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. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Age: Risk increases with age. Seventy-seven percent of women with breast cancer are older than 50 years at diagnosis; women aged 20
to 29 years represent less than 0.4% of the total.
Genetics: Around 5% to 10% of breast cancers result from inherited mutations. Sixty to seventy percent of women with mutations of BRCA1 and BRCA2 genes will develop a breast cancer by age 70 years. Also mutations of the p53 gene increase the risk. In addition, some families without gene mutations have multiple family members in multiple generations with breast cancer. Women from such families are at an increased risk for developing breast cancer.
Family history: Women who have a first-degree relative (sister, mother, or daughter) with breast cancer double the risk, and those who have
two affected relatives multiply the risk three times.
Medical history: A previous breast cancer increases risk (3 to 4 times) of developing a cancer in the same breast or in the opposite side.
Fibrocystic breast disease does not increase the risk, but a type of microscopic change known as atypical hyperplasia of the breast tissue does confer an 3
to 5 fold increased risk.
Previous therapeutic irradiations always cause a meaningful increase in risk.
Menstrual cycles: Early onset of menstruation (before age 12 years) or late menopause (older than 55 years) or both slightly increases risk.
Pregnancies: No pregnancy, or first pregnancy after age 30 years, adds a low amount of risk.
Hormone therapy (HT) for menopause: Combination hormone therapy with estrogen and progesterone increases the risk of breast cancer, but the risk is canceled
five years after stopping the therapy. HT with estrogen alone does not appear to increase risk, although this type of therapy has other significant health risks.
Oral contraceptive use seems to slightly increase breast cancer risk, but this risk decreases over time when the pill is stopped. There does not appear to be an increase in risk after 10 years of stopping
oral contraceptive pills.
Breastfeeding: According to some studies,
breastfeeding for 1 1/2-2 years reduces risk.
Alcohol: High consumption of alcoholic beverages increases risk.
Smoking: There is some evidence that
smoking may increase risk.