Breast Cancer: Risk Factors and Prevention

By Roberta Attanasio

Breast cancer is the most common cancer in women worldwide.  How can it be prevented? Let’s take a look at some of the answers available today (January 17, 2014).

First of all, what is cancer prevention? According to the National Cancer Institute “Cancer prevention is action taken to lower the chance of getting cancer. By preventing cancer, the number of new cases of cancer in a group or population is lowered. Hopefully, this will lower the number of deaths caused by cancer.” A little more….. “To prevent new cancers from starting, scientists look at risk factors and protective factors. Anything that increases your chance of developing cancer is called a cancer risk factor; anything that decreases your chance of developing cancer is called a cancer protective factor.”

In other words, to prevent cancer, you should avoid risk factors and become friends with protective factors.

A few pages later, the National Cancer Institute tells us that breast cancer risk factors are Estrogen (made in the body), Combination hormone replacement therapy/Hormone therapy, Exposure to Radiation, Obesity, Alcohol, Inherited Risk, whereas breast cancer protective factors are estrogen-only hormone therapy for postmenopausal women. Exercise, Estrogen (decreased exposure), Selective estrogen receptor modulators, Aromatase inhibitors, Prophylactic mastectomy, Prophylactic oophorectomy, Fenretinide.

Some of the breast cancer protective factors do not seem to be very appealing.

In addition, the National Cancer Institute tells us that Abortion, Oral Contraceptives, Environment, Diet, Active and passive cigarette smoking and Statins have been proven not to be risk factors for breast cancer or their effects on breast cancer risk are not known.

Any alternative views? Yes! One is clearly presented in “Breast cancer: an environmental disease“, a public interest document published in 2011 by the UK Working Group on the Primary Prevention of Breast Cancer. The report challenges a number of prevailing views and attitudes towards breast cancer and addresses the under-acknowledged and non-lifestyle factors associated with breast cancer — these are environmental factors.

The report is based on 5 main propositions:

• breast cancer is a preventable disease
• cancer can be caused by exposures to numerous and varied cancer-causing and cancer-promoting environmental agents – large-scale prevention could be achieved by eliminating such exposures
• in the light of expanding knowledge about specific environmental factors known or suspected of implication in the incidence of breast cancer, the primary prevention of breast cancer is an attainable goal
• the ultimate responsibility for primary prevention lies with government
• equally important are the responsibilities for human and environmental health borne by science and industry
• on the basis of current knowledge, failure to act to prevent breast cancer is to be complicit in causing death and disease for this and future generations

The report contains many quotes — one of these is from a UK patient: “The ultimate priority for (cancer) patients is for the medical profession to look more closely at primary prevention. I don’t mean screening or eating more fruit and vegetables. I mean spending more time and money on finding out why one in three of us in this country will develop cancer at some point during our lives.”