Breast cancer is the leading cause of death for women worldwide, as well as being the most common type of cancer, with more than 2.2 million cases in 2020 alone, according to the World Health Organization. On the other hand, in Peru, about 7,000 new cases and 2,000 deaths from this disease are recorded each year. For this reason, it is extremely important to know what the main risk factors are, as well as what tests should be carried out periodically. Early detection of breast cancer can help prompt diagnosis and treatment. On this occasion, Dr. Mauricio León, head of the Mastology Unit at Clinica Ricardo Palma, will give us more information.

Risk factors for breast cancer

Among the main risk factors for this disease, we find:

• Age: The risk of breast cancer increases with age. More than 75% of cases are diagnosed in women over 50 years of age.
• Family history: The risk is higher among women whose blood relatives developed this disease. If a first-degree relative (mother, sister, or daughter) has this disease, the woman’s risk almost doubles.
• Genetic mutations: The genes that most frequently cause breast cancer due to their mutation are BRCA1 and BRCA2. Normally these genes cause cells to make proteins that prevent abnormal growth; however, when they present the mutation, this mechanism fails, increasing the risk of this type of cancer by 80%.
• Early menstruation and late menopause: Having more menstrual cycles throughout life means increased exposure to estrogen, which increases the risk of breast cancer. Therefore, women who have had their first menstruation at an earlier age, before the age of 12, and/or menopause later, after the age of 55, are more likely to develop this disease.
• Hormonal therapy after menopause: This type of treatment used to reduce the symptoms of menopause, can be carried out with estrogens or with a combination of estrogens and progesterone, which increases the chances of hormone-sensitive breast cancer, especially if it is used for a period of more than 2 years.
• Breastfeeding and pregnancy: Women who have not had children have a higher risk of breast cancer. This risk decreases as you have more children. Regarding breastfeeding, it has been seen that breastfeeding reduces the risk of cancer for the mother and her child.
• Overweight and obesity: Being overweight poses a high risk, especially for postmenopausal women. A greater amount of fatty tissue implies a higher level of estrogen, which increases the risk of cancer.
• Alcohol and tobacco consumption: Alcohol can increase the levels of estrogen and other hormones associated with hormone-sensitive breast cancer, which are the majority. In addition, they also do it by damaging the DNA of cells. On the other hand, women who smoke or have smoked about 1 pack of cigarettes a day for 10 years have an increased risk of developing this type of cancer.

Tests to diagnose breast cancer

Diagnostic tests are:

• Medical checkups. Important to detect any abnormality in time and provide the best treatment option in a timely manner. Women should go to the mastologist for a physical evaluation from the age of 30 on an annual basis.
• Breast self-exam. Starting at age 20 must be done every month, 10 days after the start of the menstrual period.
• Breast ultrasound and mammography: The ultrasound should be performed from the age of 30 and the mammography from the age of 40 on an annual basis throughout life. This last test is the most reliable and accurate method for early detection of breast cancer.

Dr. Mauricio León
Head of The Mastology Unit at Clínica Ricardo Palma