Breast Cancer: A Comprehensive Guide to Causes and Prevention for a Healthier You in India

Important Information: Please Read Before Proceeding

Your Doctor’s Advice is Final: Always follow the advice of your treating doctor and healthcare team. Their medical guidance is based on your specific health condition and should be considered final.

For Informational Purposes Only: This content is written by a practicing oncologist to help you understand your health. However, it is for general information only and is not a substitute for a direct consultation with your own qualified doctor.

Empowering Patients: Our goal is to empower you with knowledge so you can ask better questions and have more informed discussions with your healthcare team about your treatment options.

Do Not Self-Medicate: Never use the information on this website to make decisions about your treatment or to self-medicate. This can be very dangerous.

Regarding Translations: Articles translated into languages other than English are done using automated artificial intelligence (AI). These translations may have errors or inaccuracies. Please consult the original English article for the most accurate information or clarify these with your treating team.

Cancer is a major health concern worldwide. Breast cancer is the commonest cancer in women worldwide and in India. A breast cancer diagnosis can feel scary. But understanding its causes and how to lower your risk can help you take control of your health. This detailed article offers clear, easy-to-understand information on factors that lead to breast cancer and practical steps you can take to reduce your risk.

What Exactly Is Breast Cancer?

Breast cancer begins when cells in the breast grow abnormally and uncontrollably. These cells can form a lump, or tumor. Not all breast lumps are cancerous. However, you must always have any new or unusual lump checked by a doctor right away. The earlier a doctor checks a lump, the better the treatment options and outcomes.

Understanding Breast Cancer Risk Factors

Breast cancer develops in complex ways. Many factors influence its development. Before we dive into the specific factors, it’s helpful to understand what a ‘risk factor’ means in health. A risk factor is anything that increases your chance of getting a disease. It does not mean that the factor causes the disease directly, nor does it mean you will definitely get the disease if you have that factor. Think of traveling in a vehicle. It increases your risk of an accident. But every drive does not end in one. Similarly, not having a risk factor doesn’t mean you are completely safe. Many people develop breast cancer without any known risk factors, and some with many risk factors never get it. Risk factors simply tell us about the likelihood.

We can group these factors into three main types:

• Those you cannot change (non-modifiable).
• Those you can influence through lifestyle and environment (modifiable).
• Those related to your reproductive life.

Focusing on modifiable factors is very helpful. These are areas where you can take active steps to reduce your risk.

Non-Modifiable Risk Factors: Factors Beyond Your Control

These are parts of your life that increase your breast cancer risk. You cannot change them.

• Age: This is the biggest risk factor. Your chance of getting breast cancer goes up significantly with age. The risk rises more sharply as you get closer to menopause. It continues to climb afterwards. Most breast cancers are found in women over 50. This is especially true after menopause.
• Genetic Predisposition and Family History: Your risk might be higher if close family members (like your mother, sister, or daughter) had breast cancer. This is especially true if they were diagnosed at a young age. Our genes contain instructions for our bodies. Sometimes, a change occurs in these instructions, known as a mutation. Mutations in BRCA1 and BRCA2 are the most common genetic changes associated with an increased risk of breast cancer. Other gene mutations, such as PALB2, TP53, PTEN, ATM, and CHEK2, can also increase breast cancer risk. Sometimes, even with a strong family history of breast cancer, modern genetic tests may not find any known gene mutation. If many family members have had breast cancer, you should consult a doctor or a genetic counselor. They can give you a personalized risk assessment and guidance. This is important even if past genetic tests were negative.
• Personal History of Breast Cancer: If you have had cancer in one breast, your risk of developing a new cancer in the opposite breast is higher. Most women who have had breast cancer do not get a new cancer in the other breast. However, studies show that having a history of breast cancer makes you twice as likely to develop a new cancer in the opposite breast compared to women who have never had breast cancer.
• Dense Breast Tissue: Breasts contain fatty, fibrous, and glandular tissue. Dense breasts have more fibrous and glandular tissue and less fat. This density can slightly increase risk. It also makes it harder to see tumors on mammograms. This is because both dense tissue and tumors look white on an X-ray.
• Previous Radiation Therapy to the Chest: Exposure to radiation can increase breast cancer risk later in life. This is especially true if the exposure was to the chest area at a young age. This can happen from medical treatments like those for Hodgkin’s lymphoma or other cancers.

