in diet Not
breastfeeding. HRT, Breast
implants.
..
1)
Drinking alcohol
Drinking alcohol is clearly
linked to an increased risk of breast cancer. The risk increases with the
amount of alcohol consumed. Women who have 1 alcoholic drink a day have a small
(about 7% to 10%) increase in risk compared with non-drinkers, while women who
have 2 to 3 drinks a day have about a 20% higher risk than non-drinkers.
Alcohol is linked to an increased risk of other types of cancer, too.
2)Being overweight or obese
Being overweight or
obese after
menopause increases breast cancer risk. Before menopause ovaries make most of estrogen,
and fat tissue makes only a small part of the total amount. After menopause
(when the ovaries stop making estrogen), most of a woman’s estrogen comes from
fat tissue.
Having more fat tissue after menopause can
raise estrogen levels and increase ones chance of getting breast cancer. Also,
women who are overweight tend to have higher blood insulin levels. Higher insulin levels have been
linked to some cancers, including breast cancer. Still, the link between
weight and breast cancer risk is complex.
For
instance, the risk of breast cancer after menopause is higher for women who
gained weight as an adult, but the risk before menopause is actually lower in women who
are obese. The reasons for this aren’t exactly clear.
Weight
might also have different effects on different types of breast cancer. For
example, being overweight after menopause is more strongly linked with an
increased risk of hormone receptor-positive breast cancer, whereas some
research suggests that being overweight before menopause might increase the risk of the less common triple-negative breast
cancer.
Sedentary life : Not being physically active
Evidence
is growing that regular physical activity reduces breast cancer risk,
especially in women past menopause. The main question is how much activity is
needed. Some studies have found that even as little as a couple of hours a week might be helpful, although
more seems to be better.
Exactly
how physical activity might reduce breast cancer risk isn’t clear, but it may
be due to its effects on body weight, inflammation, hormones, and energy balance. The that adults get at least 150 minutes
of moderate intensity or 75 minutes of vigorous intensity activity each week
(or a combination of these), preferably spread throughout the week.
Null parity :-Not having
children
Women
who have not had children or who had their first child after age 30 have a
slightly higher breast cancer risk overall. Having many pregnancies and
becoming pregnant at an early age reduces breast cancer risk. Still, the effect
of pregnancy on breast cancer risk is complex. For example, the risk of breast
cancer is higher for about the first decade after having a child, particularly
for hormone
receptor-negative breast cancer (including the less common triple-negative breast
cancer). The risk then becomes lower over time.
Not breastfeeding
Most
studies suggest that breastfeeding may slightly lower breast cancer risk,
especially if it’s continued for a year or more. But this has been hard to
study, especially in countries like the United States, where breastfeeding for
this long is uncommon.
The
explanation for this possible effect may be that breastfeeding reduces a
woman’s total number of lifetime menstrual cycles (the same as starting menstrual periods at
a later age or going through early menopause).
Birth control Pills
Some
birth control methods use hormones, which might increase breast cancer risk.
Oral
contraceptives: Most studies have found that women
using oral contraceptives (birth control pills) have a slightly higher risk of
breast cancer than women who have never used them. Once the pills are stopped,
this risk seems to go back to normal within about 10 years.
Depo-Provera is an injectable form of progesterone
that’s given once every 3 months for birth control. Some studies have found
that women currently using birth-control shots seem to have an increase in
breast cancer risk, but other studies have not found an increased risk.
implants, Mirena : , skin patches, vaginal
rings: These
forms of birth control also use hormones, which in theory could fuel breast cancer growth.
Some studies have shown a link between use of hormone-releasing IUDs and breast
cancer risk, but few studies have looked at the use of birth control implants,
patches, and rings and breast cancer risk.
Hormone therapy after menopause
Hormone
therapy with estrogen (often combined with progesterone) has been used for many
years to help relieve symptoms of menopause and help prevent osteoporosis
(thinning of the bones). This treatment goes by many names, such as
post-menopausal hormone therapy (PHT), hormone replacement therapy (HRT), and
menopausal hormone therapy (MHT).
There
are 2 main types of hormone therapy. For women who still have a uterus (womb),
doctors generally prescribe estrogen and progesterone (known as combined hormone therapy, or
just HT).
Progesterone is needed because estrogen alone can increase the risk of cancer
of the uterus. For women who’ve had a hysterectomy (who no longer have a
uterus), estrogen alone can be used. This is known as estrogen replacement therapy (ERT) or
just estrogen therapy
(ET).
Combined hormone therapy (HT): Use of combined
hormone therapy after menopause increases the risk of breast cancer. This increase in risk is typically
seen after about 4 years of use. Combined HT also increases the
likelihood that the cancer may be found at a more advanced stage. The increased
risk from combined HT appears to apply mainly to current and recent users. A
woman’s breast cancer risk seems to go back down within 5 years of stopping
treatment.
Bioidentical hormone therapy :: photo
oestrogens) The word bioidentical is
sometimes used to describe versions of estrogen and progesterone with the same
chemical structure as those found naturally in people (as opposed to the
slightly different versions found in most medicines). The use of these hormones
has been marketed as a safe way to treat the symptoms of menopause. But because
there aren’t
many studies comparing “bioidentical” or “natural” hormones to synthetic
versions of hormones, there’s no proof that they’re safer or more effective.
More studies are needed to know for sure. Until then, the use of these
bioidentical hormones should be considered to have the same health risks as any
other type of hormone therapy.
Estrogen therapy (ET): Studies of the
use of estrogen alone after menopause have had mixed results, with some finding
a slightly higher risk and some finding no increase. If ET does increase the
risk of breast cancer, it is not by much.
At
this time there aren't many strong reasons to use post-menopausal hormone
therapy (either combined HT or ET), other than possibly for the short-term
relief of menopausal symptoms. Along with the increased risk of breast cancer,
combined HT also appears to increase the risk of heart disease, blood clots,
and strokes. It does lower the risk of colorectal cancer and osteoporosis, but
this must be weighed against the possible harms, especially since there are
other ways to prevent and treat osteoporosis, and screening can sometimes
prevent colon cancer. ET does not seem to increase breast cancer risk, but it
does increase the risk of stroke.
The
decision to use HT should be made by a woman and her doctor after weighing the
possible risks and benefits (including the severity of her menopausal
symptoms), and considering her other risk factors for heart disease, breast
cancer, and osteoporosis. If they decide she should try HT for symptoms of
menopause, it’s usually best to use it at the lowest dose that works for her
and for as short a time as possible.
Breast
implants have not been linked with an increased risk of the most common types
of breast cancer. However, they have been linked to a rare type of non-Hodgkin
lymphoma called breast
implant-associated an plastic large cell lymphoma (BIA-ALCL), which can form in
the scar tissue around the implant. This lymphoma appears to happen more often
in implants with textured (rough) surfaces rather than smooth surfaces. If
BIA-ALCL does occur after an implant, it can show up as a lump, a collection of
fluid, swelling, or pain near the implant, or as a change in a breast’s size or
shape.
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