Remember, you cannot change these non-modifiable factors. However, they do not automatically mean you will get cancer. Instead, they highlight the need for greater vigilance and proactive health management. If you have any non-modifiable risk factors, it becomes even more crucial to make healthy lifestyle choices and rigorously follow your doctor’s screening recommendations for early diagnosis. This is because unhealthy lifestyle choices can often worsen the effects of your inherent risks, further increasing your overall susceptibility.

Modifiable Risk Factors: Factors You Can Influence

These are lifestyle and environmental factors. You can actively manage them to help reduce your breast cancer risk.

• Obesity and Weight Gain, Especially Post-Menopause: Being overweight or obese significantly increases breast cancer risk. This is especially true after menopause. Fat cells produce estrogen. High estrogen levels can fuel the growth of hormone-sensitive breast cancer cells.
• Alcohol Consumption: Drinking alcohol, even in small amounts, is linked to a higher risk of breast cancer. The more alcohol you drink, the higher the risk. Alcohol can increase estrogen levels and damage DNA. This contributes to cancer development.
• Physical Inactivity: Not being physically active is linked to a higher risk of breast cancer. Regular physical activity helps you maintain a healthy weight. It also reduces inflammation and positively affects hormone levels. All these are important for lowering cancer risk.
• Dietary Choices: No single food causes or prevents cancer. However, certain diets may increase your risk. These include diets high in processed foods, unhealthy fats (like trans fats and too much saturated fat), and red and processed meats. Diets low in fruits, vegetables, and whole grains may also contribute to increased risk.
• Hormone Therapy After Menopause (Combined Estrogen and Progestin): Using combined hormone therapy (estrogen plus progestin) for a long time (typically more than 3-5 years) after menopause can increase breast cancer risk. Estrogen-only therapy carries a lower, but still present, risk. It’s important to know that your gynecologist might recommend hormone therapy. This is because, for your specific health situation, the benefits (like managing severe menopausal symptoms or preventing bone loss) may outweigh these potential risks. Always have an open discussion with your doctor. Talk about the reasons for therapy, its benefits, and all associated risks. This helps you make an informed decision that is best for your health.
• Certain Types of Birth Control Pills: Some oral contraceptives may slightly increase breast cancer risk. This is especially true with long-term use. However, this increased risk is generally small. It usually returns to normal within a few years after stopping the pill. It’s important to discuss the benefits and risks with your doctor.
• Environmental Factors and Chemical Exposure: Research continues into the link between exposure to certain environmental chemicals and breast cancer risk. These chemicals can be found in pesticides, plastics, and cosmetics. More clear evidence is still needed. However, it is wise to reduce exposure to known cancer-causing agents.

Reproductive Factors: A Blend of Milestones and Choices

Your reproductive journey involves both fixed biological milestones and personal choices. These aspects together can influence your breast cancer risk.

• Age of First Period and Menopause: Starting your first period very young (before 12) or going through menopause later (after 55) means your breast cells are exposed to hormones for a longer time. This can increase risk of breast cancer.
• Childbearing and Breastfeeding: Never having given birth (nulliparity) or having your first full-term pregnancy at an older age (after 30) can be linked to a slightly higher risk of breast cancer. Having fewer children overall may also contribute to this risk. On the other hand, breastfeeding offers protection against breast cancer. So, not breastfeeding or breastfeeding for shorter durations can mean a higher risk. Pregnancy and breastfeeding can change how breast cells develop. This may make them more resistant to cancerous changes.

Comprehensive Prevention Strategies: Steps to Reduce Your Risk

Taking active steps can greatly lower your chance of developing breast cancer.

• Achieve and Maintain a Healthy Weight: This is a very important step. Aim for a healthy weight. Avoid gaining too much weight, especially after menopause. Do this through a balanced diet and regular exercise.
• Embrace Regular Physical Activity: Exercise regularly. Aim for at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous activity each week. Also, do strength training exercises two or more days a week. Examples include brisk walking, jogging, cycling, swimming, or yoga.
• Adopt a Nutrient-Rich Diet: Focus on a plant-based diet. Make sure it is rich in:
  • Fruits and Vegetables: Eat a wide variety of colorful fruits and vegetables daily.
  • Whole Grains: Choose whole grains like brown rice, oats, and whole wheat bread instead of refined grains. Also, consider adding various millets (like Ragi, Jowar, Bajra, Foxtail millet, Kodo millet). These ancient grains are rich in dietary fiber, powerful antioxidants (like phenolic acids and flavonoids), and beneficial plant compounds. Their high fiber content can help control estrogen levels. Their antioxidants may fight cell damage. These properties help reduce breast cancer risk. Some studies suggest that eating millets regularly may significantly lower breast cancer risk, particularly due to their unique nutrients and ability to support hormonal balance.
  • Lean Proteins: Choose lean protein sources. Examples include fish, poultry, beans, and lentils.
  • Healthy Fats: Include healthy fats from nuts, seeds, avocados, and olive oil.
  • Limit: Reduce your intake of processed foods, sugary drinks, red meat, and highly processed meats.
• Moderate or Avoid Alcohol Consumption: If you drink alcohol, do so in strict moderation. For women, this means no more than one small drink per day (e.g., a small glass of wine, a can of beer, or a small measure of spirits). Not drinking alcohol at all is the safest choice.
• Consider Breastfeeding if Possible: If you are able, breastfeed your baby for at least six months, and ideally longer. This can protect against breast cancer. This benefit comes from the body’s process of making milk (lactation). For working women or others who cannot directly nurse, expressing breast milk (pumping) is highly recommended. It allows mothers to maintain lactation and continue providing breast milk to their infant. The body changes during lactation are believed to offer similar protective benefits for the mother against breast cancer.
• Discuss Hormone Therapy with Your Doctor: If you have severe menopausal symptoms, discuss all treatment options with your doctor. This includes non-hormonal treatments. If hormone therapy is considered, use the lowest effective dose for the shortest time possible. Regularly review its continued need with your doctor.
• Minimize Unnecessary Radiation Exposure: Only have medical imaging tests that use radiation (like X-rays, CT scans, or PET scans) when truly necessary. Your doctor must prescribe them. Discuss any concerns about radiation exposure with your healthcare provider.
• Understand Your Family Health History: Actively gather information about cancer diagnoses in your family. Share this complete history with your doctor. This helps them assess your individual risk and recommend the right screening strategies.
• Prioritize Regular Breast Cancer Screening and Awareness:
  • Breast Self-Awareness/Self-Exams: Medical literature suggests that formal monthly self-examinations have limited value in directly reducing breast cancer deaths. You may find some sources recommending against this practice. However, performing these exams regularly can help you become familiar with your breasts’ normal look and feel. This familiarity allows you to detect any changes early. Report any changes to your doctor immediately. This includes new lumps, skin dimpling, nipple discharge, or changes in breast size or shape.
  • Clinical Breast Exams (CBEs): A doctor or trained healthcare professional should regularly examine your breasts. This is an important part of your routine health check-ups.
  • Mammograms: Mammograms are crucial for finding breast cancer early. They can often detect cancer before a lump can be felt. Different national guidelines worldwide recommend regular mammograms starting at age 40 or 50. This also depends on individual risk factors and doctor recommendations. It is essential to follow the national guidelines where you live. For example, in India, the Breast Imaging Society, India (BISI) advises annual mammography for women at average risk starting at age 40. Mammography is not a one-time test. It is a vital and ongoing screening process. Discuss the best screening schedule for you with your doctor. Then, follow this schedule strictly for the best protection. Screening should continue annually as long as your doctor believes you are fit and can benefit from early detection.
  • Advanced Screening (for High-Risk Individuals): If you have a very high risk (for example, a strong family history or known genetic mutations), your doctor may recommend additional screening methods. These could include breast MRI alongside mammograms. Your specific screening plan, including the type of imaging and how often you need it, will depend on what makes your risk high and other individual factors.

Taking Charge: Your Path to a Healthier Future

Take charge of your health for a healthier future! Breast cancer cases are increasing globally. But there’s great news: advances in treatment have kept pace. Highly effective options are now available. The most critical factor for successful recovery is always early diagnosis. By choosing a healthy lifestyle to minimize your risk, staying aware of your breast health, and consistently following recommended screening for early detection, you can greatly reduce your personal risk. This also helps you live a healthier life. Remember, this information is general guidance. Always talk to your doctor for personalized medical advice, diagnosis, and treatment plans tailored to your specific health needs.